Need Info/Advice

Question: I’ve just joined this list, because I think that I have RSI in my right arm. Could someone give me some feedback if these symptoms are what you’d expect, and if they have any suggestions to calm them down a bit?  I’ve not had any treatment yet.
I’ve got a loss of grip strength – things just slide through my fingers, even though I’m holding on tightly, and my arm goes hot and cold quite a bit.  In addition, my funny bone feels like its being hit constantly and my shoulder hurts, and it always feels like I’ve got insects crawling on that side of my neck. I used to be double jointed in that hand, but now my middle finger especially is not so flexible – it kind of draws in when my symptoms are worst, and I wake up four or five times a night with my hand asleep. Other than that, after I stretch my arm my hand often hurts.
One of my friends (whom I was whining to) said this sounded like carpal tunnel or RSI, especially since it’s been going on for almost five years. I didn’t have treatment before because I’ve moved from the States, and as you know, doctoring is mighty expensive there. I work with computers constantly, and I’ve slowed my typing down from over 100 wpm to about 75-80, and I’ve reduced the amount I do, but it’s not making much difference, and I don’t want to keep taking Ibuprofen as it’s bad for your liver.
Does anyone else have symptoms like this? If so, what do you do for them? I found I get about a half a day’s relief if I go to a beauty salon and get a hot paraffin treatment, but that’s rather expensive…
Any help greatly appreciated!

Answer 1:  The harsh truth I’m afraid is that, regardless of what you have, you cannot hope to recover without having any time off. I found that out the hard way. Some of you on the list may disagree with what I have written below, but please feel free to argue!!
1.) Take some time of work. I couldn’t move my arms at all; it only took a week to settle down. It is important that you don’t sit and do nothing whilst being off. One of the best things I found was simply to go for a walk, gently swinging my arms. 2.) Loose the tablets! All tablets do is mask the pain. Therefore all you will do is make things worse. By all means take a tablet when you have finished for the day, but don’t use them thinking they are solving the problem, ‘cos they aint.
3.) Take a break! Look at your work. How often are you taking breaks? After making a 90% recovery from RSI I take a 5 minute break every 25 minutes. It actually means I am much more productive. In addition, I now use a piece of software called ‘Workpace’. (I have mentioned this before, but I have now purchased it as it has helped me so much) This makes me have a ‘micropause’. A 10 second break which I just put my arms to my sides and let the blood flow back into them.
4.) Working Environment. There are plenty of resources on the net that cover this in detail, but basically, if you are not sitting properly then game over!
5.) Voice recognition software. If it is feasible to use it in your work environment, then buy Dragon Naturally Speaking 3.0 or Dragon Dictate, which will slash your typing time.
6.) A final point. There are many treatments available for RSI, and it is a very individual choice as to what is the most effective. It also can be expensive. I found the Alexander technique good, as my posture was appalling (probablythe original reason for my RSI). But don’t waste money on miracle drugs…..
If you want any more info then please email me / the group. As I said at the start, I can only talk from my experience. I’m sure other members of the group have their own opinions…

Answer 2:  Every time somebody asks these questions I wish I had written  a file somewhere with all the information in! Remind me to save this note! Anyway here goes with my opinions on what to do with your RSI… this is based on my own experience and you should be aware that different people find different things helpful.

You should make sure that you understand what type of RSI you have, you can damage your tendons, the tendon sheaths, muscles and/or nerves. Treatment depends on what you’ve done to yourself! I would advise you asking your GP to refer you to a specialist (and don’t talk to anyone who wants to operate!). From your description of your symptoms I would say you had adverse neurological tension, also known as adverse muscular tension, adverse muscular dynamics etc. which is my main problem. I have been shown a set of stretching exercises by a specialist physiotherapist and also go regularly to a sports masseur. I had laser treatment for my damaged tendons which I found quite effective… ultrasound seemed to have no effect on either the pain or the damage.
You must give up the action which is causing trouble; I was pretty worried about this as I spent all my time in front of a PC. However, I now use a voice interface to the computer (which I am writing this message with) so I hardly do any typing. I also use a touch pad instead of the mouse which is a great help. Make sure that your hobbies at home (e.g. do you do embroidery?) are not reinforcing the problem.
I never found Ibuprofen was any use, but I tend to use painkillers with a muscle relaxant (Boots does a good one) as this is tackling the problem as well as the pain.
Get your workstation looked at by someone who understands ergonomics… do you have a health and safety representative where work? My problem was caused by sitting at a desk which was too high (as well as trying to do the work of three people!)
Finally, try to take a complete break… although I was signed off work by my doctor at the time I felt obliged to keep coming into work it didn’t do any good.
There are no miracle solutions for this problem; I am just about coming up to the second anniversary of going down with RSI. But don’t get depressed, the symptoms can be kept well under control if you
treat your body sensibly.

