Choosing the Right Mouse in Office Ergonomics

Mouse selection is one of those topics that looks deceptively simple on the surface and then gets more complicated the longer you work in office ergonomics. Most of us have seen the same pattern play out: a client reports wrist or elbow pain, a mouse gets swapped out, and sometimes it helps… and sometimes it doesn’t. When it doesn’t, it’s usually not because the mouse was “bad,” but because it was chosen without fully understanding what was driving the load in the first place.

This post takes a step back and looks at mouse selection the way most experienced ergonomists actually think about it in practice: through biomechanics, task demands, motor control, and system design. Not symptom shortcuts.

Why the mouse matters more than people think

From an exposure standpoint, the mouse is one of the most frequently used tools in office work. In many knowledge-based roles, it’s used thousands of times per day, often in sustained or constrained postures. Epidemiological research has consistently linked intensive mouse use with increased risk of upper extremity musculoskeletal disorders, including wrist, elbow, and shoulder complaints (Gerr et al., 2002; Andersen et al., 2008).

What’s important here is not just repetition, but how the mouse changes joint positions and muscle demands. A mouse is not a neutral tool. By design, it influences:

• Forearm pronation or supination

• Wrist extension and deviation

• Grip and pinch forces

• Reach distance and shoulder loading

• The motor strategy used to move the cursor

Once you start looking at it this way, mouse selection becomes a legitimate exposure-control decision rather than a comfort add-on.

Start with ergonomics fundamentals (even when it feels obvious)

Before getting into mouse types, it’s worth saying out loud what experienced ergonomists already know but sometimes get pressured to skip: a mouse cannot compensate for a poor workstation setup.

If the desk is too high, the mouse is too far away, or the user is externally rotating the shoulder to reach it, no mouse design is going to fix that. At best, it might shift symptoms temporarily. At worst, it introduces a new problem somewhere else.

This is where root cause analysis matters. Wrist pain, for example, might be driven by:

• Excessive wrist extension from desk height

• Forearm pronation combined with deviation

• Sustained reach increasing shoulder torque

• High precision demands with inadequate support

Without identifying which of those is actually happening, mouse recommendations become guesswork.

A quick biomechanics refresher (without the textbook tone)

The upper extremity works as a linked system. Changes at the mouse affect the wrist, forearm, elbow, and shoulder together, not in isolation. From a mechanical perspective, two concepts are especially useful here:

1. Joint position and internal load
Neutral joint positions generally minimize tendon friction and nerve compression. As the wrist moves into extension, deviation, or sustained pronation, internal tissue loading increases. This has been shown clearly in studies examining carpal tunnel pressure and forearm muscle activation (Keir et al., 1997).

2. Moment arms and reach
The farther the mouse is from the body, the greater the shoulder moment arm. Even small increases in reach can significantly increase shoulder muscle activity over time. That cumulative load often shows up as neck or shoulder discomfort long before the user connects it to the mouse.

Motor control still matters (even if clients never mention it)

Mouse use isn’t just a physical task, it’s a motor control task. Fitts’ Law, which most of us were introduced to in school, is still relevant here. Cursor movement depends on distance, target size, and control strategy (Fitts, 1954).

When you change the mouse, you change:

• How movement is generated (arm vs. wrist vs. fingers)

• The speed-accuracy tradeoff

• Cognitive effort during fine tasks

That’s why some devices feel great physically but frustrating initially from a performance standpoint. It’s also why adaptation time has an effect and why abandoning a new mouse after one day tells you very little about whether it was a good recommendation.

A practical look at common mouse categories

Standard mouse

The standard mouse isn’t inherently “bad.” It’s familiar, low-cognitive-load, and often ambidextrous. That last point is underrated. From a hierarchy-of-controls perspective, switching hands with an ambidextrous mouse can be a surprisingly effective administrative control, especially for unilateral symptoms.

The downside is that standard mice require full forearm pronation and often promote wrist deviation and contact stress. Over long durations, that combination can increase forearm and wrist loading.

Vertical mice

Vertical mice aim to reduce forearm pronation by placing the hand in a more neutral, handshake-like position. EMG studies have shown reduced forearm muscle activation compared to traditional mice (Quemelo & Vieira, 2013), which lines up with what many clinicians see anecdotally.

The trade-offs are real, though:

• There is a learning curve

• Fine motor precision may drop temporarily

• Sizing and angle matter more than people realize

When vertical mice work well, it’s usually because pronation and wrist posture were true contributors, not just because the user had “wrist pain.”

Semi-vertical mice

These sit somewhere between standard and fully vertical designs. They don’t eliminate pronation, but they reduce it. In practice, they’re often easier for users to adapt to and can be useful in preventative or early-discomfort cases.

Central pointing devices (roller mice)

Central pointing devices are especially interesting from a shoulder-load perspective. By eliminating lateral reach, they reduce shoulder abduction and external rotation demands. They also encourage more symmetrical use of the upper limbs.

They do require careful keyboard selection, as they increase the distance to the keys. Pairing them with a compact keyboard is often what makes or breaks success.

Trackballs

Trackballs reduce arm movement and can be very helpful for users with shoulder pain or limited space. The main concern is where the movement is transferred. Thumb-controlled trackballs can overload the thumb, while small balls can increase fingertip strain.

Larger balls that involve more of the hand tend to distribute load better, but they still shift demand distally.

Trackpads

Trackpads remove the need to grip but increase finger motion and sustained contact. They work well for gesture-heavy workflows (common in macOS environments) but can fatigue the fingers during high-volume pointing tasks.

Joystick mice

Joystick mice are less common in general office ergonomics but can be extremely useful in specific cases, particularly where wrist motion is limited or a tremor is present. The key is training the user to move from the arm rather than the wrist.

Matching the device to the exposure... not the diagnosis

One of the most useful shifts in thinking is moving away from diagnosis-based recommendations and toward exposure-based ones.

For example:

• If pronation is high → reduce pronation

• If reach is the issue → centralize the device

• If grip force is high → reduce or eliminate grip

• If one side is overloaded → consider bilateral strategies

Sometimes the best “mouse solution” is switching hands, adjusting reach, or changing keyboard size, not introducing a new device at all.

Adaptation is part of the intervention

Any new mouse is a motor learning task. A short-term dip in speed or accuracy is normal, and comfort improvements often lag behind the initial change. Most users need several days to adapt, sometimes longer for more dramatic design changes.

Setting this expectation up front is part of good ergonomics practice.

Final thought

There isn’t a universally best mouse. There’s only the best match between the person, the task, and the setup, at this point in time.

When mouse selection is grounded in biomechanics, motor control, and exposure reduction, it becomes a powerful tool. When it’s treated as a quick fix, it rarely delivers lasting results.

FREE ERGONOMICS TRAINING FOR HEALTHCARE PROFESSSIONALS:

Discover How to Confidently Conduct Office Ergonomic Assessments

(Even If You’re Just Getting Started!)

Find Out What Businesses Are Really Looking For In An Ergonomics Consultant & How To Actually Position Yourself As The Go-To Expert In Your City.

Click here to start.

Key references (for those who want to go deeper)

• Andersen, J. H., et al. (2008). Computer use and carpal tunnel syndrome.

• Fitts, P. M. (1954). The information capacity of the human motor system.

• Gerr, F., et al. (2002). A prospective study of computer users.

• Keir, P. J., et al. (1997). Carpal tunnel pressure and wrist posture.

• Kroemer, K. H. E., & Grandjean, E. (1997). Fitting the Task to the Human.

• Quemelo, P. R. V., & Vieira, E. R. (2013). Biomechanics of computer mouse use.