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Monday, October 25, 2010

Repetitive Strain Injury( More common for computer users)

RSI
Repetitive Strain Injuries [In INDIA its commonly known as Computer Related Injuries(CRI)] is an umbrella term used to describe a collection of overuse disorders that affect the muscles, tendons, fascia, and neurovascular structures, typically in the neck, back and upper limbs, though virtually any part of the body, including head, jaw, chest, eyes, vocal cords and legs can get affected.

COMMON SYMPTOMS

Discomfort, fatigue or pain.
Swelling, redness, coldness or warmth.
“Catching” or “snapping” with movement.
Loss of grip strength, heaviness or clumsiness of the hand.
Stiffness.
Burning, numbness, tingling.
Visual strain.
The injury accumulates slowly leading to difficulty in day-to-day activities such as shaking hands, opening doors, holding newspapers, using a comb, or even holding a tea cup.
High Risk Groups
  • Computer Users
  • Musicians
  • Health Professionals: Surgeons, Dentists, Nurses, Massage Therapists
  • Laboratory workers
  • Teachers
  • Manual Labourers, Assembly Line Workers
  • Check out clerks
  • Hairdressers
  • Butchers
  • Sportspersons
  • Children
  • Housewives
Prevalence
  1. 15-25% of all computer users worldwide (both vocational and recreational) are estimated to have RSI. By this estimate, over 5 million Indian computer users (out of an estimated 28 million) may already be having RSI.
  2. RSI accounted for 66% of all work-related illnesses in USA (1999).
  3. A survey of 500 software professionals at Hyderabad in 2000 revealed that over 50% had symptoms of established RSI.
  4. Preliminary results of our ongoing prospective study among over 35,000 Indian computer professionals (2001-2008) found that over 75% reported musculoskeletal symptoms. This is the largest study ever undertaken to identify the prevalence, causes and results of treatment of Computer Related RSI.
Why should you bother about RSI?
  1. If you are reading this, even YOU could be at risk! NO ONE is immune to RSI: whether you are a week old in the industry or whether you are the C.E.O.
  2. RSI can seriously disrupt work and domestic life. We know of 70 young Indian computer professionals who have lost their jobs due to advanced, neglected RSI, since 2001.
  3. RSI is not a compensable occupational illness in India, even though over $250 billion are spent every year in USA as a consequence of RSI. There are no protective laws once workers get injured and are unable to work productively. The onus of RSI prevention is entirely on Indian workers.
  4. If RSI is not diagnosed and treated correctly and at an early stage, it can lead to a dreaded and crippling complication called Reflex Sympathetic Dystrophy.

Social costs of RSI
Economic costs of RSI
Diminished health
Decreased productivity & quality
Psychosocial consequences, e.g., anxiety, stress and depression
Lost wages
Diminished community involvement
Absenteeism
Diminished ability to participate in recreational activities
Doctor visits, cost of medical procedures and ergonomic modifications
Overall diminished quality of life
Employee turnover

Recruiting and training new staff

Retraining injured workers

Decreased employee morale

Compensation expenditures
Current scenario in India
  • Early identification of RSI and competent medical intervention is critical to arrest and reverse the injury in its early stages
  • Unfortunately, Indian medical professionals (in general) are not equipped to diagnose or treat RSI's, since it is a relatively recent phenomenon here. Ergonomics, RSI and Myofascial Disorders do not even find a passing mention in the Indian Medical Curriculum and it is not unusual to find Indian doctors (even specialists) and physiotherapists who have not even heard of RSI, let alone have the ability to treat it.
Top pitfalls in RSI Treatment in India
  1. Misdiagnosis as "Spondylitis, "Arthritis," "Slipped Disc," or "Muscle Sprain" seems to be the rule rather than an exception. Diagnosis of RSI is entirely based on a skilled musculoskeletal examination by an expert, and no "special" tests including MRI scans or nerve conduction studies can reliably diagnose it.
  2. Inappropriate medications, e.g., corticosteroids (or Cortisone), antidepressants, Vitamin B12 and multi-vitamins, Unspecified Health Pills and Oils, etc. Medicines and potions (whether Allopathic or Alternative) make little difference in the long term.
  3. Conventional physiotherapy is usually ineffective (Ultrasound, Short Wave Diathermy, etc.) and sometimes dangerous (traction and isometric/resistive neck exercises).
  4. Inappropriate surgery for a presumed diagnosis of Carpal Tunnel Syndrome or Slipped Disc, with disastrous consequences.
  5. Total reliance on fancy ergonomic gadgetry, special chairs, wrist rests, split keyboards, anti-glare screens, etc. to prevent RSI, while ignoring human factors (e.g., practical training in posture, body awareness, typing technique, breaks)
  6. Often, RSI sufferers are told "it's all in your mind" and the only way to recover is to get "it out of your mind!" No further clues are usually provided as to how to achieve this laudable goal. Worse, others are condemned to referral to a psychiatrist because the "specialist" could not find anything wrong on examination or investigations.
  7. No significant attempts at identifying and correcting predisposing factors for RSI, e.g., ergonomic or postural problems.
  8. Alternative medicine practitioners who practice a single technique often have a single-track approach to diagnosis and treatment ("when the only tool you have is a hammer, everything looks like a nail!"). Most have no knowledge whatsoever of RSI and can severely aggravate an existing RSI and prolong the recovery period. However, some modalities like Yoga, Tai Chi and Alexander Technique, when used appropriately and in a holistic environment, are beneficial in RSI.

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