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Repetitive strain injury (RSI)
Computer and Health
By Dr Rob Hicks
Let's not repeat the strain!
As many of us spend more and more time in front of computers, the chances of developing repetitive strain injury (RSI) increase. For some people, the pain of RSI is so great that it prevents them from working at all. However, it doesn't develop overnight, so by always remembering that prevention is better than a cure, problems can often be avoided in the first place.
What is RSI?
Occupational overuse syndrome, work-related upper limb injury, and isometric contraction myopathy, are all phrases used to describe what is more commonly known as RSI.
Overuse of the muscles of the hands, wrists, arms, or shoulders on a repeated, and usually, daily basis, causes injury to these muscles. This results in inflammation that is never really given a chance to recover, since these everyday harmful activities invariably continue.
Most often blamed for RSI are the computer keyboard and mouse, but they shouldn't be charged with sole responsibility. For a start, the body was never designed to sit hunched over a desk. Poorly positioned and organised workstations add to the problem. Let's not forget, the longer someone puts a strain on muscles by sitting incorrectly for far too long without taking a break, then the more likely the body is to suffer the consequences.
The change in our home life and activities also contributes. Computers are ever present, and young children and teenagers are at risk of developing RSI because of the use of computer games, whether they be hand-held or played on the TV or computer.
Tense muscles do not function correctly, which means that someone under stress is also much more likely to suffer muscle damage and subsequent RSI.
RSI isn't new
Protect yourself
- Assess workstation and seating position
- Try a foam wrist support
- Stretch to warm up and warm down muscles
- Take a short break every twenty minutes
- Practice relaxation
But RSI is not a new phenomenon. Tennis elbow and golfer's elbow are two common examples of other overuse syndromes. They have been around for a long time and you don't have to play tennis or golf either.
Anyone who overuses their muscles in their arms and hands repeatedly may develop RSI. Workers on factory assembly lines, musicians, dressmakers, and cleaners; the list of people who often suffer is long. It's only since office work and computers have become such a prominent part of everyday life that these have fallen under the spotlight.
Identifying RSI
It may be months, even years, before someone starts to experience the discomfort and pain of RSI. This is because it takes time for the repetitive damage to reach a level where it causes problems.
A slight ache every now and then may be all that's felt to start with and, when this is the case, it will probably be ignored. As time passes and the damage continues, symptoms occur whilst performing the repeated activity, when typing for example. As the situation becomes more severe, pain may be felt most of the time, even with the slightest movement. One or both upper limbs may be affected, depending on which is being used to perform the repetitive activity causing the problem.
Many people find they also experience numbness and tingling. Sometimes, this and the pain mean that they find it difficult to hold objects, and often drop them.
Beware of RSI
Possible treatments
- Heat or cold packs
- Arnica
- Painkillers
- Anti-inflammatory medicines
- Elastic wrist supports
- Acupuncture
- Firm wrist splints
- Physiotherapy
- Osteopathy
- Alexander technique
Someone is at risk of suffering with RSI if their job involves performing repetitive movement over and over again. This risk is increased if they spend long periods of time, sitting on an uncomfortable seat, or at a poorly arranged workstation without taking a break.
Prevention is always better than a cure, which is why it's important to ask your employer to assess and make sure that your workstation and seating position are correct. It's amazing how a simple adaptation, such as using a foam support to rest the wrists on when typing, can make all the difference.
These movements are in fact similar to giving the muscles a workout. This means that just like with any exercise or sport, they need warming up beforehand, and to go through a warm down period afterwards.
Try not to sit for longer than twenty minutes without taking a short break to stretch and relax. Stress makes matters worse, so relaxation techniques or yoga can be a good help. Gentle stretching exercises are all that's needed.
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Health at Work - Physical Health
You don't have to work on a building site for your job to affect your health; even the more sedentary occupations can be a risk.
