The selection of a difference of 1.0 for pain score change is based on the affects from the expected difference of 27 to 40% in pinch force. Unfortunately, the investigators do not have good dose-response data linking reduction in a risk factor level, such as pinch force, to a reduction in pain levels. If the dose-response relationship is linear, the investigators might expect a similar reduction in pain intensity. In 3 prior RCT intervention studies, although the interventions were different than in this proposal, the investigators observed such effect levels. The studies were among engineers, customer service, garment workers with study durations of 6, 12 and 4 months. The observed effects on upper extremity pain scores were 41% (1.2/2.9), 28% (0.7/2.3), 42% (1.0/2.4) (Tittranonda et al., 1999; Rempel et al., 2006; Rempel et al., 2007).