FAQ: How to Prevent RSI (Repetitive Stress Injury)

After a long day on the keyboard, your hands may begin to ache. There may be a burning ache in the back of the wrists or soreness in the fingers. Your hands will be numb or weak; you won't be able to open a jar, turn a door handle, or shake someone's hands. The upper part of your forearm may ache. Your shoulder may ache with a radiating pain into your back. Your lower back may ache. The back of your thighs will hurt, with pain up to the back of your head. You may get headaches and nausea.

This injury is called Cumulative Trauma Disorder (CTD) or Repetitive Strain Injury (RSI). The names cover many different types of injuries, including Carpel Tunnel Syndrome (CTS), tendonitis (inflammation of the tendons), ulnar nerve entrapment at the wrist or elbow, numbness (called white fingers ) and other inflammations of the nerves, tendons, ligaments, or muscles. RSI can range from a bit of soreness to complete disability.

How Do I Get It?

You begin to develop RSI when your body doesn't move enough, the few movements are repetitive, you hold your body in an unnatural position, or you're stressed. RSI is not just a computer injury. Gardeners, supermarket checkout clerks, painters, etc., can develop it. RSI is not a modern problem. Prehistoric women developed RSI because of the strenuous work in grinding wheat for their daily bread.

How Do I Cure It?

There is no complete understanding of the causes, cures, or prevention of RSI. There are a number of treatments, including vitamins and surgery. There is no evidence that vitamins help. Surgery is popular, especially for the surgeons, but this is just cutting off whatever hurts. If you continue to work in poor conditions, you'll continue to develop it.

What about Alternative Design Keyboards ?

There is no evidence that alternative keyboards can prevent or help RSI. These keyboards are often sold with a thirty day money back policy. Try one and see if it helps. Don't try one just before a deadline; it'll take about two weeks to get used to it. An affordable alternative keyboard is the MiniErgo at 800-282-ERGO. There is also the Kinesis keyboard at 800-454-6374. Microsoft has also introduced an alternative design keyboard for under $100.

Will It Just Go Away?

Once you develop RSI, you'll have it for many years. The pain may go away, but a long stretch of typing will quickly bring it back. You can't just keep on working and only do something about it when it starts.

How Do I Prevent It?

Here are several things to do:

  • Warm up your fingers for five minutes before typing. Wiggle your fingers as if playing the piano.
  • Get an swivel office chair and adjust the seat and back to fit your body.
  • Sit up straight. Don't slouch on the back of the chair.
  • Hang your upper arms straight down from your shoulders. This relaxes your back and shoulders.
  • The keyboard should be placed so that the lower arms are bent slightly downwards.
  • The wrists should be lower than the elbows. This relaxes the wrist muscles and tendons.
  • Your typing teacher taught you not to rest your wrists. Wrong. Rest your wrists on a wrist pad. Otherwise, you hold your hands up in the air all day, which puts strain on the back muscles. Most wrist pads are too low. You can use several to get the right height. The wrists should be flexed slightly downward.
  • Your feet should sit firmly on a footrest. Otherwise, you'll put pressure on the thighs and get swelling, varicose veins, etc.
  • Ask your employer to give you the proper equipment. Tell your employer that you'll keep a log of the problem and jot your symptoms in your desk calendar. Tell your doctor about the pain. This will help you to document a health injury claim.
  • Take frequent breaks. Every thirty minutes, take a five minute break. Stand up and move around. Place your phone, dictionary, and printer on the other side of the room so that you occasionally get up. If you use the automatic save, then you can use this to know when to take a break.
  • If you feel shooting pains in your wrists or arms, stop typing immediately. Do something else for at least an hour.
  • The screen should be placed so that the top is level with your eyes. Raise the screen with a monitor arm or (my favorite) put several telephone books under it. If you peer down at your screen, you put stress on your neck and back.
  • Get an adjustable copy holder (a standing clipboard) that stands next to your screen. This holds your material at eye level and reduces neck strain. Rubbermaid Corporation has developed a line of ergonomic products for the desktop. Call Rubbermaid at 800-521-8270 for a free catalog. They will also send you a booklet on how to sit at a keyboard.
  • Keep your wrists and forearms warm. Cold air will stiffen the muscles. Wear a light long sleeve shirt or light typist's gloves. You can also take a pair of large light cotton or wool gloves and cut off the fingers.
  • Listen to your mother. Don't sit in front of your computer all day. Move things away from your desk so that you have to get up. Go for walks. Bicycle to work or park six blocks away. Get a dog.

If It's Too Late

  • If you have pain in your hands or arms, see a doctor. Most doctors, however, don't know much about RSI. Ask a hospital physiotherapy department for a referral.
  • Ice pads stop the pain. Heat pads feel good, but the pain will last longer.
  • Motrin (the generic name is ibuprofen ) pain tablets may relieve inflammation.
  • Massages by a physiotherapist, chiropractor, or trained person will help. Because you sit all day and don't move, the muscle waste chemicals collect at the ends of the muscle fibers. A massage forces this waste out of the muscles and into the bloodstream. A long walk will do the same thing and it'll be cheaper.

After four to six months of complete rest, the pain will go away. This doesn't mean that you're cured. A stretch of typing will bring it right back again at full strength.

If you reach complete disability, a voice dictation system can replace the keyboard and let you talk to the computer. You can enter text and command it by speaking. People with severe RSI use this successfully.