DXT Ergonomic Mouse Review

A couple of years ago, I wrote that the Evoluent vertical mouse “is probably what the standard ‘mouse’ should look like.” I have now found another model that I think is even closer to this ideal: The DXT precision mouse from City Ergonomics. Here’s why.

A bit of background

A few weeks ago, I had the privilege of conducting a Skype interview with James Bowden, inventor of the DXT mouse. We used Skype because Mr. Bowden is based in the UK, where he and his son Stephen manufacture and market the DXT through their company, City Ergonomics. The Bowdens are truly interesting folks whom I would love to meet in person someday. (They also have the most delightful accents; I could listen to them read the phone book.)

DXT mouse - side view

The DXT mouse looks simple, but its design addresses serious ergonomic issues in a truly elegant way.

Mr. Bowden is well qualified to address physiological ergonomic issues, having spent his career as a physiotherapist. While working in that capacity at Shell Oil, he noticed that one department – exploration and development – was sending him more than its share of back and neck patients. Upon investigation, he discovered that this line of work requires near-constant mouse use. The department provided a type of ergonomic mouse, which did help to prevent wrist problems, but didn’t seem to do much for the neck and shoulder epidemic.

After years of dealing with the situation, Mr. Bowden concluded that the world needed a new mouse design. In 2005, he and the younger Mr. Bowden – a career ergonomist – created the DXT precision mouse based on their experience and expertise.

DXT Ergonomic Mouse
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So it’s another vertical mouse. So what?

The DXT mouse is not the first vertical design to hit the market. That sector is already crowded with such luminaries as the aforementioned Evoluent, the 3M ergonomic mouse, and the AirO2bic – just to name a few I’ve personally tried. All make the same basic claim: Palm-flat mousing is unnatural and evil, “handshake” mousing is natural and good. They then sprinkle this concept with their own particular flavor, for example, “zero pinch-force,” wireless freedom,” or even “lighted logo.” (Sorry, Evoluent.) The DXT has a flavor too – but in my opinion, it offers a bit more substance than some of the others. Let’s look at a few key points.

Precision, precision, precision

The majority of ergonomic mouse designs sacrifice some degree of precision by transferring the workload from your hands and fingers to your arms, shoulders, and elbows. Intuitively, the reasoning behind this is quite sound. The muscles and tendons in your arms are bigger, therefore stronger and harder to damage, than the small ones that control your fingers. Also, mousing with the entire arm tends to keep your wrist straight, without the harmful sideways wrist-flicks of the conventional mouse.

DXT mouse - left hand

Gripped with either hand, the DXT feels much like using a stylus.

As a user of the Contour mouse – one of the original “whole arm” designs – I’ve dealt with this issue of precision for many years, and worked around it in two ways. When doing moderately precise work, I shift to Contour’s “precision” posture, an alternative position where the heel of the hand rests on the work surface. For the really precise tasks, I keep a Wacom tablet and stylus handy.

The DXT mouse reverses the common arm-loading approach. Instead, it unloads your arm and shoulder, and transfers nearly all the work to your hand and fingers. Using the DXT, in fact, feels very much like using the stylus I mentioned earlier, and the resulting precision is about what you would expect. It is also easy and natural to use without retraining – so much so that I quickly turned the onboard DPI setting all the way up, and kept perfect control. I even found that my left hand could work with almost as much finesse as my right (and I am very right-handed).

What of the concern about small tendons? Mr. Bowden holds that the hand and fingers are perfectly capable of pulling their own weight – if they are kept within safe ranges of motion, without being locked into one repeated position. This concept drives everything about the DXT mouse design. Being physically small, vertically oriented, and capable of very high operating speeds, it allows the hand to accomplish a lot of work with a little motion – all while keeping the wrist in a neutral position.

DXT Ergonomic Mouse
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Made for use, not rest

Try this experiment sometime: Don’t use your left arm for two weeks. At the end of that period, see which of your arms is in better shape. On second thought, don’t try that; you already know the result anyway. Our bodies were designed for motion that’s how they develop and maintain strength. Yet many ergonomic devices address pain issues by permanently immobilizing the “trouble spot,” such as the wrist or fingers. This approach generally stops the pain, but risks atrophying the immobilized joints. Also, the same stress may simply be transferred to another area, which will become its own “trouble spot” with time.

Far better, counsels Mr. Bowden, to fix the problem at the root. Every part of the body was made to be used, so don’t immobilize it – design devices that use it properly, within its natural range of motion. This reasoning feels right to me, and the DXT mouse in my hand feels even righter.

