Question: I’ve now read this. It’s a bit inconclusive (the work being reported, that is, not just the article). Most of it is about a specific (and least prevalent) form of RSI called focal dystonia, which causes clumsiness and dysfunction, but no pain. (BTW they report that this disorder has been experimentally caused in monkeys by forcing them to perform fast repetitive actions to get any food). Brain scans etc show that this condition of the hands seems to be caused by the brain getting confused and scrambling its neural map of the hands/nerves/tendons/muscles. Applying this finding to humans with focal dystonia, extensive ‘re-education’ (specific physiotherapy, essentially) enables the brain to reprogram itself and sort the problem out . . . success with 14 out of 16 patients after 12 weeks of therapy.
But what about the painful conditions the rest of us suffer from . . . ?? The experimenter concerned thinks (insufficient hard evidence yet) that similar mechanisms may be at work in other forms of RSI, and also in the registering of pain (ie: the brain starts to register as painful things which ‘shouldn’t be’) . . . . but other researchers disagree and think that most forms of RSI aren’t like this at all. The experimenter tried her re-education programme on 4 computer users and 4 sign language interpreters with ‘overuse’ RSI and pain, and within 3 months, she says, all had improved dramatically. Coincidence? Placebo effect? repaired brain map? . . . asks the article.
‘The Strain is in the Brain’
New Scientist_, 10/4/99, pp 26-30
Nancy M. Byl
‘A primate model for studying focal dystonia and repetitive strain injury’
Physical Therapy_ vol 77 (1997) p 269 *
William Bara-Jimenez et al
‘Abnormal somatosensory homunculus in dystonia of the hand’
Annals of Neurology vol 44 (1998) p 828 *
Victor Candia et al
‘Constraint-induced movement therapy for focal hand dystonia in musicians’
The Lancet vol 353 (1999) p 42 *
*[sorry, they don’t give the full pages run in the NS footnote!!]
Answer 1: Oh *terrific*. I just hope they managed to unscramble the monkeys… But what about the painful conditions the rest of us suffer from . . Hear hear! Well, I would probably improve, but then, I’ve had no treatment whatsoever ever, and *still* can’t get referred back to a specialist: so any kind of medical attention *at all* would probably help me 🙂 — it was such a small study that she couldn’t have controlled for previous treatment and care etc., but really, she should.
Answer 2: I find this very interesting. Personally, I think RSI is more than just physical because of repetitive movements. My ‘hypothesis’ is, it has to do with electromagnetical influences as well. This weekend I saw on television that some experiment has shown that mobile telephones cause the brains to warm up a little, and as a result to act faster. I think the computer environment influences the nerve system in some way. ‘Carpal tunnel’ is nonsense, in my view. How could the tunnel be too small, suddenly? I am glad I refused a surgery! I feel sure research should not only give attention to the physical aspects, but to the nerve system as well. It is Monday morning now; I came into the office half an hour ago and right now I feel the soft pain in my eyes from the lights and the screen, and the tickling feeling in my arms as soon as I approach the keyboard. Are there any researchers
reading this? I am curious, what do you think about research on the nerve system and brains, connected to RSI?
Answer 3: One advantage of this type of research is that it shows that RSI‘s are not only to be seen as single injuries to certain structures at fixed points (as in nerve impingements), but also lead to other sometimes more systemic reactions. Reactions we do not always understand yet (as in RSD or cortex changes). But it sure would have implications for prevention, diagnosis and (multidisciplinary) treatment.