| Welcome to the General Information FAQ! Advice
for the initially injured, basic ergonomics information, and pointers to additional
resources across the Internet and inside your local bookstore. Provides information and
website links related to office ergonomics, RSIs, medical and alternative health
information sources, and related topics. Lists additional information resources including
support groups, publications, mail lists, newsgroups, FTP and Gopher sites, and some of
the best informational websites in existance.
The educational material provided in this website is intended for informational
purposes only -- consult a health professional familiar with RSIs for specific treatment
recommendations. If you are experiencing injury symptoms, consult with your health
professional as soon as possible. Even a few days can make a big difference between a
rapid, easy recovery and a prolonged, difficult process of fighting chronic symptoms.
Q: What are repetitive strain injuries (RSIs)?
A: RSIs are not so much diseases as they are a response to
excessive and repetitive demands placed on the body. The hundreds of known repetitive
stress injuries, or RSIs, all have a similar cause: excessive wear and tear on the soft
tissues of the body (tendons, nerves, circulatory system, etc.).
They start when you do the same task over and over again, from clicking a mouse to
craning to see the computer monitor. If your body doesn't get a chance to heal, the damage
adds up, and can eventually destroy your ability to do your job. (CNN -- Working Wounded)
RSI is a general, umbrella term for these host of injuries, other terms used for RSI
include:
- CTD - Cumulative Trauma Disorder
- MSD-Musculoskeletal Disorders
- OOS - Occupational Overuse Syndrome
- RMI - Repetitive Motion Injury
- UEMSD - Upper Extremity Musculoskeletal Disorder
- WRULD - Work-Related Upper Limb Disorders.
Following are some specific examples of injuries typically considered RSIs:
- Tenosynovitis - an inflammation of the tendon sheath.
- Tendonitis - an inflammation of a tendon.
- Epicondylitis - an inflammation of the tendons where they attach to the bones at the
elbow.
- Carpal Tunnel Syndrome - a condition which develops when the median nerve is compressed
within the carpal tunnel.
- Cubital Tunnel Syndrome - involves compression of the ulnar nerve where it passes the
elbow point near the "funny bone".
- Thoracic Outlet Syndrome - affects the nerves and blood vessels of the neck and
shoulder.Others:
See the Glossary and RSI Information for more terms and definitions.
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Q: What are the injury signs that I
should look for?
A: Typical injury symptoms include tightness, general
soreness, dull ache, throbbing, sharp pain, numbness, tingling. burning, swelling, and
loss of strength in your upper extremities (hands, arms, shoulders, and neck). Some injury
symptoms are not obviously work related - Carpal Tunnel Syndrome (CTS) is an example of
this where hand numbness, pain, tingling frequently occurs at night while trying to sleep.
When physical activities (work, sports, hobbies, etc.) become excessive to the point of
injury, localized fatigue is usually the first sign of excessive strain to the body.
Symptoms of localized fatigue are discomfort (aches and pains), loss of strength, and
trembling in the affected limbs. These symptoms tend to increase as the offending activity
is continued and usually decrease or disappear within hours or minutes of stopping the
task. When symptoms of fatigue persist, even after normal rest, this may indicate a
problem exists. If you are still tired and in pain after a night's rest, the activity in
question may be stressing you to the point of injury.
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Q: What should I do
if I experience RSI-related pain?
A: First, and foremost of importance: if you experience pain
at all, then you absolutely need to go see a doctor. As soon as you possibly can, the
difference of a day or two can mean the difference between a short recovery and a long,
drawn-out ordeal. GO SEE A DOCTOR. Now, your garden-variety doctor may not necessarily be
familiar with this sort of injury. Generally, any hospital with an occupational therapy
clinic will offer specialists in these kinds of problems. DON'T WAIT, THOUGH. GO SEE A
DOCTOR. The information provided here, or any other published document, must not replace
being diagnosed and treated by a medical specialist.
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Q: What are typical injury risk
factors?
A: There are physical activities that have been identified
as risk factors for RSIs as well as personal/medical conditions and
environmental/psychosocial risk factors. These are briefly discussed below:
Physical activity (occupational work or not) risk factors have generally
been considered to be the following:
- Repetition - performing repeated motions in the same way with the same body
part.
