It worries me greatly that there is a consensus that stress is psychological, developing on this list. Stress can be physical quite as much as psychological and we do well to always allow for that fact. Too many people are unhappy about believing that stress is a very (if not the most) important causative factor in RSI/WRULDs. They seem to see it as something they ought to “snap out of” or “it’s all in the mind”. Let me give you a clear for instance which is from outside the RSI area. My wife had a benign tumour in the bone of one hand and had an operation to remove this. She is a coeliac – that is, she is intolerant to gluten, found in wheat, oats, barley and rye. Despite her holding her diet totally gluten-free for the whole period, she had severe coeliac symptoms for nearly two months. This caused by the “insult” to her hand. The doctors had not thought to warn her that this would probably happen – but they are not coeliacs themselves. The point is that stressors are stressors, whether they are physical injuries, cold, heat, pain or psychological. RSI hurts just as much whatever the cause but let’s get away from the idea that “stress” is a negative word and that one shouldn’t admit to it as a primary cause.

Comment 1: I have been giving talks on “stress” to cancer support groups recently. It seems that many of them feel blamed by others for their own cancers – “you must have been festering inside for years, and now it’s happened”. This is the downside of “new age health”! One person at my talk was quite massively relieved when I explained my view that “stress = being ready to act for too long without a rest”, and that this can come about from poor job design just as easily as it can arise from prolonged emotions (or to put it another way, readiness is emotional). Many people still think that “psychological” means “not real” – not realising that as soon as you get ready to do something, real physical events begin in your body which if sustained for long periods are precisely the same as “stress”. Not at all harmful if it cycles readiness – let go – readiness, but not good for you if you’re always one or the other.

Comment 2: Firstly let me establish the fact that I believe that the majority of people who come to me with RSI and associated disorders are suffering from a primarily physical condition. Secondly, that I find that physical signs and symptoms are the predominant factors in the majority of cases. However, ‘psychological’ factors can have a bearing on the problem albeit, a secondary influence. Stress in the lay sense can be defined as combination of several factors:

  1. Excessive sensory input e.g. noise, heat, cold, light, smell, touch and interruptions.
  2. Frustration, when a person finds themselves in a situation where they can neither proceed, retreat or stay where they are. This can apply to long and short term life decisions as well as to the physical world.

A combination of these two stressors results in a rise in the adrenaline levels as a short and long term response. When the adrenaline levels are raised the reflex threshold of the nervous system is altered whilst that state persists. This means that muscles become tenser, pain is amplified and more easily triggered, and mood changes can become more sudden and extreme. Another interplaying factor can be a persons’ habitual response to pain, this is generally conditioned whilst a child by parents either reacting calmly or by panicking when we, as children receive an injury. This factor can combine with negative outcome expectations with regard to their ‘problem’. This latter factor is conditioned by the negative attitudes of peers, doctors, and authority to the potential cure or the disorder. It is a trauma in itself to have sought treatment to no avail, furthering conditioning our response to the disorder. So you can see that if a person is suffering from physically induced RSI symptoms, that their psyche, as a composite of the above factors, can amplify the problem. These observations are based on 20 years of treating people in pain of all types.

Comment 3: *Personal opinion with the weight of many years experience in Health and Safety.* One thing that is worrying me is the strong tendency – clearly visible on this list and rampant elsewhere that stress is in some way psychological and therefore not somehow “real”. Stress is a physiological reaction in the body and can cause huge damage. Stressors can be psychological and social but they can also be physical – cold, heat, draughts, glare and so on. Excess stress tends to cause the body to fail at its weakest point. This can be a genetic weakness (my wife’s coeliac disease became expressed after several years of unremitting stress), or particularly where a part of the body is already being mechanically affected, this may break down at that point. RSI being a possible candidate for this mode. The problem is that taking the stress away will not necessarily heal the problem, because the stress has acted causally as a trigger factor, not a direct acting cause. Now let me remind you that I am NOT medically qualified, so this is only my opinion but I’m not just “the man in the street” either. I’ll be happy to debate around this with others on the list, as this may help to confirm or deny my ideas.

Comment 4:  “Stress is a physiological reaction in the body and can cause huge damage”. Absolutely. Anyone who doubts it should read Hans Selye’s book, “The Stress of Life”, which describes in careful detail the precise physiological effects of stress on animals. However — although I agree with you that stress is real and causes real damage, unfortunately the word has other, coded meanings, and some doctors do use it in that way. If a doctor attributes RSI to stress, it’s all too likely that he does not mean “Your work has caused stress to your body resulting in physiological damage.” He probably means it just the way it’s heard: “RSI rubbish, you just can’t cope with the ordinary pressures of life.”

That’s my view, at any rate. A doctor who does mean stress as a cause of physiological damage should be careful to make that clear when he uses the word. It’s too loaded for professionals to go around using it without explaining themselves. Just to indulge in a little more unsubstantiated opinion. I reckon that if you think your doctor is implying that it’s all in your head, he probably is. I think that with RSI, very often removing that particular stress does indeed solve the problem. Going by what many people have reported on the list over the years.

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