It's Not Carpal Tunnel Syndrome! RSI Theory and Therapy for Computer Professionals News & Views Book Review

by Al Brown Al Brown is a senior editor at Oki Data, a senior member of STC, and a junior member of AARP. Originally published in News & Views July 2000 issue. Copyright 2000 STC-Philadelphia Metro Chapter. For permission to reprint this article, contact the Managing Editor.

Our local NPR station's new program for the over-fifty crowd, "Been There, Done That," has a segment on the Failing Body Part of the Week. You may be a long way from membership in the AARP, but your work habits and conditions can make some of your body parts fail prematurely. It's Not Carpal Tunnel Syndrome! provides some useful information on how to prevent that from happening. The authors define RSI-Repetitive Stress Injury-as "muscle pain or nerve problems of the hands, arms or shoulders...believed to be caused by overuse." It can manifest itself in many ways: numbness, pins-and-needles sensations, or soreness in joints, muscles, back, or neck, which range from mild discomfort to complete inability to work. Injury, according to this book, results from repetitive work at the keyboard in one position over a long period of time. Stress and fatigue cause posture to collapse forward, inflaming muscles and thereby pinching nerves and blood vessels, causing your body to accommodate, which leads to fibrous tissue build up that binds nerves, resulting in...well, you get the idea. Being the perfectionists we are, we're too absorbed by internal and external demands to notice minor discomfort until fingers go numb on the steering wheel, pain in an elbow or shoulder wakes us up, or the mouse hand gets sore. Judging from this book, the research in this area is mostly anecdotal, and the larger picture is not well understood. A doctor's diagnosis, then, focuses on symptoms-hence the emphasis on carpal tunnel syndrome, which in its narrowest technical sense is rare, but which acts as a surrogate for any discomfort in the wrist. Treatment of these symptoms with drugs, wrist braces, and even surgery, will produce some relief, but the problem will return in time, because the complex of the disorder extends beyond the specific site of discomfort. The authors' general approach is to avoid any treatment that addresses only the specific symptoms, because that does not produce any meaningful improvement. A well-qualified physical therapist is a better bet. The section on therapy is perhaps the most thought-provoking and useful part of the book. It provides information and suggestions you can use even if you haven't been convinced by this time that every part of your body between your hips and your chin is atrophying. A physical therapist can use specialized massage techniques to eliminate muscle spasms and "trigger points" that press on nerves. There are also many exercises you can do on your own, such as "Glide" exercises to free entrapped nerves, and strength and endurance exercises, as well as warm-up and flexibility work. A lot of what the authors say about posture will remind you of your mother's complaints, but some of the ideas about how to make your workplace less hostile may come as a surprise. For example, using a wrist rest may put pressure on a nerve. Over the long term, touch-typing can put more strain on your hand than typing with two fingers, which requires you to move the whole arm instead of just reaching with the fingers. Efficiency may be hazardous to your health. The section on theory covers in considerable detail the anatomy of RSI, as well as its numerous identified subsets, such as tendonitis. The final section adopts an activist stance, giving guidelines on how to promote RSI awareness and prevention in your workplace. In a departure from most books, references appear in the middle, between the section on theory and the one on therapy. Why? Because you should learn as much as you can about the condition before you decide how to deal with it. That includes evaluating alternative approaches. This may seem unorthodox, but it puts information where you need it, and encourages you to test the book's ideas against others. I'm skeptical of panaceas, and the last thing I need is another set of rituals to add to the exercise, diet, computer virus, and political correctness exorcisms that rule our lives these days. This book presents a commonsense approach to a potential problem we all face by virtue of the kind of work we do. At the very least, it's worth a few minutes to check out the authors' web site-www.RSIProgram.com-to decide how much of their information you want to take to heart. It's Not Carpal Tunnel Syndrome! RSI Theory and Therapy for Computer Professionals, Suprana Damany and Jack Bellis. Simax 2000. ISBN 0-9655109-9-9 $19.95.

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Last updated: October 10, 2000 (mvh)