Answer 3:  It sounds like you have a problem with the nerves in your neck/arm. It could be Adverse Neurological Tension – ANT (sometimes called Adverse Mechanical Tension – AMT), coupled with a problem in your neck. For the ANT you need to be taught a series of stretches to do, a good physiotherapist should be able to do this. For the neck go and see a Chiropractor or Osteopath. Get your GP to tell you of a good one. The Chiropractor or Osteopath should also know about Trigger points – check when you make your first appointment. You will have to pay as the NHS does not cover treatment by Chiropractors or Osteopaths, if you have medical insurance it might cover you.
It is probably not CT, as this would only affect your hand. Are you leaning on your right elbow? As this can squash the nerve where it passes through the groove on the underside of the elbow. Are you using a mouse a lot? This can really aggravate the shoulder.
For more information on ANT/AMT, Trigger points etc. look in the RSI-UK web pages and the RSI-UK archive.
Here is a re-post, of one of my earlier postings, with some info on ANT/AMT:
————————————————————
AMT probably occurs to some extent in all cases of OOS/RSI. AMT – Adverse Mechanical Tension (sometimes Adverse Neurological Tension) This is where the nerve (in the arm, shoulder etc.) becomes tethered. This means the nerve cannot slide in its protective sheath and so causes pain, tingling, misfiring of the muscles and spasm. The nerve can become tethered due to a pressure point on the nerve or damage to the sheath it runs in. The way this is treated is by a series of stretches for your arms which stretch the nerves and removes/relieves the tethered points. Doing the stretches relieves the pain because it untethers the nerve and allows it to slide freely again. Your Physio will tell you how to do these. He/She should also teach you exercises to mobilize your back/neck as a lot of RSI sufferers have problems here without realizing it and these can cause symptoms in the hands and arms.
The original cause of the tether could be due to muscles being tight and scrunched. This is often the case with OOS/RSI and happens because of the static posture you sit in at a keyboard. As the muscles are tight they press on the nerves as they pass through/around the muscle group. This also results in restriction of the blood supply to the muscles at the microscopic level and this results in your muscles getting fatigued. Eventually the muscles stay in this fatigued state as the never get to relax and have the blood supply restored. Surrounding muscles become tight to support the fatigued muscles and the problem spreads. For further information ask your physio and look at ALL of the RSI-UK archive. The archive has lots of information on AMT, nerves etc.
What i found good for treating my AMT and associated RSI problems was:
1. Learn the AMT stretches and do them as often as you can.
2. Find a good masseuse/aromatherapist to get any knots out of your back/shoulders and try trigger point therapy for any residual pains
3. Learn the Alexander Technique for problems with the back/neck/shoulders and to improve your posture.

Answer 4:  Every time somebody asks these questions I wish I had written a file somewhere with all the information in! Remind me to save this note!
We really need a FAQ — something that doesn’t try to cover everything, but provides some basic information for those newly-diagnosed — very much along the lines of the recent responses. It could include pointers to websites for further information, plus info about joining RSIA, etc.
FAQs, of course, are usually (though not always) associated with newsgroups. There is no group for RSI in the uk.* hierarchy. Personally, I’m doubtful whether it would be desirable to create an RSI newsgroup — it might just end up being a dumping ground for RSI-related spam. However, I’m open to argument on that point. In any event, a FAQ for RSI could easily be posted regularly to uk.people.health. Lots of people might see it, in that way, and thus be made aware of the existence of RSI-UK and all the other RSI resources on the net. And newly-diagnosed enquirers on RSI-UK could be emailed a copy of the FAQ. This would be good, IMO, because although there *are* wonderful resources available on the net, e.g. the TIFAQ, very often people aren’t up to surfing around on the web when they’ve just been hit by RSI.
In addition — the UK newsgroup uk.answers is currently being re-chartered. The revised charter, if approved, will allow FAQs regularly posted to UK newsgroups to be posted also to uk.answers, so that there will be a single repository for UK-relevant FAQs. If this proposal succeeds, then people will be able to subscribe to one newsgroup — uk.answers — and get access to all the FAQs that are now available within the uk.* hierarchy. Pretty good stuff, I think. It would be great to have something on RSI included.
Would anyone (or a consortium of ones) be prepared to undertake the writing and maintaining of such a FAQ?

