WritersServices.com Factsheet - Repetitive Strain Injury

These medical conditions as are categorised as 'distinct'. Giving something a name, especially if it is a 'syndrome', does not imply that it is understood or even recognised by all medical practitioners. If people report pain in multiple areas they are suffering from 'diffuse' RSI. Layman’s terms Tennis Elbow is Lateral Epicondylitis. You are affected if the outer part of the elbow, where all the extensor muscles of the hand attach, becomes painful and tender. It could also be called plasterer's or painter's elbow, as it can be caused by repeated bending of the wrist leading to overuse and possible tiny ruptures of the forearm muscles and tendon of the elbow where the forearm muscles are attached.  But it can also result from a specific strain or knock. It is very similar to golfer's elbow, found in keen golfers, which affects the inside of the elbow.

Golfer's Elbow is Medial Epicondylitis. Here it is the inner part of the elbow that becomes painful and tender to touch. Among golfers it is caused by the rotation of the wrists during a swing, when the muscles on the inside of the forearm are stressed. All the flexor muscles, which pull the palm towards the arm, attach to the inner part of the elbow. So it can also affect keyboard or mouse users, if there is too much strain on the arms as a result of a bad working environment.

The keyboard operator can be afflicted by all these 'sporting' ailments simultaneously! This inflammation of the tendons produces a stabbing pain and is treated, under medical supervision, with strong pain-killers and/or anti-inflammatory drugs. However, time to recover, which can take weeks, and modified working practices are the only true cure. What Causes Repetitive Strain Injury (RSI)? Many things have been blamed including:

	Physiological causes such as vitamin deficiencies, wrist shape, neck and spine bone shape, plus overall physical and mental health have all been implicated.
	Women appear to be at a higher risk, possibly because of the nature of traditional female work but studies have shown an increase in symptoms while taking oral contraceptives, during pregnancy and after the menopause.
	But poor posture, bad work habits, long hours, stressful work, physical stress, heavy workloads and an improper exercise regime coupled with lack of regular breaks are all known to cause RSI.

Explanation for RSI The arm and hand are wonderful and complex structures. But their skeletal structure makes it difficult to localise problems. Muscles are often remote from the digit they act on, connected by tendons. They have evolved to cope with a range of tasks. It is perhaps the modern tendency to repeat a limited range of movements that causes problems, thus the strong recommendation to take breaks and vary the tasks carried out.

The most general explanation for the cause of RSI is repeated compression in areas where the nerves or blood supply are susceptible to pinching during sustained activity. If this damage is not given time to recover and, if necessary, heal, then an RSI might result. The vulnerable elbow What Can Computer Users Do?

	Be alert for early symptoms. Common ones include: Tenderness and pain in the neck, shoulder, upper back, arm, elbow and hands Swelling in the hands and forearms Muscle twitches or spasms Tingling and loss of sensation in the hand or arm Unexplained weakness and strength in the hands and arms, such as when gripping handles Decreased sensitivity or unusual sensations such as numbness or loss of feeling in the hand Stiffness or locking of the fingers, hands and possibly arms when working
	As the problem starts with mild pain, which might be perceived simply as tiredness during the working day, be alert. The point at which tiredness becomes pain is subjective. Initially the condition goes away overnight. But if you do not heed these warnings, the pain in your hands, wrists and arms might become persistent. RSI is a progressive condition.
	Time how long you can type without feeling any symptoms and record this time. Then set this as a limit and make sure you always work less than this, then take a break. As far as RSI is concerned, a change is often as good as a rest, so shuffle some papers, read through what you have written or perform a different task to allow time to rest your arms and hands.
	Make sure your work area is ergonomically sensible.
	Become self-conscious about your posture until you establish good habits and eliminate bad practice.
	Employ some of the available technology such as voice recognition software to reduce the amount of work your hands have to do.

Self-treatment

	Several short breaks are better than a few long ones. Just let your arms relax in your lap or at your side for a few minutes. Every half-hour find an excuse to get up from your desk to loosen your neck and shoulder muscles.
	Gentle exercise such as swimming, walking and stretching and massage are good to maintain muscular condition which probably helps avoid tiredness.
	Massage is relaxing and may help to stretch muscles but also risks aggravating the injury.
	Stretching prior to every activity, whether it is work or play, is always recommended.
	Put ice or heat packs on affected areas. One reduces swelling, the other stimulates blood flow.
	Hot baths and saunas also stimulate blood flow which can aid recovery.
	You can apply a tubular bandage which may help, possibly by limiting the amount you can use your muscles.
	Yoga, meditation and other body-awareness exercises such as the Alexander Technique can be beneficial for the back, neck and shoulders.

  Sources of help

	Primary health care workers
	Chiropractors and osteopaths
	Sports injury specialists and physiotherapists
	Equipment that reduces the need to use your hands
	The interaction of medics, media and lawyers has probably not helped sufferers. Check the litigious experience of Australia in the 1980s.

© charles jones 2002 © writersservices.com 2002