Natively ambidextrous

DXT mouse - top viewSince the mousing hand tends to get overworked, many people like to split the load. Most ergonomic mice come with hand-specific versions, so the ambidextrous user ends up investing in not one, but two expensive new gadgets. Not so with the DXT, which is elegantly ambidextrous by design.

Since the DXT mouse is vertical, right-click and left click don’t change positions when you change hands. Because its cable comes out the side and not the back, it doesn’t change positions either. The pointer and scroll wheel do unavoidably reverse course, but these can be changed with the touch of a handy button, and the current mode tracked with two easy-to-see blue lights.

Do you believe in the Pinch Force Monster?

In any discussion of vertical mice, someone will soon mention “pinch force,” with an ominous shudder. The warning goes like this: Most vertical mice require you to “pinch” the mouse between your thumb and forefinger in order to click. (The AirO2bic mouse is an exception; it is held steady by the weight of your hand, so there is no need to pinch.) This pinch force, you are solemnly assured, will eventually blow out some part of your hand – probably your thumb. Best stay away from vertical mice.

DXT mouse - front on viewWhen I brought up the pinch force concern to Mr. Bowden, he responded with some interesting facts and a bit of history. Pinch force, he says, first came on the ergonomic radar from the medical industry, where it dogged endoscope operators. Endoscopists basically spend their lives squeezing a handle, and this repeated squeezing action was found to cause certain types of RSI. When you apply this logic to the vertical mouse, it suddenly doesn’t look so ergonomic anymore. But wait – does this logic apply to a typical vertical mouse? Mr. Bowden says no.

Here’s the key: Studies found that repeated pinch force is only a concern if that force is more than about 2.2 pounds. Here’s another experiment for you: Get a kitchen scale and press down on it with your fingers until the meter shows two pounds. Now ask yourself how that compares to the force you use when clicking a mouse. Unless you’re one of these folks who feels compelled to press on peripherals until the plastic deforms, I’m guessing you stay well below the threshold of danger.

So in short, according to Mr. Bowden, there is a Pinch Force Monster – but unless you’re an endoscopist (or someone who cuts thick things with scissors for a living) you don’t have to worry about him.

Footprints on the desk

DXT Ergonomic Mouse
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The DXT has one of the smallest footprints I’ve ever seen, which makes it great for compact installations. I found it nested nicely to the right of my split Kinesis Freestyle keyboard, and worked well on the smooth surface of my desk.

Though small, the mouse is also tall – tall enough to trip my hand up once or twice on the way over to the keyboard. Problems like this one tend to go away as you get used to them, so I wouldn’t worry about any long-term trip hazard.

One thing I would worry about is the height of your desk. To use the DXT – or any vertical mouse – it must be at or a little below the level of your elbow. This point cannot be overemphasized: If you try to use a vertical mouse on a desk that’s too tall, you’ll get zero ergonomics, plenty of ouches, and probably some copious medical bills. Please don’t go there!


The DXT mouse has a whole lot of things going for it. It presents the “handshake” grip in a compact, ambidextrous package that yields comfort and remarkable precision with zero retraining. Unless you have a high work surface that you can’t change, there’s no ergonomic mouse I would recommend more highly.

Disclosure: This review was made with a complimentary sample from City Ergonomics’ US distributor.

Our company, Cyberwitz LLC, provides various services for City Ergonomics, unrelated to my evaluation of their products. Opinions expressed here, naturally, are my own.

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  1. Van
    Posted February 24, 2016 at 5:59 pm | Permalink

    “But wait – does this logic apply to a typical vertical mouse? Mr. Bowden says no.” I have to disagree based on my experience using trackballs that require frequent use of the thumb. I’m now on my third Logitech trackball model and have come to the conclusion that I need to go back to a mouse because of pain in my thumbs, which I attribute to trackball use. I prefer trackballs because they are stationary, but that’s not worth putting up with pain.

    • Jason
      Posted February 24, 2016 at 6:43 pm | Permalink

      I join you in despising thumb-operated trackballs. But have you actually used a vertical mouse such as the DXT or Evoluent? Because I have, and neither significantly bothered my (very sensitive) thumbs.

  2. Emmy
    Posted October 20, 2015 at 2:24 pm | Permalink

    Hi Jason, I love your reviews, thank you. I like the design of the DXT and the footprint but I wanted to ask a question. I have thumb pain and I think this maybe wouldn’t be a good design for me since I would have to squeeze thumb and index fingers. I understand S. Bowden’s assessment that the fingers should be used as such, but I think not when pain is already present as in thumbs. Is the grip needed for the DXT to make movements a hard grip where I think more thumb pain would occur?

