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Wear and Tear - preventing repetitive stress injury in the workplace
American Fitness, Jan, 2001 by Carol Krucoff, Michell Krucoff
How can you prevent repetitive stress injury in the workplace?
Repetitive stress injury (RSI) has been called the workplace epidemic of the modern age. A disabling ailment whose symptoms range from minor pain to loss of function in the affected body part, RSI affects millions of people who spend long hours at computers, switchboards and other worksites where repetitive motions are performed--typically hand-intensive exercises such as keyboarding or cutting. Two of the most common RSIs are carpal tunnel syndrome and "mouse elbow."
Carpal Tunnel Syndrome
More than 5 million Americans suffer from carpal tunnel syndrome, one of the most common conditions affecting the hand and wrist. The ailment occurs when the median nerve (the major nerve that carries the impulses from the brain to the hand) becomes compressed. The median nerve begins in the neck and runs underneath the collarbone, across the armpit and down the full length of the arm before it passes through a narrow passageway in the wrist called the carpal tunnel. The tendons that enable the hand to close also pass through this passageway. When these tendons are stressed due to repetitive motions, they swell inside the tunnel and compress the median nerve. This results in numbness, tingling, pain and burning sensations in the hand, often accompanied by clumsiness. Symptoms often begin in the wrist and move down into the thumb, index and middle fingers or back toward the elbow. Sometimes there is associated pain in the arm and shoulder. Frequently, sufferers awaken in the middle of the night with discomfort or a "pins and needles" feeling in the hand.
Other conditions associated with swelling and compression of the median nerve include pregnancy, diabetes, kidney problems, hypothyroidism, rheumatoid arthritis and obesity. Women are more likely than men to get carpal tunnel syndrome; they may be more vulnerable because they have smaller wrists than men but tendons that are the same size. Also, hormonal fluctuations of the menstrual cycle can result in fluid retention, which can cause wrists to swell.
Mild cases of carpal tunnel syndrome may be treated by wearing a brace or splint at night to allow the wrist to rest and, in turn, shrink the swollen membranes and relieve pressure on the nerve. However, wearing splints by day is controversial, because some physicians believe this can cause the muscles to atrophy and lead to further problems. Medications may also be prescribed to help reduce swelling. Since specific motions can help relieve pressure on the median nerve, exercises can also be essential in preventing and treating carpal tunnel syndrome.
Severe cases of carpal tunnel syndrome may require surgery to release the pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel. An estimated 240,000 such surgical procedures are performed each year, but they are controversial and considered by many to be a last resort procedure since many people continue to have some symptoms, such as pain or loss of grip strength, after the operation.
Mouse Elbow
"Mouse elbow" is an increasingly common RSI in which elbow pain is experienced after long hours of clicking the computer mouse. Like its sport counterpart tennis elbow, mouse elbow is an inflammation of tendons in the elbow--specifically the lateral epicondyle of the humerus, which forms the origin of several muscles in the forearm and hand. Typically caused by low-grade, repetitive overuse, mouse elbow can also result when a single trauma initiates a small tear to the tendons. The ailment is associated with motions that combine rotating the wrist with applying force, such as in using a screwdriver, golf club or tennis racquet.
Mouse elbow can take a long time to heal since tendons don't get much time off to rest and have a modest blood supply. Treatment includes medication and ice massage to reduce inflammation, wearing a tennis elbow band for support, and doing exercises to stretch and strengthen the muscles of the forearm.
Preventive Measures
Badly designed computer workstations heighten the risk of RSI. Since prevention is the best cure, be sure to:
* Keep the monitor straight ahead of you, about an arm's length away, with the center of the screen positioned where your gaze naturally falls (typically a few inches below eye level).
* Adjust keyboard height so the forearms, wrists and hands are aligned parallel to the floor or bent slightly down from elbow to hand. Don't let the hands bend back.
* Position your mouse within easy reach, directly next to and on the same level as your keyboard.
* Don't rest your wrists on anything while you're typing and don't bend them up, down or to the side.
* Adjust chair height so your thighs are parallel to the floor. If your feet don't touch the floor, place them on a footstool. An ergonomically designed chair with good back support may also be helpful.
* Sit with good posture, keeping your spine against the back of your chair and upper body in a relaxed, comfortable position-without slouching.
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