The clear film that you put on the underside of your ruler really helps a lot. i have carpel tunnel syndrome and found that my cutting improved very much once I started to use it. You can also get braces to wear on your hands while you cut. Mine have a metal bar down the inside (runs vertically across the palm of my hand)and they seem to help a lot. I also found that if I use a ruler that has a bar on it that kind of hooks over the edge of your cutting mat, it helps a lot. I use a blue rotary cutter (forget the brand name) that really is much easier to use than an Olfa. Another thing I found really helpful is to make sure that your blades are always sharp. It took me awhile to find out what worked for me, but once I did things got way better. Keep trying till you finds what works best for you.