I found this online
to get all your mouse buttons to work with X

edit your Xfree86 mouse section with

code:--------------------------------------------------------------------------------
Identifier "Mouse1"
Driver "mouse"
Option "Protocol" "ExplorerPS/2"
Option "Device" "/dev/psaux"
Option "Resolution" "300" (not required)
Option "Buttons" "7"
Option "ZAxisMapping" "6 7"
--------------------------------------------------------------------------------

Then you need to do "xmodmap -e "pointer 1236745" I have a script in .kde/Autostart to do this when ever I startx

code:--------------------------------------------------------------------------------
#!/bin/sh

xmodmap -e "pointer = 1 2 3 6 7 4 5"
--------------------------------------------------------------------------------

Once you have verified that your wheel works you can test to see if the extra buttons are seen by X with "xev" (place the pointer in the square and click the buttons to see the events).
Next you need to download and install imwheel and create .imwheelrc in your home directory with the following,

code:--------------------------------------------------------------------------------
".*"
None, Up, Alt_L|Left
None, Down, Alt_L|Right
--------------------------------------------------------------------------------

Next start imwheel with imwheel -k -b "67" I use another script in /kde/Autostart for this as well,

code:--------------------------------------------------------------------------------
#!/bin/sh
imwheel -k -b "67"
--------------------------------------------------------------------------------

have fun

I forgot one thing
you can get imwheel from here

http://jcatki.no-ip.org/imwheel/