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In the Danger Zone

PC users risk their health and careers every time they sit down to work

by Saleem Khan

Pain.

The pain awakened me. The searing hot, electric bolt of a blade slicing open my forearms, gouging through the unyielding bone of my wrists then snaking up the centre of my palms to my fingertips. Atop my arms steel bristles scraped my skin, the tendons along the back of my hands riddled with thousands of shards of glass. Every movement sent a jolt coursing through my wrists as though spikes were being pounded into them.

I looked at my limbs. Both were almost cartoonishly swollen and red, the right more than the left.

Rolling to a sitting position in my bed, I reached for my watch on my night table to find I couldn't pick it up -- I could barely move my fingers.

I was suffering from a repetitive strain injury.

That was the experience of one person afflicted by an insidious, silent epidemic stalking office workers, students, and technology professionals throughout North America. Read on to learn how avoid becoming a victim.

What is RSI?

Repetitive strain injury (RSI) is a catchall term for a range of motion-induced disorders that result from damage to muscles, nerves and associated tissues through prolonged, repeated activity. RSI goes by several other names, including repetitive motion injury (RMI), musculoskeletal disorder (MSD) and cumulative trauma disorder (CTD), but regardless of what it's called it is the number one occupational health hazard for journalists, high-tech workers, and other vocations that require people to spend a significant amount of time engaged in repetitive tasks.

It is currently thought RSIs afflicted people at least as early as the 19th century, when the condition was diagnosed as arthritis. Other forms of RSI that may have been misunderstood in the past include writer's cramp, tennis elbow, Pac-man Thumb, and Breakdancer's Neck.

Today, the cumulative effect of repeated, prolonged sessions of computer use by millions of people can account for the burgeoning ranks of the injured.

The US Bureau of Labor Statistics counted RSIs as 18 per cent of all occupational illnesses in 1980, a number that nearly quadrupled to 66 per cent by 1998.

According to Statistics Canada's discontinued Canadian National Work Injuries Statistics Program, the number of work-related injuries has been dropping by about 10 per cent a year since 1990. But cases of Carpal Tunnel Syndrome (CTS) alone have jumped at almost twice that rate, from more than 1,300 reported in Ontario in 1990 to almost 3,600 in 1996. (The NWISP's activities are now conducted by the Association of Workers' Compensation Boards of Canada).

As shocking as these statistics seem, the actual incidence of CTS and other RSIs is likely much greater -- it is estimated just one out of every 10 cases of RSI is reported or identified. There are two major reasons for this deficiency in reporting:

In both the USA and Canada, there is no standardized national, state, or province-wide system for reporting work-related RSIs, so occurrences are often lumped in with other statistics. Illustrating this reporting problem, the Ontario Workplace Safety and Insurance Board (formerly the Workers' Compensation Board) statistics for CTS conflict with those from the Canadian National Work Injuries Statistics Program. The WSIB cites 1,044 claimed occurrences in 1990, rising as high as 1,451 in 1993 before dropping to 969 in 1996.
People often don't realise they have a problem; they feel fatigued and think they just need more sleep, need to change their diets, or are tense due to stress. There are no obvious early warning signs, so by the time an individual realizes something is wrong, it is often too late to prevent serious damage.

In the USA, the Occupational Safety and Health Administration (OSHA) counts the cost of RSIs at more than $20 billion in workers' compensation claims annually, and an estimated $54 billion a year for indirect costs such as lost work time and productivity, and training replacement employees when a worker is injured. Similar statistics for Canada were unavailable.

Source: IBM

Recognizing risk

There are a wide variety of RSIs, but one of the most common is Carpal Tunnel Syndrome.

CTS occurs when the median nerve, which runs from the arm to the hand through a passage in the wrist called the carpal tunnel, is pinched by inflamed muscles and tendons surrounding the tunnel. This tissue damage can easily be caused by performing routine task on a computer, such as typing, and mouse-clicking.

The onset of CTS or any RSI can be accelerated by stress -- a common condition in today's fast-paced, high technology work environments.

Poor typing posture over sustained periods -- also commonly enforced by inadequate workstation arrangements -- are also contributing factors. Dim, blurry monitors set at a low angle, and ill-placed keyboards and mice can leave workers hunched over, trying to read the text on the screen as their hands hook above the keyboard to type.

Warning signs of an oncoming RSI are frequently difficult to identify since they are so similar -- and attributable -- to common illnesses and complaints, such as colds, flu, poor diet or fitness, and so on. General stiffness and soreness that migrates to other parts of the body, tension, soreness and occasional sharp pains or low-grade burning are all easily dismissed by people as unrelated aches.

Remedies for RSIs can include discontinuing the physical activity that caused the injury, taking anti-inflammatory drugs, splinting the injury, acupuncture, physiotherapy or heat therapy, and even corrective surgery.

Preventing RSIs

There are are number of steps you can take to avoid developing an RSI.

Talk to an expert. Discuss RSIs with your doctor. He or she may be able to give you advice or refer you to an ergonomist, physical therapist or doctor who specializes in RSI treatment and prevention.

Mom was right. Good posture is important! When you're at your workstation, sit up straight in your chair with your feet flat on the floor. When you type, your shoulders should be relaxed, your wrists straight and in line or slightly lower than your elbows.

Get comfortable. Set up a good workstation. Ensure you're comfortable so you don't have to stretch or strain to see or reach anything, and that your setup doesn't promote poor posture. You don't need to spend hundreds or thousands of dollars on a fancy chair -- most doctors say any chair that provides good lower back support, combined with a work surface that allows you to keep your upper body relaxed is enough -- but a well-designed chair (like the Geartest.com reviewed Aeron chair) can be an investment in your health that is worth considering.

Use your brain. Make your computer work for you. Leaning in to read dirty screens and blurry picture tubes ruins your posture. Place your mouse and keyboard where you won't have to reach for them. Dr. Alan Hedge of Cornell University's Ergonomics Lab has found that a decent chair and a keyboard tilted 15 degrees away from the user virtually eliminates the key factors that cause computer-related RSI

Stay warm. The cold causes muscles to contract and fall prone to repetitive strain injury.

Stretch it out. The value of stretching and strengthening cannot be overstated. Ask your doctor or therapist to teach you the best stretches and strengthening exercises for the parts of your body that have been weakened by either underuse or overuse. If you don't stretch, the exercises won't help, and may even cause harm. Lifting even light weights may worsen an injury, especially to the forearm and wrist.

Shape up. The value of general health and fitness in combatting RSIs cannot be overstated. Exercise, eat right and get plenty of rest. One or two hours of light exercise a week can have a significant effect on your general fitness, as can eating healthily. There is some evidence B-complex vitamins can lessen one's risk of developing a RSI.

Break it up. Take breaks often -- at least five minutes for every per 30 to 45 minutes of work. Use some of your break time to stretch areas of your body that feel tight. Do some isometric exercises or take a short walk to stretch your other muscles.

Journalist Saleem Khan is working on a book about RSIs. A version of this column appeared in the Spring 2000 issue of MEDIA magazine.