Repetitive Stain Injury. - Review - book review

REPETITIVE STRAIN INJURY A Computer User's Guide Emil Pascarelli, MD, and Deborah Quilter. 1994; 218 pp. $17.95. Wiley & Sons, Inc.

I have had RSI (repetitive strain injury) for three-and-a-half years, and for about eight months had no diagnosis. I've used computers for much of the last thirty-five years. At the beginning, I could only type for ten minutes without significant pain. The thing that helped me most was the Sorehand e-mail discussion (listserv). It is a high-traffic list, with a number of dedicated people who are wonderful resources. There are ideas for books to check out, equipment, software (PowerClicks--lets me use keys instead of mouse clicks in some programs, not all). I've followed discussions of voice-recognition software; Alexander, Feldenkrais, Tai Chi, Hellerwork, and other kinds of body work; kinds of chairs; dealing with Workers Comp; magnets; chiropractors; the medical system; herbs; green tea; how to stretch; strengthening programs; keyboard shortcuts; the foot mouse; etc. There is a searchable archive.

Repetitive Strain Injury (it is often called "the Bible" on the Sorehand list) gives a wonderful overview of RSI, some ideas for gentle treatments you can use (and when not to), and a basis for talking to a doctor. The chart, "The Continuum of RSI," can be very reassuring or very sobering, depending, but it helps people understand how serious their situation could get. I posted pages of the book in my cubicle, used the ice massage, stretches, stopped using splints. And felt much better about seeing a doctor.

"Once people have damaged their soft tissues, they are always at greater risk for reinjury or chronic bouts of RSI. RSI can be prevented through education, ergonomics, and enlightened job design. RSI is far easier to prevent than cure, and if people don't heed this warning, all of society will eventually pay because its tax dollars will have to support permanently disabled people who otherwise would have led productive and self-sufficient lives.

THE CONTINUUM OF RSI

          Pre-RSI               Early RSI

Symptom   "Funny" feeling       Intermittent
          in arms or            twinges of pain
          hands.                or tingling while
                                typing.
Outcome   Relieved by rest.     Relieved by rest
                                and rehabilitation.

          Danger Zone           Chronic Pain

Symptom   Weakness,             Weakness,
          clumsiness;           constant pain,
          pain intermittent     not relieved
          but not necessarily   by rest; made
          relieved by rest;     worse by any activ-
          daily activi-         ity; disability.
          ties impaired;
          depression.
Outcome   Moderate risk         High risk of permanent
          of permanent          impairment.
          impairment.

          Complex Chronic Pain;
          Reflex Sympathetic Dysfunction

Symptom   Chronic pain; RSD, dystonia;
          severe depression.
Outcome   Permanent disability.

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COPYRIGHT 2001 Gale Group