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Topic: Help with RSI?

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worm Posted – 3/17/2006 12:49:53 PM | show profile
After a very busy few weeks, I think I may have injured myself by working too long, too hard. My thumb and forefinger feel as though I have stress fractures--no pain with touch, just when I use them for anything that requires even the slightest force, including typing, opening a bottle of water, holding a coffee cup, etc. I've been taking Advil for the inflammation and pain, I've been using wrist splints, and I've been working many more breaks into my days. I've taken full days off to rest my hands. Still, the minute I get back to typing, PAIN. I figure I have RSI.

Have any of you also experienced this? Did anything help? I've tried a voice recognition program, but I find that I can't write ''out loud,'' almost as if I use different parts of my brain for typing and speaking. I bought a new ergonomic keyboard. I have lots of work piling up...I could use any advice you can offer.
flipflap Posted – 3/17/2006 2:53:40 PM | show profile
worm, I'm really sorry to hear about this. I had a very bad case of RSI several yrs. ago and had to stop work completely. I mean completely. I could not even hold a newspaper between my thumb and forefinger, it was that bad. Just my right hand though. I managed to get workers comp from my PT job & a partial disability settlement! It took me a few yrs to get better.

It upsets me to even hear about anyone else getting this insidious dis-ease. So please see a doctor and get treatment asap. Also I remembered there was a recent thread on this subject:
http://www.mediabistro.com/bbs/cache/t24089_1.asp

It sounds like you are doing a lot of the right things, but right now you really need to rest your hands (or is it one hand?) completely. I cannot emphasize that enough. If you absolutely must work, I URGE you to PLEASE TRY to adapt to the voice recognition program for now. When I had it I actually learned to scribble with my left hand.

As for opening bottles, cans etc., that kind of stuff, there are adaptive devices you can get through catalogs. I had (still have, don't really need now) a lot of these gadgets. Pull tabs were also a big problem for me. I actually used to go out on the street and ask strangers to open stuff for me. They saw my jumbo splint & were very jelpful! The really insidious thing about RSI is that it's not enough to just stop typing, resting means not opening bottles, holding coffee cups, etc.
flipflap Posted – 3/17/2006 3:00:57 PM | show profile
I recommend seeing a Feldenkrais practitioner who is also a PT or OT. You can find one through the Feldenkrais Guild. Feldenkrais, named after its oringinator Moshe Feldenkrais, teaches awareness through movement. I tried many OTs, Pt,s massage therapists etc. This is the only thing that helped me recover.
worm Posted – 3/17/2006 3:45:30 PM | show profile
flipflap--thank you. not working is not an option...I have a book due in summer. It is one hand, so I'm typing here left-handed. I will definitely look for the therapist you suggested. I didn't know about that. Will my physician be able to do anything for me, or is rest the only remedy? (I'm freelance, no disability for me.)
flipflap Posted – 3/17/2006 4:05:37 PM | show profile
yes, I understand. Most people can't stop working. But I do worry about you overusing your left hand. My doc was top notch but it's the OTs who can help you. I urge you check out the Feldenkrais practitioner site and call up any OTs or PTs in your area. http://www.feldenkrais.com/guild/find/#usa

Are you in NYC? My doc was in a dept at St. Luke's Roosevelt Hospital for performing artists that treated many musicians who of course had RSI long before computer keyboard injuries turned up. My doc was in the vanguard as far as treating journalists & office workers with RSI. In fact, I just googled him and found out he has a book out called Repititive Strain Injury: A Computer User's Guide.'' Now I'm curious to read it. (Maybe I'm in it-ha ha) His name is Dr. Emil Pascarelli. I have no idea if he's still at St. Lukes, but it's a good place. The docs there & the staff OTs know how to treat this problem. There are too many docs who recommend ''operations'' & workers comp mills.

I'm curious about the voice recognition software. It was in its infancy when I had RSI, so wasnt really an option.
flipflap Posted – 3/17/2006 4:19:50 PM | show profile
worm, I think you'll be able to find out everything you need to know in Pascarelli's two books.
His bio:
EMIL PASCARELLI, M.D., is one of the world?s leading experts on repetitive strain injury. He is currently Emeritus Professor of Clinical Medicine at Columbia University in New York and Adjunct Associate Professor of Clinical Public Health at Cornell University. He has published articles on RSI in top medical journals. Dr. Pascarelli is the coauthor of the bestselling Repetitive Strain Injury.

