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The following information is a compilation of things I have read and experienced both as a patient and a field observer. It is by no means the most technically up-to-date and medically proven information. This study of ergonomics is developing rapidly and this may not be state-of-the-art/science by the time you read it.
On July 1, the National Institute of Occupational Safety & Health (NIOSH) issued a major critical review of scientific literature pertaining to work-related musculoskeletal disorders of the neck, upper extremities and lower back. After reviewing more than 2,000 epidemiological studies and carefully analyzing 600, NIOSH has concluded that the greatest risk of musculoskeletaldisorders occurs in a small number of industries where workers face intense, prolonged exposure to several risk factors simultaneously.
The strongest evidence of a causal relationship between physical work factors and musculoskeletal disorders was found in these cases:
- Posture and neck and neck/shoulder disorders
- A combination of repetition, force, and posture and elbow disorders
- A combination of repetition, force, posture, and vibration and carpal tunnel syndrome
- A combination of repetition, force and posture and tendonitis
- Vibration and hand-arm vibration syndrome
- Lifting and forceful movement and back disorders
- Whole body vibration and back disorders
RSI may affect many parts of the body in many different ways. It can involve muscle, fascia, blood vessels, nerves, and joints. Pain in one part of the body, the hand for instance, can be the result of a problem in the hand, wrist, arm, shoulder, or neck. RSI only tells us how people got hurt - repetitive forceful movements. Diagnosis may be simple or complex depending on the site and severity of the problem. When treatment is started early and the offending cause is corrected, cure may be rapid. If not, some people incur permanent damage. Medical treatment is only part of the cure. If the cause of the problem itself is not evaluated to determine the contributing factors, the treatment will be less than successful. A cure for RSI is not the same for everyone. It is both illness and individual specific.
Combinations of many things can speed recovery. These may include medication, physical therapy, massage, movement awareness training, stretches, exercises, ice, heat, meditation, dietary supplements, chiropractic, physical therapy, ergonomic equipment, changes in work habits and body usage, and acupuncture. Permanent and total recovery from the damage may be elusive, with recurrences and flare-ups being common.
The following have been useful for me or recommended by others:
1. LEARN EVERYTHING YOU CAN ABOUT YOUR PARTICULAR ILLNESS.
a) Read the following books (purchase your own or borrow from your local library):
- Repetitive Strain Injury A Computer User's Guide, by Emil Pascarelli, MD and Deborah Quilter.
- Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries: A Self-Care Program, by Sharon J. Butler
- Spontaneous Healing, by Andrew Weil
b) Collect general information from the Internet with care. CAVEAT: Some information may not be reliable, so verify be trying something that might cause harm.
Some starting points are the following:
c) Information on ergonomic equipment is available at the following websites:
d) Subscribe to the Sorehand email list by:
- Sending an e-mail to
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In the body of the message say "subscribe Sorehand your name".
- After your subscription is confirmed send mail to
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In the body of the message say "set sorehand digest". Save the user directions for future reference. Same caveat as #1 applies.
2. DO NOT UNDERESTIMATE THE POTENTIAL SERIOUSNESS OF YOUR PAIN
Many ergonomically related illness can progress to long-term or even permanent disabilities. The sooner you get professional help and correct your activity patterns, the faster you will heal. However, healing may take time - more than you might expect. The analogy to weight loss is similar - it is hard to correct what took years to accumulate. Do not return to the source of the problem and think you can work through it. In my experience, those that took time to heal recovered better than those that refused to change the work or life style that precipitated the problem.
3. DO NOT JUMP AT THE FIRST QUICK FIX FOR YOUR ILLNESS
Getting well is a complex, multi-faceted process. Many sources of help are available. These include the medical and ergonomic professionals at your workplace or local medical facility. If your illness is related to your work, have that work evaluated for improved operation. No amount of medical intervention will help if you continue to harm yourself with improper or forceful movements. Take time to evaluate your work, home, and leisure activities that could be contributing to your pain.
Surgery should be the last resort when lifestyle modifications, medication, rest, physical therapy have failed. Do not undergo surgery until you understand the diagnosis, the details of the procedure, the proven record of success, and the consequences of failure. If you are uncomfortable with the medical provider’s response, get a second or third opinion. Be sure diagnostic tests confirm the problem that is to be corrected. If your doctor dismisses or belittles your complaints or claims that repetitive traumas do not exist, get another with a good reputation in treating your type of RSI.
4. DO NOT SABOTAGE YOUR RECOVERY
Pain is not a sign of physical or emotional weakness. It is a signal that something is wrong. You are the most knowledgeable person regarding your own body. Listen to it. Determine what helps and what hinders your recovery. Keep a diary of your activities, medications, exercises, stress levels, and work habit changes.
DO NOT BE MACHO AND CONTINUE THE HABITS, CONDITIONS, AND PACE AS WHAT HURT YOU IN THE FIRST PLACE.
Leisure or home activities may contribute to your illness. Something as simple as carrying a heavy purse or briefcase may aggravate hand, wrist, shoulder or back problems. Try to vary the muscle groups that you use throughout the day. If you sit at a computer at work, do something physical in the evening or vice versa. If whatever you are doing hurts, stop doing it.
Coworkers or family members may be willing to help with chores while you are healing. Alternate work methods, such as keystrokes in place of mousing, or task rotations to limit time in repetitive positions. Ask for help when needed.
5. GET THE BEST PROFESSIONAL CARE YOU CAN FIND AND AFFORD AND ROUTINELY REEVALUATE YOUR PROGRESS
The mainstream medical community also has many branches: physiatrist, osteopaths, neurologists, physical and occupational therapists, general practitioners, and hand surgeons. Each brings something to the table, but the most important things is how good the medical professional is in treating YOUR illness.
RSI illnesses are not addressed in many medical school curricula. If you study the references listed in #1 you will more prepared to ask questions and judge the degree of knowledge of the caregiver. This applies to medical doctors and physical or occupational therapists as well as alternative medicine practitioners.
Mainstream physical therapists are well trained in techniques for strengthening muscles that have atrophied due to injury or splinting, but such techniques are not always appropriate for RSI problems. Nerve conduction tests, usually administered by a neurologist, are an accurate indicator of nerve damage, but not of nerve inflammation. If the test results are positive that means that you have nerve damage. A negative test, done properly, indicates you do not have a diagnosis of nerve damage, but other RSI illnesses are still possible.
The alternative medicine community has some helped some people. Help might be from a chiropractor or a masseuse. Some RSI suffers speak very highly of the stretching and body awareness branches, i.e. Yoga, Feldenkrais, Alexander, Tai-Chi etc.
6. JOIN A SUPPORT GROUP OR START YOUR OWN
The SOREHAND listserver is one place to start. A group of people that have been or are going through similar problems are valuable resources. You can learn from their experiences - good and bad.
Other sufferers can be an invaluable source of information on what resources or professional experts to try and where to find information. The emotional support from the group can be useful in battling the depression that may accompany severe RSI. |
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