Summary topics

Question:  I know this has all been repeated before some time but can I know if you think

  • RSI is chronic pain. My physio is convince that mine is chronic pain which means that there is a pain cycle set up in my head which goes off all the time. She believes this to the extent of not really working with me on trigger points, massage or stretching but concentrating only on pacing (obviously important) and exercise. This annoys me sometimes because I really need short-term relief at times and stretching.
  • The value of pain management clinics
  • Can anyone recommend a good software which forces one to take breaks etc. I used finger time but it stopped working.

Answer 1: Yes, RSI is a chronic pain condition; with a proviso that if you go on doing the thing which triggers the RSI, it is conceivable (not provable) that there continue to be tiny, invisible acute injuries e.g. in the nerves or nerve sheaths. HOWEVER, since the condition is ongoing and not clearly associated with a diagnosable injury, it is classifiable as chronic. Having a chronic pain condition does not AT ALL mean that ‘it’s all in the head’. The pain cycle includes messages sent along from your nerves. (Faulty ones perhaps, instead of the useful alarm system pain normally provides about an acute injury having occurred.) So since they have come from your nerves and are travelling about your body on what I think of as messed up circuitry (because your body’s signaling system is up the spout) why not try to do something about them at different points on the circuitry? Stretching can soothe the nerves and change the messages. Trigger points to me are places where faulty messages have jammed up the muscles’ normal working processes. No question that stretching helps things, and trigger point therapy too. After a massage therapy or a 2-hour yoga class, I have much less pain for at least 2-3 days. No question. It also raises the whole threshold at which pain may start.

I went to one pain management clincic, INPUT at St Thomas’, and all I can say is that I and others on my course got a lot out of it, including understanding. Two other people with me on the course thought it turned their lives – especially their approach to their RSI and their mood around entirely. The INPUT course certainly stresses stretching (as well as pacing and exercise,) they use a holistic approach which also looks at thoughts and feelings. The physios there definitely encourage stretching and exercise as the physical side of the pain management programme. Note pain MANAGEMENT, not pain relief. I use a timer (as taught by the pain management people).

Answer 2: I think Finger time stopped working and another one is needed. Definitely use a small timer, it is more reliable.

Answer 3: Some of the keys in dealing with chronic pain are stretching and massage. Oh, so important! RSI is caused by many things but stretching is important to get the muscles relaxed and ready to take on the new pacing schedule. Massaging trigger points is a good way to alleviate shoulder and arm (and other spots) problems/pain, that contributes to RSI. Good posture is crucial and I hope you are taught postural exercises to keep your shoulders and arms where they should be (your whole body should be in a good posture when you sit down at a computer. Exercise to strengthen your body so you can keep your good posture naturally without thinking about it. For short term relief, relax and stretch. Yoga is fantastic. Are you doing any neck stretches? Neck stretches have been very useful for me in managing pain. You will get better.

Answer 4: I have mentioned it before, so I won’t go on. I use a product called ‘WorkPace’ which is from New Zealand. It is very configurable for length of breaks, when they happen etc. I think there is a 30 day evaluation copy from their web site By the way, their web site address is (Niche Software). I have no connection with this company or product other than using it!

Answer 5: Just to add my voice briefly: My physio has said similar things, but her p.o.v. was that I was to change my mentality towards my condition, which was a bit passive and erratic. She thought that the small amount of relief to be gained from massage/trigger point stuff etc was not really worth much if that was all that I was doing to cope. She said I had to gain control of my body, by doing lots of aerobic exercise and stamina building activity, along with paced activities around the house (such as washing up 3 plates a day, progressing to 3 plates and a small saucepan and so on), and that by going to see someone once a week, to ‘take the pain’ away could almost be counterproductive as I would rely on that external aid rather than healing myself.

Can I just say though that I thought she was brilliant and the best person I have seen and she helped me a lot to understand what was going on and the holistic approach that is so necessary to cope with it all. And finally, I AM seeing someone weekly, he’s an Alex. Tech. teacher and I think that has had an ENORMOUSLY beneficial effect on my body, in conjunction with the new exercise regime and mental attitude. Am still hopefully going to see a physio who does trigger point therapy through my GP, because I think it WILL help me to help my body, but not as the be all and end all treatment to be relied upon.

Answer 6: My fingertime programme stopped working too. After 3 months. Very odd.

Answer 7: If you are going to a pain management clinic make sure it does pain ‘management’ not just pain relief. If the clinic has a clinical psychologist on the staff then you are probably OK. They will tend to be at the larger hospitals, probably the teaching hospitals.

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