Questions

A mouse alternative for carpal tunnel and RSI on a Mac

If a mouse or a MacBook trackpad has started to hurt your wrist, a finger, or a thumb, the usual advice is to change the shape of the work: different muscles, fewer clicks, more breaks. I am not a clinician, and if it hurts, see one. What I can tell you is what a Mac can do, starting with what needs no software, and where a game controller fits.

Hardware first

Vertical mice, trackballs, most joystick mice, and a Magic Trackpad all work on a Mac as ordinary pointing devices, with no app needed. They change the position of the hand rather than the amount of clicking. If one of them suits you, stop here.

Let macOS take work off your hands

  • Voice Control (System Settings, Accessibility): click, open menus, and type by voice.
  • Dictation for anything longer than a sentence.
  • Dwell (Accessibility, Keyboard: turn on the Accessibility Keyboard, then its Dwell options): rest the pointer and it clicks, so the index finger does not.
  • Sticky Keys (Accessibility, Keyboard): shortcuts one key at a time instead of a stretch.

A game controller as the mouse

A controller moves the pointer with a thumb on a stick and clicks with whichever button you choose, with the hands in a lap instead of planted on a desk. For some people that is a welcome change of load; for others, especially with thumb pain, it is worse. Try it for short sessions before you rely on it.

InputConfig turns a PS5, Xbox, Switch, or 8BitDo controller into a mouse and keyboard on a Mac, and the built-in Desktop Navigation preset is a complete mouse from the first minute. Then shape it:

  • Put the clicks where they hurt least. Any button or trigger can be the left click, and more than one can.
  • Drag without holding. Toggle on a click row makes a drag press once, press again.
  • Move shortcuts off the fingers. Copy, paste, undo, and switching apps go on buttons, and a chord gives each button a second job.
  • Switch sides through the day. Move the pointer to the other stick, or alternate between the controller and the mouse; they work together.

Download InputConfig on the Mac App StoreInputConfig is free on the Mac App Store. macOS 14 or later, no account, no tracking, open source.

Keep the mouse, give it fewer clicks

If you keep the mouse, give its spare buttons the shortcuts your fingers press most: a side button for Copy and a double click on it for Paste, or the middle button for Return. Mouse side buttons on a Mac shows how. On some MacBooks (tested on M4 models), a knock on the palm rest can run a shortcut too: see Tap the Mac.

Gaming with carpal tunnel

A controller is not automatically easier than a mouse for games. If holding buttons hurts, InputConfig can change how they behave: Toggle turns a held button, such as sprint or aim, into press once and press again; turbo repeats a press you would otherwise mash; and pulling a stick's outer deadzone in makes a short push count as a full one. In a game with its own controller support, check its settings too, and Steam Input remaps controllers for games in Steam.

Questions

Is a game controller better than a mouse for carpal tunnel?

Not for everyone, and I cannot promise it helps. It uses the thumbs instead of the wrist and index finger, which is a relief for some hands and a strain for others. Try it for short sessions first.

Do I need software for a vertical mouse or trackball on a Mac?

No. They work as a normal mouse. InputConfig is only needed to give their extra buttons jobs, or to use a game controller as the mouse.

Is InputConfig free?

Yes. It is free and open source on the Mac App Store, with no account and no network access. A tip jar is optional and unlocks nothing.

Related

Download InputConfig on the Mac App StoreFree. macOS 14 or later. No account, nothing leaves your Mac. Open source on GitHub.