over & over again

Vegetarian Times, May, 2001 by Trisha Blanchet

How to relieve--and prevent--repititive strain injuries

After Alisa Strauss completed graduate school, a lengthy internship and a two-year stint as a reporter, she was elated to land her dream job as an editor. But almost as soon as it had begun, Strauss' promising career came to a crashing halt. It wasn't a lack of talent, enthusiasm or drive that held her back--it was her wrists.

Strauss was suffering from repetitive strain injury (RSI), the result of endless hours scribbling notes and banging away on the keyboard. The condition caused severe pain in her wrists, arms and neck and eventually left her unable to type or even hold a pencil.

At her doctor's urging, Strauss decided to leave her editor's job and now works as a teacher, freelance writer and human resources professional. She is treating her condition with acupuncture and a body-movement therapy method known as Feldenkrais and hopes one day to return to her chosen field. "I'm one of the lucky ones, because I'm recovering," she says. "I got the right help."

RSI is a modern condition, the flip side to the time- and energy-savings of computers and other machinery. Relatively unheard of 15 years ago, it's the fastest-growing medical complaint of office workers. According to the Occupational Safety and Health Administration (OSHA), some 600,000 RSIs annually force workers to take time off.

While Strauss' case is severe, millions of journalists, musicians, computer technicians, machinists, athletes and assembly line workers have found themselves in the frustrating situation of being unable to stop the onward march of RSI pain. Part of that frustration comes from the fact that conventional medicine's solution to the problem is often surgery, the results of which can be short-lived. "Conventional medicine just doesn't seem to have much to offer in this area," says Strauss. "And believe me, I've looked." As a result, many are fighting back with alternative therapies designed to reduce strain on the joints, ease muscle tension, stretch tightened tissues and heal the damage wrought by repetitive body motions. "In my opinion, alternative medicine is the best way--the only way--to treat RSI," Strauss says.

It Bears Repeating

Repetitive strain injuries encompass a host of conditions, including the well-known carpal tunnel syndrome (compression of nerves in the wrist) and tendonitis (inflammation of the tendon). But they also include lesser-known ailments, such as tenosynovitis (inflammation of the tendon sheath) and thoracic outlet syndrome (injury to the nerves and blood vessels of the neck and shoulder). According to the Bureau of Labor Statistics, RSI accounts for more than one-third of all workplace injuries--and the percentage is growing every year. In November 2000, OSHA issued a standard requiring employers to provide information about RSI to all employees, including signs and symptoms, risk factors and suggested preventative measures by October 15, 2001.

Nevertheless, workers continue to flock to doctors' offices complaining of aching, tender and swollen joints; tingling or numbness in their hands, wrists or arms; decreased upper-body coordination, muscle spasms; and shooting pains. "Some of my patients say it feels like their arm falls asleep every time they try to use it," says John A. Prokopiak, a chiropractor at Pro Health Centers in Sarasota, Fla., who specializes in RSI. "The constant pressure and tension of repetitious activity does a lot of damage. Pretty soon, your body just can't do what you ask it to do." Fortunately, there are ways to combat the condition.

Rx for RSI

There are no easy answers to the RSI dilemma: Just as few people can agree on a precise definition for this ailment, so do few doctors and practitioners agree on methods for its treatment. Yet many RSI patients have found that the combination of alternative therapies, along with a strong resolve to get well, is what often yields the best long-term recovery results. "There's no pill, no drug and no surgery for this that really works," Prokopiak says. "Most carpal tunnel surgeries provide only temporary release from pain. Patients tend to focus only on the point of pain, but you have to treat the whole body to heal RSI, and it's a long-term process."

"Muscles are surrounded by connective tissues," Prokopiak explains. "These tissues slide against each other and allow each muscle to function independently. But when muscles are used repetitively, the connective tissues become scarred and rough, making them sticky--not slippery as they should be." This causes a buildup of pressure and tension in the muscles, which in turn reduces their blood supply and puts a painful squeeze on the nerves.

Prokopiak believes the root of RSI lies in this compression of muscles and nerves and says a massage-like therapeutic approach called Active Release Technique (ART) is the most effective. The technique was developed in the mid-1980s by chiropractor Michael Leahy in Colorado Springs. Though ART practitioners primarily use the therapy to treat bodybuilders and other athletes with sports injuries, they have recently realized its potential to successfully treat RSI conditions as well.