Twelve Myths About RSI
What you don't know can hurt you
By Deborah Quilter
First published December 9, 1997

When it comes to computer injuries, ignorance is agony. Many people get hurt simply because they hadn't heard of repetitive strain injury (RSI) until they were diagnosed in the doctor's office. Others get into trouble because they don't know how to set up their workstations properly, neglect to take breaks, or habitually slouch. Still others deny their injuries and continue aggravating activities despite experiencing chronic soreness, dropping things constantly, or finding it difficult to perform simple activities such as writing, opening doors, or shaking hands when they should be seeking help.

A little education can help you protect your hands. Here are some common misconceptions people have about RSI.

• I don't type much, so I won't get injured.

  People who use computers for as little as two hours a day can become severely injured. A lot of typing is only one risk factor for RSI; others include holding still for long periods, awkward positioning, poorly designed input devices, ill-fitting workstations, and poor posture. Using a mouse causes overuse of one hand and can be far more injurious than the keyboard.

• RSI is the same as carpal tunnel syndrome.

  Repetitive strain injury and carpal tunnel syndrome are not synonymous. RSI is an umbrella term for many cumulative trauma disorders, such as De Quervain's disease, tendinitis, epicondylitis, cubital tunnel syndrome, and carpal tunnel syndrome. This distinction is important. People may not know about the other common forms of RSI, and if they don't have symptoms of carpal tunnel syndrome which they might read about in the news, like wrist pain, they may put off seeking treatment because they don't realize anything serious is wrong.

• RSI is all in your head.

  While symptoms can certainly be triggered by stress, RSI is not an imaginary malady. If it were, physical ailments would disappear after people worked through psychological stumbling blocks with a therapist. If your doctor suggests your symptoms are psychosomatic, you should seek a second opinion.

  However, once you've seen a doctor about your bodily ailments, you may wish to enter psychotherapy to help you deal with frightening anxieties brought on by the all-too-real financial, physical, and job-related RSI problems.

• My injuries will go away when I stop using a computer.

  If you receive proper treatment (not just rest) at the first hint of injury, your chances of recovery are better. But many people ignore early warning signs, such as fatigue or weakness. If you wait until you experience severe, incessant pain before seeking treatment, permanent damage may be done and you may develop a chronic disability. At this stage, it may take many months of arduous rehabilitation simply to reach a pain-free state at rest.

• If I start having problems using a computer, I'll stop so I can save my hands for playing guitar (or whatever else you enjoy doing).

  Protect your hands now, because once they're injured, any activity that uses them can exacerbate the problem.

• Why should I see a doctor? This goes away by itself.

  In the earliest stages of injury, RSI frequently manifests itself with episodic bouts of soreness or other symptoms that come and go. In later stages, symptoms are present all the time. Chronic RSI does not get better by itself. It can get worse if left untreated.

• I'll just get some splints (or magnets, wrist rests, vitamin supplements) and that will take care of it.

  Attempts to self-treat RSI can have tragic results when the injury worsens. For example, splinting is a medical procedure that can lead to atrophy and even more extensive injury, and should be done only under the supervision of a physician. If you're in so much discomfort or have so little strength that you can't use a computer without wrist support, you probably shouldn't be working. You should take an active role in your healing, but let a professional guide your progress.

• I'll just take some time off and things will go back to normal when I come back to work.

  It astonishes many people that although they felt fine when they weren't using their computers, their symptoms return within moments of going back to the mouse or keyboard. Once injured, the tissue becomes fragile and prone to reinjury.

• I'll get one of those new ergonomic keyboards, or a voice-recognition system so I won't need my hands.

  New equipment won't make a disability go away, nor will it necessarily prevent injury. New gadgets don't address risk factors such as speed, repetition, poor posture, awkward positioning, weak muscles, and sedentary behavior. More often, new tools could simply shift the focal point of injury from one part of the body to another (for instance, from hands to vocal cords).

  There are no substitutes for rest, good posture, regular breaks, self-pacing, maintaining a reasonable workload, and heeding your body's warning signals that you've done enough for today. Savvy athletes understand that overtraining can lead to overuse injuries, and that proper conditioning, technique, pacing, and alignment can help prevent problems. Computer users must embrace the same principles to stay out of trouble.

• My fingers tingle, but my doctor and physical therapist say the problem is in my neck. They must not know what they're doing.

  Your doctor and therapist sound smart. Such symptoms can result from compression of the brachial plexus, an important network of nerves that leads to the hand. Tight neck muscles can cause this pressure.

• My co-worker claims he's injured, but he and I do the same job and have identical workstations, so he must be faking it.

  The roots of RSI are for more complex than jobs and workstations, and it's impossible to generalize about who will become injured. You and your co-worker may be of different age or gender, and everyone has unique anatomical structure, body composition, posture, and work habits. While some people do seem immune to injury, their poor habits may catch up with them eventually, and they may develop RSI.

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