Answer 5: Good advice from et al, but they are assuming that you have something that is untreatable. Some of the symptoms you describe could be attributable to cervical spine or neural problems that would respond to the right treatment. Talk to your friends and find a physio/osteo who has treated them successfully for problems in the neck and shoulders. Get some advice on neck and general posture when working particularly and have someone look at the layout of your workstation.

Answer 6:  Just going to add my two cents worth, having read your appeal after some weeks away. I support much of what your first respondent said, and anyone else who recommended stretches and postural and workstation changes. Yes, it is important to be sure that there is no specific diagnosable condition that can be ‘treated’ but this is not the most likely state of affairs. Beware of doctors who give the impression that they can test, treat and cure. Mostly, it’s not true.
I have effectively ‘recovered’ or got my RSI under good manageable control after about four years since the serious-crisis patch. I did use voice recognition software during some of that time, but now don’t have to use it very often as I am much better. I think the key things to realise are that you can get considerably better IF you do the right things; and that making the necessary changes in your bodily and neurological make-up is a long haul, I mean months and years. During that long haul, some treatments are needed as others have suggested, and are certainly a prop; I would go with the RSI-trained physio, and also recommend a massage therapist. But don’t bankrupt yourself because most treatments are palliatives at best.
I agree that you need to take a break, but as others have said when you go back to work you will get your symptoms again very quickly unless you have begun to take preventive and body-changing action. If you do a stretch regime rigorously every day for at least half an hour, pace and take breaks, take exercise, make sure your workstation is good ergonomically, and if you can get voice recognition software, you might be able to carry on working pretty soon. Don’t take a break and sit about getting depressed and not doing anything; even if you get better temporarily, you will just get worse when you go back to the machine. Being unfit and stiff is a major irritant to the condition, making it worse and longer to recover overall.
No-one has yet mentioned the two things that have made most difference for me. 1. swimming. I go every day. Not just good for relieving symptoms directly, but opens up the whole body, stretches and exercises it too. 2. Yoga. Must be a GOOD yoga teacher. Puts you in touch with your body and helps identify and focus on the parts which are contributing (in the neck, shoulders, spine, and shallow breathing) to the condition. Stretches and relieves tension, stops inadvertent muscle spasm etc. For me, Alexander — some of whose ideas are very useful — would have been no use at all without yoga and the awareness you gain from stretching and strengthening different parts of the body. Both swimming and yoga are much cheaper than most of the therapies and postural realignments.
my funny bone feels like it’s being hit constantly and my shoulder hurts, and it always feels like I’ve got insects crawling on that side of my neck.
Make a special effort to move the bits that hurt, gently, and/or rub them, to get the muscles to release their toxins. They may have got choked and stopped doing so.
I used to be double jointed in that hand, but now my middle finger especially is not so flexible – it kind of draws in when my symptoms are worst, and I wake up four or five times a night with my hand asleep. Other than that, after I stretch my arm my hand often hurts.
Regualrly stretch your arms and fingers in a gentle kind of way. Probably do it before going to sleep. Don’t not stretch at all because it induces pain, but try to avoid pain; just do it more gently, and stretch all the bits separately so that the blood flow can more freely through them all. Apparently double-jointedness is a risk factor.
One of my friends (whom I was whining to) said this sounded like carpal tunnel or RSI, especially since it’s been going on for almost five years. I didn’t have treatment before because I’ve moved from the States, and as you know, doctoring is mighty expensive there.
In the States people often call RSI carpal tunnel when it is nothing of the sort, in my view because Americans like to have their condition called something technical, or doctors like to call it something that they can charge a large amount to treat. CT is very specific and it is in the hand.  I agree with those who say quit the pills.
I found I get about a half a day’s relief if I go to a beauty salon and get a hot paraffin treatment, but that’s rather expensive…
If heat helps, use it. Bathe your hands or arms in a nice hot basin of water, perhaps with some Epsom salts in it. This would be a lot less expensive than the beauty salon.


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