- Posture - placing a joint towards its extreme end of movement in any direction
away from its neutral, centered position.
- Force - performing an activity with excessive muscular exertion/force.
- Static Exertion - holding an object or a body position in a still, fixed
manner.
- Contact Stress - direct pressure on nerves or tendons due to resting the body
part against a hard and possibly angled surface.
Note: Our bodies are designed to perform all of these activities, however, as
they are done in combination, and for extended periods of time, risk of injury increases.
This is true whether the activities are performed at work or play.
NIOSH's comprehensive paper on Musculoskeletal Disorders (MSDs) and Workplace Factors
http://www.cdc.gov/niosh/ergosci1.html
Hand/Wrist Basics
http://www.ur-net.com/office-ergo/alternat.htm
Personal, medical conditions may increase the risk of injury. For CTS, these
conditions include:
- Diabetes
- Rheumatoid arthritis
- Thyroid disease
- Gout
- Being overweight or sudden weight gain
- Hormone conditions (pregnancy, hysterectomy or removal of both ovaries)
- Fluid retention (pregnancy, birth control, and sudden weight gain)
- Previous injuries
- Smoking may also increase the risk
CNN - Study: Workplace not always main carpal tunnel culprit
http://cnn.com/HEALTH/9807/28/carpal.tunnel/index.html
Environmental/Psychosocial issues that can also contribute to injury
risk are:
- Low levels of job satisfaction
- Infrequent or inflexible breaks
- Monotonous work (low activity variety and fast pace)
- Limited autonomy (lack of control over the work performed)
- Perception of intensified workload and work pressure (deadlines, monitoring, bad
management)
- Limited support from supervisors and co-workers
Understanding the Injured Worker: Psychology's Role in Worker's
Compensation
Clinical psychologist Kevin Gaffney, Psy.D.
http://www.healthpsych.com/ccia.html
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Q: What can I do to avoid
injury?
A: It is best, for all concerned, for each of us to avoid
RSIs altogether. The general key is to avoid the above mentioned risk factors – move
around and vary the physical activities that you do throughout the day. Below are some
avenues that companies and individuals are following in the attempt to stay healthy and
safe.
Workstation Ergonomics - The physical design of the workplace
(workstations, tools, job design) has a large influence on how we work. Proper placement
and design of computer equipment and other office items, so as to avoid injury risk
factors, is an aim of ergonomics. Generally, keep those items that you use frequently
close to you to avoid frequent reaching and awkward postures when you use them. For more
ideas, see Ergonomics.
Injury and Somatic Awareness - Knowing about RSI injury risk factors and
being able to recognize symptoms when they occur is an important step in avoiding injury,
as well as being able to take care of the injury and it's likely cause, when it does
occur. Beyond these items are individual workstyle issues, such as how hard we strike the
keyboard keys or squeeze the mouse, how we position our fingers, wrists, arms, and
shoulders while we work; and where we place items frequently used throughout the day. We
don't generally pay a lot of attention of how we go about doing our daily activities until
our body starts telling us something is wrong by hurting. Many people ignore what their
body is telling them and work through the pain to get the job done. The main issue here is
to listen to your body and take a break, change how you are doing the activity that hurts,
or get help. There are several ways of learning more about our bodies and how they move
(somatic education) include training classes provided by Physical or Occupational
Therapists, Biofeedback, Feldenkrais Method or Alexander Technique practitioners, and
eastern techniques through Yoga and Tai Chi. (see Alternative
Health)
General Health - Taking care of ourselves through good nutrition and
stretching/exercise helps our body be ready for the daily exertions we place on it.
Several personal/medical risk factors can be addressed through spending the time to take
care of ourselves, so our body can take care of us.
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Q: Ouch! Too late, I'm hurt. Who can help me?
A: A variety of professions and organizations either
directly or indirectly deal with issues related to RSIs. As a first step, you need to find
a health professional that is knowledgeable about RSIs, get diagnosed, and begin medical
treatment of your injury. There are many good information
sources and articles to learn more about RSIs as well as mail lists and support groups that can help in making the
changes that might be needed to heal from RSIs.