    • Jason
      Posted October 20, 2015 at 4:07 pm | Permalink

      I would describe the DXT grip as pretty similar to that of a pen, only you can hold it more loosely than that due to its size and stability. There’s really no need to choke down on it in my experience. Whether or not it hurts or helps your beleaguered thumb probably depends on what messed up your thumb in the first place. If you think the DXT sounds good otherwise, I would take the small risk of trying it, and send it back if it doesn’t work out.

      • Emmy
        Posted October 21, 2015 at 11:54 am | Permalink

        Thank you Jason. I might try the AirO2bic first and then the DXT. I appreciate your evaluations very much.

  3. Warren
    Posted October 9, 2015 at 10:25 pm | Permalink

    A few days after beginning a new job that had me using a computer all day every day, I started to develop hand and wrist discomfort. Wanting to forestall anything that might cause lasting harm, I found this review and started my workstation upgrade by replacing my traditional mouse with the DXT. After one day my discomfort had noticeably diminished and in a few days had ended entirely.

    I have since made other ergonomic improvements to my workstation, and all have been positive. However the biggest single improvement for me has been switching to the DXT mouse, which has served me well day in and day out for a year now. Thank you Jason for bringing this great mouse to my attention.

    • Jason
      Posted October 12, 2015 at 12:48 pm | Permalink

      Awesome story! Thanks for coming back to let us know how it went for you. The DXT is a pretty amazing product.

  4. Felix
    Posted April 21, 2015 at 10:53 pm | Permalink

    As a mouse the DXT works quite well but three things make the wireless version a real nuissance: (1) you can not switch is off and therefore when your travel the mouse is repeatedly activited by movements draining the battery and making the red lights flashing in your bag; (2) the battery capacity is very poor, so you have to recharge it every 2-3 days. (3) Due to the USB charging and the frequent charges it needs you possess a part-time wired mouse occupying even two USB ports as it needs one for charging and the other one for the transmitter. Too much weakness for such an expensive tool!

    • Jason
      Posted April 23, 2015 at 12:53 pm | Permalink

      Thanks for commenting with these issues, Felix. I think, though, that they may already have been addressed in the latest-greatest version of the DXT. I just got my sample of the new model, and I see right away that there is now an on/off switch. I haven’t tried the mouse to test the battery life, but I will include something about that in my review if I am able to test it for the requisite length of time.

      • Stephen Bowden
        Posted August 22, 2015 at 3:22 am | Permalink

        Yes the DXT wireless does have an on off button and an increased battery size. During testing and user feedback the new vesion can work upto 3 weeks.

        You can find more information and support at http://www.cityergonomics.com

      • Jason
        Posted August 24, 2015 at 10:11 am | Permalink

        My writeup of the new mouse, by the way, is still coming. 🙂

  5. Frank Panucci
    Posted October 9, 2014 at 7:14 pm | Permalink

    I agree with you about the DXT mouse. It’s generally excellent for strain relief (but overpriced for its flimsy construction). However, it shares one undesirable characteristic with the Evoluent mouse (of which I own two): It does not work with all KVM (keyboard/video/mouse) switches. As do my two Evoluents (models 2 and 4), the DXT is not recognized by the KVM and no signal is passed to attached PCs. I tried multiple KVMs but it did not help. I use several PCs simultaneously with a single monitor, keyboard, and mouse, so a KVM switch is necessary for me. This is unfortunate because of the DXT’s near-perfect configuration.

    The Evoluent mouse is discussed on a forum visited by Evoluent engineers. They have officially & explicitly stated the Evoluent’s design issue that prevents universal KVM recognition will not be remedied. I do not know if Kinesis, the maker of the DXT mouse, has publicly acknowledged this problem.

    • Jason
      Posted October 10, 2014 at 6:45 pm | Permalink

      Thanks for mentioning the possible issue with KVM switches. Please note, though, that Kinesis is not the manufacturer of the DXT mouse; only the US distributor.

  6. Juan
    Posted June 20, 2014 at 12:07 am | Permalink

    Vertical mice are the best ergo solution for extensive computer users. When I engaged in a job requiring to use CAD/REVIT software all day long, I begun to experience pain in my hand muscles at night. My wife bought me a vertical mouse, not so expensive like the ones posted, and the pain disappeared right away.

