December 17, 1989

MANY THANKS to the scores of readers who sent me data on repetitive stress injuries (RSIs) during my forced semi-retirement in the month of November. I am successfully healing my hands and wrists from carpal tunnel syndrome and tendinitis, two forms of RSI which are often a direct result of spending too much time typing hunched in front of a computer terminal.

Computer-related RSIs and other high-tech hazards are getting noticed in the real world, and it’s about time. There’s a story on RSI in this month’s Glamour Magazine, of all places, and last month I saw a piece on RSIs in Family Home Circle.

A particularly hefty story on computer-related hazards in the January 1990 issue of Macworld magazine has hit the streets, too. Written by Diana Hembree, who broke the story of widespread RSI among computer users in 1987, the piece details RSI, as well as eye strain and VDT-related radiation concerns.

As a result of such media attention, employers are realizing that RSI is a potentially debilitating disease. Worker complaints are not simply a way to get out of the office a few hours a week (physical therapy being such fun). And some good solutions are emerging from what’s been a confusing goulash of cause, effect and treatment.

Most computer users are scared they have RSI, and want to know the symptoms, which are:
* Wrist aches, especially ones that get worse the more you type.
* Numbness in the hands, usually at night, off the job (a sign of carpal tunnel syndrome).
* Pins & needles in the hands, on or off the job.
* Sharp pains in hands, arms, shoulders, upper back and neck, and/or muscle spasms in those same regions.

Treatment is more controversial. According to a piece by Laurie Garrett, Newsday’s Science & Medicine reporter, the high incidence of RSI in Australia prompted a detailed analysis of the problem, which the Royal Australian College of Physicians caled an “epidemic which has been the most significant public-health issue in the history of Australia.”

The College of Physicians said prevention was the key, and recommended treating RSI by implementing sweeping ergonomic changes, decreasing stress, increasing relaxation, and exercising.

The College strongly opposed surgery of any kind, long-term splinting or prolonged rest, high-dose anti-inflammatory drugs, and injections, though all of these treatments are frequently used in the U.S. Surgery does make the hands highly susceptible to re-injury, especially if you return to the same job and workstation.

Some RSI victims find surgery is too invasive, and shots and drugs don’t help. They often seek out — with varying success — alternative “body work” therapies, including “trigger point” (a pain-relieving technique), acupuncture, chiropractic and a rehabilitation treatment called the Alexander Technique.

But everyone agrees an ounce of prevention is worth a pound of cure, the best prevention being good workstation ergonomics.

The American National Standards Institute prepared a document called “American National Standards for Human Factors Engineering of Visual Display Terminal Workstations.” It’s available for $25 from Human Factors Society, P.O. Box 1369, Santa Monica, CA 90406. Phone (213) 394-1811.
Closer to home, a Menlo Park-based company has devised a handsome booklet and HyperCard stack (with animated exercises) called “Computer Comfort,” that details how to work safely at the computer with less strain on neck, back, hands and eyes.

Authors Melissa Mayfield, Lisa Voge and Michael Heley are various combinations of registered occupational therapists, instructional media designers and programmers. Voge is also a hand therapist and ergonomic consultant to high-tech companies. One book is $8.50, and a book/stack combo is $35, but both get cheaper if you buy in volume (hint to employers). Write to Computer Comfort, 117 Woodland Avenue, Menlo Park, CA 94025.

But good ergonomics or no, RSI sufferers who get well enough to go back to work must acknowledge and act on the reality that RSI has changed their work habits forever. Common sense says those 14-hour stints in front of the screen just won’t cut it anymore.

This is a bitter pill to swallow for people who tend to work for too many hours straight, but I find it comforting. Try as we might to keep up with our ultra-productive, never-tiring machines, computers don’t have nerves that get pinched by swollen tendons. We do, and despite all, I am delighted that the human body has its own way of monkey-wrenching our tendency toward compulsive work.

So if there’s the lesson for computer users in the 1990s: take it easy, or else.