Definition
It is an overuse injury affecting the soft tissues (muscles, tendons and nerves) of the neck, shoulder, upper and lower back, arms and hands.
Incidence
About 15-25 percent of all the computer users across the globe are affected by RSI. About 75 percent of the IT professionals are affected with RSI at some stage of their career.
Why does RSI happen?
RSI happens due to following reasons:
- Improper use of the computers.
- The mouse and the keyboard placed at uncomfortable heights and positions.
- Very hard keyboards or forceful typing over them.
- Height of the monitors kept at uncomfortable levels.
- Improperpostures of the neck and back while working.
- Poorly designed unscientific working chairs.
- Extreme mental and physical stress.
Presentation
RSI is infamous for a varied presentation stumping even a most experienced Orthopedicians. Hence, a high degree of suspicion is required to diagnose this problem. The presentation could range from:
Neck: It can cause acute and chronic neck pains. In the long run, it may predispose to cervical Spondylosis.
Eyes: It may affect the vision and cause irritation and blurring. (It is known as computer eye injury).
Shoulder: Shoulder pain is a very common complaint.
Elbow: It can lead to Tennis elbow, Golfers elbow, pain within the wrist joint, etc.
Forearm: Forearm muscle cramps, fatigue, etc.
Wrist: It can lead to Carpal-Tunnel syndrome, wrist pain, etc.
Fingers: It can cause pain in the fingers. There could be a feeling of tingling and numbnessof the fingers.
Backache: This is a frequent complaint and can affect the upper, middle or lower back.
Stages
Stage I symptoms are seen only while at work and do not persist.
Stage II symptoms persist but disappear with rest.
Stage III symptoms are permanent.
Investigations
Routine investigations like laboratory tests, plain X-ray,CT scan, MRI, etc. are not of much importance in detecting RSI. The diagnosis is mainly clinical.
Treatment:
Preventive Measures
In this condition too, prevention is better than cure. The recommended preventive and awareness measures are:
- Awareness about this problem.
- Proper postures during work.
- Using ergonomically designed chairs.
- The neck, elbow and shoulder should be placed at a comfortable height.
- The height of the computer monitor should be just above the eye level.
- Taking breaks from typing at every five minutes, fifteen and half an hour of typing.
- Taking a short break after every half an hour. Getting up, taking a short walk and sitting against for work is a good practice.
- Neck, shoulder, back, elbow and fingers stretches help to relieve pain and stress.
- Yoga and meditation helps to combat mental and physical stress.
- Keeping realistic goals and philosophical attitude defuses mental tension and prevents burn out.
Curative Measures
Treatment of problems like neck pain, shoulder pain, elbow problems like tennis elbow, wrist problems like compartment syndrome have been dealt in relevant sections! However in the event of pain the following general measures are done.
Drugs: Pain killers like NSAIDs are the d rugs of choice. The more popular ones belong to nimesulides, rofecoxib, valedicoxib, diclofenac sodium, etc. They are preferably taken for short spells and that too after consultation and recommendation from hour doctor.
Physiotherapy: This consists of gentle massage, heat therapies like hot water packs, TENS, ultrasound, short wave diathermy, etc.
Exercises: Once the pain subsides, patient is instructed to carry out suitable neck, shoulder, elbow and finger exercises.
Surgery: This is rarely required.
Health Education
This is the most important aspect of tackling this highly preventable problem. The aspects mentioned in the above columns have to be scrupulously enforced to keep this problem at bay.
Role of the Institutions
Institutions should provide good working conditions and facilities to all its workers. Good illuminati on, recreation facilities, and realistic workloads go a long way in helping the employees cope with this problem.
