All About YOU! A Veterans Guide To Surviving Repetitive Strain Injury

Roberta West is a long term sufferer of Tenosynovitis (RSI) of 26 years duration. She is a writer and mother of three sons. She has recently completed her BA (Hons) Literature through distance learning with the Open University in Britain. She was injured with RSI as a secretary in the 'Boom and Bust' housing market industry, of the late 80's.

If you get treatment early, and manage it. Varying work practices, staying relaxed and stretchhhhhhhhhhh­iiiiiiiiiiiiiiiiiiing often, will give you the key to surviving Repetitive Strain Injury. Just don't panic.

With a condition such as RSI you may suffer from a combination of problems that have been put together under this 'Umbrella' term that all too often can lead to misdiagnosis/under-diagnosis and general demoralisation in the sufferer. I would advise anyone who finds themselves suffering from symptoms, to firstly insist on Nerve Conduction Tests, and a thorough examination by a neurologist/physiotherapist/health professional, of all the nerve/neurological pathways in your upper body/tendons/Muscles, in order to arrive an accurate and comprehensive, diagnosis that can then be used to treat you successfully, and most importantly, early in the onset of symptoms.

Such early intervention/diagnosis, will negate the need of the last resort, of eventually requiring surgery. Carpal Tunnel Syndrome, is both an RSI and a nerve damage/entrapment condition that is reported to respond well to surgery, but not all RSI's will be relieved from Carpal Tunnel Release CTR surgery. Mind/body treatments/practice, ultimately use physical manipulation to release tension in muscles and joint areas where symptoms concentrate, (Trigger points/hot spots and are thought to be the most helpful for those that do not/or would not respond to CTR surgery.

On a social level

Most RSI's are generally invisible to the untrained eye, and have in the distant past, been barely recognised by either most Health professionals, or the public at large. However, awareness is growing as occurrence of RSI's in the Work Place increases to alarming numbers today, due to, one would guess, the vast increase in computer based jobs, that require most professions to have keyboarding skills, that in the past, secretaries/typists would fulfil. The office for Official Government Statistics claims no increase in cases of RSI's since 2002, at the height of awareness and increase in cases reported. This may be true, but 200,000 different people per year being afflicted by this painful, and all too often, life changing debility, is a recipe for disaster for future generations. These statistics do not factor in the amount of unreported cases of RSI, by people in fear of losing their jobs. Desk top professionals are everywhere, and everyone, business's and the young in particular, seem to have the iphone, where messaging has been turned into an essential art of the masses and business, alike.

Computer gaming is also thought to be a big contribution to the increase in RSI amongst the young and under forties. Posture has a huge part to play in this aspect of risk of getting an RSI. Despite this, you may find that you have to deal with a lot of people's ignorance and misunderstanding, including from family, extended and otherwise, and from friends too, on a daily basis.

The problem is that if someone can't see the problem, and you don't complain (something sufferers rarely do for fear of stigmatisation or being seen as a moaner to their loved ones and friends/or possibly losing their income/job) then it can all the more easily, be ignored. There is also the anomaly of the condition's intensity of pain variations, according to your hand use activity, on a day to day basis. You could feel fine one day, and think yourself able to weed the garden, for instance, for a couple of hours, and be seen to do this without obvious difficulty. Unfortunately you can often develop (Post Activity Pain) once you rest, and it is usually at the end of the day, where others may not see your painful state. During this post active time, inflammation builds up before it gradually subsides. At this time of heightened pain you can feel unable to do the barest necessities such as holding a cup, or turning a key. These anomalies in your abilities from one time to the next, can often cause doubt in others minds, even those closest to you. This applies to both professional and personal relationships. As a sufferer for the past twenty six years, being originally diagnosed with tenosynovitis with a negative NCT result, I have experienced such doubts amongst the closest of my friends and family, (ALWAYS FORGIVEN) and also a lot of scepticism from a variety of health professionals, tellingly, other than most of my Doctors, who got to know me well, and other professionals such as my main physiotherapist over several years. Emotionally, this, more often than not, unspoken doubt from an observer, can be devastating and psychologically crippling to the sufferer. On top of the physical pain and countless limitations an RSI sufferer may have to deal with, this added indignity can quickly overwhelm, and depression can set in.

RSI is an insidious condition with many layers that will make you cry out loud, but it is surmountable, and treatable, if we don't give up.

For Instant Pain Relief.

Rest is the most helpful. Ice (not directly applied) is highly effective if positioned at inflamed hot spots. (mainly wrists but /elbows/forearms/neck/nerve junctions).

Splints are useful in preventing bending of the wrists, and hence tendon flexor area over the carpal tunnel. This reduces inflammation, whilst enabling continued use of your hands/fingers. It is sensible to limit use as splinting can weaken the muscles, and also encourages 'over use' of hands, which in turn exacerbates inflammation in the long term.

Stress is a major factor in RSI

It stands to reason that if we are stressed our bodies are held in a 'stressed state' that increases pressure around the muscles and tendons through the hands, wrists and forearms, shoulders, neck and back muscles, causing tightness and pain. It is important to find a means of relaxing in order to manage pain of RSI, and/or hopefully, be cured. It depends of the extent of the initial injury, and whether or not it is picked up early, plus, our personal circumstances are hugely relevant. For instance, motherhood can be a time of life that is not conducive to rest, but despite the difficulties and pain, it can still be one of the best times of your life, particularly if you have a loving partner/family/friends as support to help you cope.

