Simple Question?

Question: I got a mild case of RSI by using some bad office equipment. Now, two months on its getting better (I’ve continued to work through it). In any of your experiences is the problem that I have likely to occur again? Am I susceptible to these kinds of problems?

Answer 1: You didn’t have any rest or time off or treatment of any kind? A physio told me (it was thought I’d recovered) that I was as likely to get it again as she was to get it. Well, I got it again. “Am I susceptible to these kinds of problems?” – You could be, I suppose. The real correlation is between overwork of a particular kind and RSI — once called Overwork or Overuse Syndrome — though bad equipment makes it worse.(One condition makes people more susceptible to RSI: rheumatoid arthritis. If people who have that do a lot of typing, they are more likely than people whose hands and wrists aren’t already inflamed to get RSI of some kind.) But the most important thing is to see a doctor quickly. My symptoms were mild: it was thought I’d been diagnosed so early I’d be OK. My hands are now permanently damaged. People do recover and you could be fine, but please get an examination and treatment if you can.

Answer 2: I did see a doctor shortly after the pain began, who prescribed some anti-inflammatory topical cream. But the healing process does seem to be long (2 months+). What surprised me was that in the space of one week I had gone from Ok, no problems to pains in my arms, wrists, hands and numbness/tingling in one finger. As soon as I removed the arm-rests from my chair things started to get better, but now I still have aches in different places in my arms etc.

Answer 3:  I use a topical medicine like that: ibugel BP, though as a pain-reliever. My GP originally didn’t prescribe anything and it was my employers who said I should be signed off work, and when I didn’t get better quickly, even resting, he referred me to a rheumatologist. (The condition isn’t a rheumatological one, but that’s the right referral to make.) “But the healing process does seem to be long (2 months+)”. – Yes. When it was thought I was better, I’d rested my hands and wrists and arms (insofar as that is possible) for some weeks. I’m afraid that isn’t surprising though it’s possible you had symptoms you didn’t notice, or attributed to the wrong thing. I thought my keyboard as giving me static electricity charges, I noticed my hands were getting clumsy, etc. I thought the clumsy etc. was tiredness and overwork, as it was.

As soon as I removed the arm-rests from my chair things started to get better. Some people find arm rests help. I don’t use mine – they’re, luckily, so low-placed I’d have to make an effort to do that! I know they don’t help me. “but now I still have aches in different places in my arms etc.” – This sounds to me like what’s called, unhelpfully, “diffuse” RSI. (I get pains all over the place too, now; but there was and is a definite locus of acute pain.) Really you should be referred on but I know that can be difficult. You do have a right to a second opinion but insisting is I imagine a problem. Seeing a qualified physio – qualified to treat RSI might be a good first step. I’m thinking this through as I write. I’m afraid I’m feeling very low today (if you do: we’re here! I know it’s only me today; I imagine other people will email you later this afternoon). And so I’m being imprecise.

Look. You work, like me. The people you need are the Department of Employment’s Disability Employment Advisers. I probably got their name wrong who work collectively as PACT. There are 2 organizations called PACT, so you might want to ring your local DOEmp office and ask where their PACT is. They assess you. They can give tangible help too. In your case the important thing is that you could get a specialist assessment from one of their physio people. But you do have to wait for that. (PACT is the Access to Work Scheme and it covers people in work and people looking for work.) So though it would be worth talking to PACT anyway – “my” PACT are exceptionally nice. Try to see someone else, preferably through your doctor, as well. If your work involves typing several of us here can give more specific advice and so on.

PS RSI and depression are linked because it is a depressing thing to have. If you get any lack of understanding (I have; and that puts it mildly) email us. If anyone says your pains are psychosomatic this list has the research papers and references that show RSI is real (not that psychosomatic pain is not). I got through because of help from places like this List and because I read a book that talked about the depression and “feelings of low self-esteem and unworthiness” (it’s a good book: it’s just describing the symptoms) and said to myself, “unworthiness?!  it isn’t my fault I got this”.

Answer 4: That’s not to say that there’s no psychosomatic contribution to it, though; being generally stressed (causing a higher level of resting muscle tension, which seems to be a contributory factor to RSI in general) may make it worse, my GP reckons, and I’m inclined to agree. If you’ve never learnt relaxation techniques, it might be worth having a look at them, I guess – have any of you tried this? (I learnt them long before I got RSI; I’d be interested to hear from anyone who learnt them after getting RSI, and found they did or didn’t make a difference then.)

I’d highly recommend cognitive therapy.  It got me out of long-term depression. It tends not to be available privately (I’m cynically inclined to assume that it’s because it takes fewer sessions than the other kinds of therapy) so you have to get your GP to refer you to a psychiatrist who refers you to a clinical psychologist who does the treatment — although to a large extent it’s the patient who does the treatment, with techniques taught by the therapist. A side point: I asked the psychiatrist about whether it’s possible to relearn muscle grip (e.g. through behavioural techniques) and he said basically no: how hard you grip something seems to be pretty fixed for each individual. I’ve always gripped things too hard – pens, bike handlebas, etc. I wonder whether that might have been a warning sign for subsequent RSI.

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