The other one is Dr. Pascarelli's Complete Guide to Repetitive Strain Injury : What You Need to Know About RSI and Carpal Tunnel Syndrome
worm Posted – 3/17/2006 4:25:23 PM | show profile
You're a godsend. I'm going to order the books this minute.
lostriker Posted – 3/17/2006 10:47:26 PM | show profile | email poster
RSI ideas
dear worm--
Your hands are worth more than even the book you have to finish. typing one-handed is good, and there is also software called ''word recognition'' software that can save you some keystrokes by guessing the words you are typing after a few letters. You might also have to strictly structure your time so that you don't type for too long, not more than half an hour at a time, maybe, and then have a break.
There is a yoga teacher named Deborah Quilter who has written some books on RSI- has it herself. you can learn a lot at her website: http://www.rsihelp.com/ . I went to a training by her (I have RSI, too) and she knows a lot about how your hand and body position while typing can contribute to RSI. For instance, those wrist rests are terrible for RSI.
One thing that helped me in the long term was acupuncture. You can get acupuncture for $25 a session at the Tri-State College of Acupuncture in Manhattan on 14 St. It's done by students under a teacher's supervision, and is quite pleasant.
I also recommend massage for your upper body -- You probably have tension all over your neck, arms, back and shoulders that is hard to get rid of just by stretching. I recommend those little Chinese Tui Na places that charge $30 for 30 minutes, etc. It's a powerful form of massage that packs a lot of work into a short time. Don't let them work on the acutely hurting hand, but they can work around it, on the arm. Tell them if they are using too much pressure--it tends to be a little stronger than traditional Swedish massage.
Good luck --
wanderlust Posted – 3/17/2006 11:00:46 PM | show profile | email poster
Go see a Doc!...and other advice from fellow RSI sufferer.
I`ve suffered from RSI for over 2 years, and I`ve had to quit working for months because of this.

I've learned how to care for my wrists and can work fairly normally at this point -- but basically, tendonitis of the type that I have (very similiar to the symptoms you describe) is a chronic condition that I'll always have to manage. There is no quick fix...

The best of the treatment I've gone through:

1) GO SEE A DOCTOR. Seriously. This is a serious MEDICAL condition, and it directly affects your work and livelihood, not to mention your ability to feed, bathe, and take care of yourself (believe me - I know what it's like to not be able to brush your teeth correctly or open a jar because of the pain.) I was referred to an orthopedist, then started physical therapy. The combination of therapeutic massage + exercises did wonders, but only over weeks' time.

2) http://www.rsi.deas.harvard.edu/
the single best and most comprehensive website on RSI and treatment

3) http://www.workpace.com/
A program you can download (free 30 day trial, then you can buy it if you like it) that makes you take micropauses while you type and monitors your typing speed, etc. AMAZING. Can actually work safely now without (much) pain.

4) http://www.kinesis-ergo.com/
The BEST ergonomic keyboard out there, from my POV. It is very pricey ($250), but is absolutely worth it - hackers and programmers and geeks all raved about it on the review sites. Worth the price b/c it really does change the way you type, as opposed to the store-bought ergo. keyboards that only minimally change the position of your wrists. Evaluate your work station ergonomics as well.

The combination of all of the above has allowed me to keep my semi-obssessive hours on the computer.

I really hope this helps! Please take care of yourself, keep non-work typing to an absolute mininum. Feel free to e-mail me with any Qs, etc...
flipflap Posted – 3/24/2006 12:25:48 PM | show profile
david-thanks for fixing the thread

how are you, worm?
worm Posted – 3/24/2006 4:48:14 PM | show profile
Thank you for all the wonderful advice! I haven't been able to read this thread for a while.

I stopped working since I first wrote, about a week now. I have a new prescription antiinflammatory medication. And I'm seeing a physical therapist for the first time next week. Yes, I have a LOT of neck, shoulder, upper back tension. (Is massage therapy tax deductable for something like this?) I didn't realize that might all be related.