Back Pain
Back pain is a fairly universal experience. Some see it as an inevitable legacy of our evolution, the result of turning a body designed to hang from a horizontal spine into a vertical spire, where a carefully balanced mechanism of muscles and joints must support organs and tissues pulling the column of vertebral bones downwards.
Back problems often start at work. Take an office worker who typically spends up to 40 hours a week hunched solid over their desk, nurses who need to frequently lift patients, a taxi driver bent into the driving seat for over 25,000 miles a year, a farmer constantly lifting sacks, seeds and machinery, or a checkout assistant sat on a poorly designed chair at her till all day (57% experience lower back pain each year). Our backs may be put under prolonged strain by our jobs and its hardly surprising that something within the delicate balance of bones and muscles so often fails.
Carpal Tunnel Syndrome
I'm seeing more and more people in my surgery suffering from carpal tunnel syndrome, and one of the things it appears to be related to, is using computer keyboards.
In the wrist, there is a tunnel formed by the strong tissue through which the tendons of the hand and the median nerve pass. It's a tight squeeze, so anything that reduces the space in the tunnel, such as fluid or inflammation of the tendon coatings, exerts pressure on this nerve. It's believed that repetitive overuse of the hand tendons, as with any tendon or muscle, causes them to become inflamed. Hence why keyboard use or other repetitive activities can be responsible.
When the nerve is compressed, people suffer discomfort, numbness, pins and needles, and sometimes, pain in the thumb, index, middle, and side of the ring finger, next to the middle finger. This is where the median nerve endings are distributed. Tingling often wakes sufferers up at night; when vigorously shaking the hands and arms is what brings relief. Men will also describe dropping things, or being clumsy with simple, but fiddly tasks, such as fitting a plug, for example.
Eye Problems :: Regular eye checks, Tips to reduce eye strain, First aid for eyes
Most people give hardly a thought to the amazing work our eyes do to enable us to see, until things start to go wrong. It's often at work (or school) that people begin to realise they have a problem. That doesn't mean that work is harmful to your eyes (although it can be) but that work or school is where we most need to see well.
We may be stressed, tired, trying to read tiny print or study tiny diagrams, and using our brains to think out problems fast, relying on all our senses. And so often these days, work also means sitting staring at a computer screen or VDU which puts extra demands on our eyes.
Regular Eye Checks.
So looking after your eyes at work is vital. But many people don't even have regular sight tests. It is estimated that as many as one in three working people have visual defects (like short or long sightedness) which have never even been diagnosed or have not been properly corrected. These problems may come to light when you do visually demanding work.
Make sure you have your eyes tested at least once a year or more often if you have symptoms. You may be able to demand that your employer provides regular eye tests especially if you work at a VDU - check Health & Safety regulations.
Symptoms suggesting eye problems are: Problems seeing or reading, Blurred vision, Headaches, Dizziness, Pain in the eyes, Watery eyes, Dry eyes
Headaches at Work :: Triggers of a headache at work, Preventing headaches, Making your work environment comfortable and stress-free
Headaches are such a common health problem that its not surprising that they often occur while people are at work. But there may be very specific reasons, related to the job or the working environment, why some people particularly suffer from headaches while they are trying to do their job.
Headaches can be hugely disruptive to work. More than 18 million working days are lost each year because of migraines, for example. This particularly debilitating type of headache can cause intense symptoms lasting up to 3 days and which are often so severe that concentration and co-ordination becomes very difficult and it is simply impossible to carry on working. In severe cases headaches can interfere with promotion and career prospects. Employers may worry that the person simply isn't up to the stresses of the job while those people with frequent headaches fear that they are letting down their colleagues because they insist on regular breaks or other conditions to avoid triggering a headache.
What triggers headaches at work? All types of headaches, especially tension or stress related headaches and migraine, are common in the workplace, probably because many similar trigger factors may be involved (see Box below). In some types of headache, especially migraine, a number of trigger factors may add up until a threshold is passed and a headache results.