Suggested Reading:
Selecting a Treating
Physician by Joan Lichterman (Founder, East Bay RSI Support Group)
It is important to realize that you need to learn as much as you can about your
injury and take a personal interest in determining what needs to be done to avoid future
flare-ups and re-injury – Others can not do it
for you. Unlike most injuries that you can go to a doctor and "get
fixed" with little personal effort, RSIs are brought on and aggravated by a variety
of stimuli/activities/reasons. These factors occur throughout your day and must be
identified and eliminated, or at least reduced as much as possible, so you can heal.
Unfortunately, RSIs often carry with them complications that flow into the job's workers' compensation, legal, and disability
issues. RSIs are a fairly politically charged
issue as well since Federal and State OSHA organizations are attempting to create
ergonomic standards.
See Organizations and Services
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Q: What kinds of products
can help?
A: Hopefully the answers provided above have instilled an
awareness that avoiding, or recovering from, RSIs is more of a process, than a simple
one-answer quick-fix. Products can help address the injury
risk factors described earlier, but need to be part of an overall program tailored to
your injury and type of work performed. Below is a list of typical products and brief
descriptions. Hyperlinks are provided for more information and to view representative
products.
Furniture - What you sit in, the furniture that
holds and positions your computer and office equipment, and how they are set up and
adjusted, probably has the largest affect of all the products on your ability to work with
reduced injury risk.
Keyboards - Keyboards have a lot of design issues
that have made them subject to many studies and litigation over the last three decades. A
variety of keyboard designs are now available to assist in avoiding awkward postures
related to keyboarding.
It is important to understand that your typing technique and where you locate the
keyboard for use is as important, if not more so, than the keyboard design itself.
Speech Recognition - For those injured computer users
that have limited use of their hands, speech recognition is a valid tool to assist in
getting the job done.
This is a complex technology and requires serious dedication, training, and help
from those familiar with the available products. If you're just curious, wait awhile
before making the plunge – new and better products are hitting the market at an
amazing rate.
Pointing Devices - Squeeze it, roll it, touch it, look at it,
fly it through the air in front of you, there is an amazing variety of devices that allow
you to move your cursor around the screen. Much of the problems encountered by computing
may well be the fault of a little rodent (mouse), as well as how we use it. Mice,
trackballs, touchpads, and other devices require different physical demands and thus
provide a change for hurting fingers and hands.
Whether you change devices, or hands in their use, you're still at risk if you
don't watch your methods of use and give it a rest and stretch periodically.
Accessories - Helpful little items ranging from
wrist rests to foot rests and many items in between. Furniture, office, and computer
accessories can help keep neutral postures and reduce static and forceful exertions
related to RSIs.
Many accessories have been called quick fixes, bandaids, or crutches because
sometimes with a little body awareness, proper typing/mousing technique, and getting the
workstation set up right to start with, some of these little aids might not be needed at
all.
Software - Sometimes it is just too hard to remember to
vary your work at the computer when you're actively mind-melding/bonding with your silicon
partner. There is a growing list of software available to remind you to take a break,
stretch/exercise, and train you in the finer points of ergonomics, all right on your own
computer.
From freeware to corporate training packages worth hundreds of dollars, it's worth
checking out what might help. Make sure of the computer system requirements as some
packages have lots of graphics, animations and video clips in them. Those already injured
should clear the excersizes with their health professional before using them.
Resellers - Some products are readily available at
your local computer super store, or off of the Internet, however many of the larger and
more specialized products are only available through resellers focusing on the ergonomic
and healthcare markets.
If you know what you need then the catalog or website ordering may work well for you,
especially if they have a good return policy. If you need more assistance, look up your
local reseller that may have a well stocked showroom so that you can try the products out
first, as is generally recommended for many products (especially keyboards and chairs).
Many resellers will also let you borrow the items for use in your workplace to make sure
it is the solution for you.
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Q: Where can I go to get more information?
A: There are many information sources online and off that
are excellent. The best resources that we've found can be found listed or linked to in the
Information Content bar along the left of this webpage. Of particular
interest are:
Also see what Articles might be of interest to you
as well as those found in The RSI Network
newsletter archives.
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