  7. Hieronymus P. Organthruster
    Posted September 25, 2013 at 6:10 am | Permalink

    Like you my problem is painful thumbs, a problem exacerbated by tensed-up movements. Because my work involves precision I have always used my fingers and thumb to move desktop mice, not my arm and shoulder. I have tried mice that lift my thumb off the desk, and thus force me to use other bits of my body to move them, but no matter how hard I try they never click (pun unintended).

    That’s why I ended up with the Contour RollerMouse, and the DXT mouse I tried before it made no difference to me. You are essentially forced to control the thing with a grip of some description, and all movement is made by fingers and thumb – same as any regular desktop rodent.

    OK, so it does make you rotate your hand through ninety degrees, and while I appreciate there may be some evidence this can alleviate certain types of discomfort, for me the pain was no better. It’s basically a cross between using a standard mouse and holding a pen, and if your thumbs are as knackered as mine, that’s the last thing I want.

    Hence the RollerMouse, which I can operate entirely and very accurately with fingers. It’s let down by a lack of software support from the manufacturer – fixed some time soon, I hope – and by some odd design decisions, such as the wide spacing of and pressure required to operate the buttons, and the scroll wheel being more than an inch back from my fingertips.

    The search continues…

    • Jason
      Posted September 25, 2013 at 9:47 am | Permalink

      I’m happy to say that my own thumb issues have gotten better with time.

      For unrelated reasons, I actually switched to the DXT mouse a few weeks ago. Personally I am finding it very comfortable to use, and it scarcely bothers my thumbs at all. I’m a big fan of the RollerMouse too, but it isn’t really practical for me right now due to its space consumption and relative imprecision vs. the DXT.

      You’re quite right that the DXT grip is like a cross between a mouse and a pen or stylus. For me this is a really good thing, because it makes movement so precise that I seldom even reach for my graphics tablet anymore. But, I totally understand why the design wouldn’t work for someone in your situation.

  8. Stephen Bowden
    Posted July 9, 2013 at 12:50 pm | Permalink

    You can review the recent study which the DXT Ergonomic Mouse was involved in at http://www.cityergonomics.com/dxt-ergonomic-mouse-comes-out-top-in-us-study/

    The study looked at comfort and accuracy compared to a standard computer mouse and the evoluent mouse.

  9. Nancy L.
    Posted April 17, 2013 at 10:29 am | Permalink

    Hi Jason,
    This was an informative and insightful article. Your bio says that you don’t have training or expertise in ergonomics but you do know to ask the right questions. I’m a physical therapist, certified hand therapist and ergonomist and I appreciate that. Thanks for the info.

    • Jason
      Posted April 17, 2013 at 10:35 am | Permalink

      Thanks for the kind feedback. I consider that a high compliment indeed coming from a “real” ergonomist. 🙂

  10. Cindey Benner
    Posted April 17, 2013 at 9:49 am | Permalink

    Thanks to Russ Hitt, I love my DXT mouse, had it for a year now, often when using the traditional pronation mouse, I feel a cramping from the “grip”. With the DXT, I just push it around the pad and it does all the work.
    I can’t wait for the wireless one, maybe this year’s Ergo Conference in LV it will win!

    • Jason
      Posted April 17, 2013 at 9:51 am | Permalink

      It certainly deserves an award of some kind – as does Russ, I might add. Thanks for posting.

  11. Andy
    Posted February 5, 2013 at 7:27 pm | Permalink

    Thanks for this interesting review. I’ve been using an Apple TrackPad for many months and at the end of my workday have forearm and wrist pain. The DXT intrigues me. Are you going to sell it through your website? – Thanks… – Andy

    • Jason
      Posted February 5, 2013 at 7:34 pm | Permalink

      Thanks for commenting; sorry to hear about your trackpad woes. Yes, I will be selling the DXT mouse in the EI Store, but I’m waiting to list it until the new models come out. (City Ergonomics is introducing a wireless version.) If you would like to buy one before then, please email jason {at} ergonomicinfo dot com and I can get it special-ordered for you.

      • Andy
        Posted February 5, 2013 at 10:22 pm | Permalink

        I’d like to buy a wireless model from you when it’s available. Can you let me know at that time? Let me know if you don’t already have my email address. Thanks, Jason!

        • Jason
          Posted February 6, 2013 at 11:36 am | Permalink

          I’ve got your email and I will let you know the minute it’s available to me. Thanks!

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  • About The Blogger

    Jason, the All Things Ergo bloggerI'm Jason, a user of many ergonomic devices by necessity and choice. I'm also a partner in a business that operates a number of commercial enterprises, including All Things Ergo.

    I have no particular training or expertise in the area of ergonomics. My views are based on my own personal experience, and what works for me won't necessarily work for you.