The first thing we need to consider is relaxation, and we can all find this in deep slow breathing' that will have you relaxing within a few minutes. This is one of the keys in why 'Mind/Body exercises/practices such as Tai Chi and Yoga can be so successful in controlling RSI symptoms and pain, and ultimately helping in managing your condition, and hopefully, eventual recovery. Movement is synchronised with your breathing. (Stepping (Action) movement (breathe in) sinking into step (slow breathe out. You don't need to know Tai Chi or other Mind/Body practice's, you can simply achieve relaxation by breathing more slowly, consciously, and deeply in this manner. In through the nose (tip of tongue on roof of mouth just behind your front upper teeth) Out through the nose (Breathing out through mouth is recommended for people with health problems relating to lungs/asthma etc.). ((((Whilst breathing, your tummy should be relaxed on in breath, and you should practice contracting the pelvic floor on your exhale)))) This is Tai Chi breathing, and how we all breathed as babies and small children, until we were introduced to 'The System' of School etc. etc., where we were taught tummy IN chest OUT sort of stance/breathing rhythms, especially those of us who were post war and sixties babies. Learning to breath correctly, is the first key to relaxation, but it also energises through increased oxygen throughout the blood stream, that also leads to a slower heart rate/blood pressure.

Emotional Stress Relief

Having a good cry now and again, is also good for relieving stress, don't hold it in or back, just try not to let such emotions build up, by not dealing with them at all, because slowly and surely, those feelings will develop into full blown depression. Think, 'slow and easy exercise'. Do a little, rest enough, do a little more, rest again, above all, take your time. Rushing at things causes stress in the body, and ultimately increases tension and pain. On this level, I think men are affected more than women by their very nature of 'Hunter Gatherer' genealogy.

Regarding family life/relationships - Strong relationships seem to survive, you just have to live a little differently, and your family and friends, be able to accept this, which is easier said than achieved, but no matter what our situation, ignorance and judgements by others, can be one of the most difficult aspects of RSI to cope with. It is insult to injury, but it can also drive a great deal of inspiration your way, if you channel such energy/emotions into positive action, rather than allow it to harm you, your closest loved ones, and in turn your relationships generally. We must always try to rise above whatever prejudices and misunderstanding that comes our way.

Reducing Hand Use

It is always important with RSI, to try to reduce stress on your hands, but particularly in the early stage of your injuries, if, in my opinion, you want the best chance of a recovery.

A well informed Employer,

willing to give you the Time off' you may need to gain a full recovery, is very important, too. This 'Time' will take away unnecessary financial worry of permanently losing your income and employment/career, (I know how that feels) all of which would lead to further stress on your physical and psychological nervous system.

All activity will cause some strain,

so balance is required, and this is where the 'Human' factor, comes to bare, especially if you are a woman. No sexism here, it is just a fact that women have to have things in order around them, and 'Women's work!' is rarely ever finished, so we women in particular, have to change our way of thinking and doing things, if we want to manage symptoms, and increase the chance of a complete recovery. We have to get used to 'untidy' being OK, from time to time, but we also have to keep some semblance of normality in ours and our families lives. However, from the onset of such an injury, the priority should be you. You need to acknowledge from the start of symptoms, that you may never make much of any recovery if you do not reduce strain on your hands and get 'Good' advice with 'Appropriate' treatment, as early as possible.

Work based training and ergonomic tweaking

of your work station, is essential to most Desk Top occupations. Voice activated just isn't the same, and I have found, makes mistakes, that requires longer periods of time at the workstation. Rest breaks/routine change and circulation exercises/moving around from time to time (IE NOT spending one whole hour at one sitting, at a computer.

Slow and gentle stretching exercises

have been the most helpful to my experience of living with RSI. As far as returning to your job if you have to stop work. Having an employer that is willing to be flexible with your working practices, and provide health and safety recommended work stations/and introduce regular training in creating variety in your work routine, will certainly make all the difference to a full recovery and an eventual return to 'Normal' life.

Diet

Eating the right foods has been a revelation to me since I became Gluten Free in the last year, but I have eaten quite healthily prior to this, with some good results in controlling my overall health, which in turn helps me deal with RSI. Inflammation is a factor, and high antioxidant foods, together with cutting out foods that are known to increase inflammation, are well worth investigating. After all, we are what we eat, and if certain foods make you feel in more pain, it would seem obvious to cut that food out, but do your research thoroughly. The internet is full of good intentions, but some of them do more harm than good. Always check with our own Doctor before making drastic changes to your diet.

The most important thing to remember is NEVER give up hope, and always seek help in managing your pain and symptoms. I would add, to try not to rely on Pain Meds 24/7 (Support groups are more helpful) and seeking out immediate pain relief such as stretching/ice. There is light out there, but you could blow it out if you leave it too long. RSI is an 'Invisible Condition' most often related to nerve pain. If left untreated, permanent damage to the nerves may occur.

To sum up, from my own experiences, taking care of 'You' is our greatest key to managing 'Our' repetitive strain injury. We can do it. We must own it, control it and manage it. Ultimately, we can beat it.

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