After a week off, the pain has decreased, but I am reminded of it when I do little things, such as pressing the locking button on my dog's retractable leash. Wherever possible, I've made accomodations so I don't have to do the painful stuff. I've noticed that using the mouse absolutely kills, so I've stopped; I got a new electric toothbrush.

I also picked up one of those books. I can't believe that this ''little'' problem can be so life-altering and debilitating. Crap. I've been known as a work-horse writer, always there, always working. Thank you all so much for the verbal slap across the face. I get it...and I appreciate your help and concern more than you'll ever know.
flipflap Posted – 3/26/2006 11:50:15 PM | show profile
worm, it sounds like you are on the right track.

Another adaptive device that might help you in the short term are specailly made foam cylinders that you can put around eating utensils, toothbrushes, etc. Makes it a lot easier to hold. There's probably a website that sells all this stuff. I'm going to look into that keyboard mentioned by the other poster. Yes, lots of good advice here as usual.
willwriteforfood Posted – 3/27/2006 9:05:58 PM | show profile
I'm not sure if you have already done this, but it's not just your ergonomic keyboard that makes a difference. Make sure your chair is at the correct height and that your forearms are level and your back is against the back rest. This does make a big difference. You might also look at your mouse and make sure it fits your hand properly. Those adjustments made a big difference for me.

I'm sorry you are going through all of this. I think massage therapy is tax deductible as a medical expense but the total bills (of all medical) have to be over a certain percentage of your Gross Adjusted Income before you can claim it. I would certainly keep track of the expense though.

I have a lot of back and neck problems and one of the best things that has helped me is Electro Stimulation Treatment (they call it Estim at my Physical Therapy clinic). It has worked wonders for me.

Your regular doctor can also inject an anti-inflammatory directly into the site of the pain which works a whole lot better than the tablets.

Depending on how good your medical plan is, you might try getting a referral to a pain management clinic. They helped me with my back. I'm not sure how good it would be for an RSI injury, but if this is stemming from your neck and back then it's worth a try.

Another thought is maybe you could make notes about your book plan and have someone else type it for you. I totally understand what you mean about thinking differently when typing. My mind goes completely blank when I'm speaking instead of typing. Maybe seeing the words on the screen from someone else typing (with the slight delay) will keep your thought process flowing. Just an idea.

Good luck! I hope it gets better soon!
sparky_fuego Posted – 3/29/2006 4:45:24 PM | show profile | email poster
worm, sorry to hear you've joined the club. i had great luck working with a local massage guy who had experience with RSI. you really need someone who understands both the physical and mental aspects of this problem. i went twice a week for six months and have been largely pain-free for almost year -- and i didn't stop working during the treatments. but, in addition to undoing all the body problems, i began meditating, changed my desk and chair set-ups and began taking frequent stretching breaks. taking these steps concurrent with my therapy (and sticking with them) was the key to getting out of trouble. i also know what to do the MOMENT i feel the old pain coming back.

good luck with your recovery. please feel free to email me with questions or if you just want to talk to someone who's been there.
wyoreporter Posted – 4/9/2006 8:25:52 PM | show profile
I was diagnosed 10 years ago and I had to make changes in my life and lifestyle, but as you can see, I am still typing. Read what you can. I picked up a book that Pascarelli cowrote and I recommend it highly, even though it's out of print.
See an occupational therapist; a good one will help you change bad habits you may not even be aware of.
Rest your hands. If you can stand it, ice your hand, or hold a can of cold soda to help keep the swelling in check. Splints are good if used correctly.
And if you want to keep typing, you may have to give up racquet sports, skiing, anything that uses your hands in a repetitive way, because it's more stress and more injury.

Good luck. There is hope.
Detgirl Posted – 4/12/2006 11:25:13 AM | show profile
Also struggling with RSI...seeing a physical therapist and exercises/ultrasound seem to be helping. But I get flare-ups when I use the mouse for more than a couple minutes. Does anyone have any recommendations for something other than the traditional mouse setup? (trackball, pen tablet, etc) Thanks for the other helpful suggestions.
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