Dream2be

In the last decade, hundreds of thousands of otherwise healthy individuals have developed a painful, debilitating and sometimes disabling condition known as Repetitive Strain Injury (RSI).
RSI is a multifactorial complaints syndrome affecting the neck, upper back, shoulder, upper and lower arm, elbow, wrist or hand, or a combination of these areas, which leads either to impairment or to participation problems. The syndrome is characterized by disturbance in the balance between load and physical capacity, preceded by activities that involve repeated movements or prolonged periods spent with one or more of the relevant body parts in a fixed position as one of the presumed etiological factors. (Health Council of the Netherlands, The Hague, 2000: Publication No. 2000/22E, p. 18).

RSI is a diffuse disorder of muscle, fascia, tendon and/or neurovascular structures. Some sources include disorders of the lower back and lower extremeties in the definition of RSI.

RSI is also known as Work Related Musculoskeletal Disorder (WRMSD), Cumulative Trauma Disorder (CTD), Computer Related Injury (CRI), Work Related Upper Limb Disorder (WRULD), and Occupational Overuse Syndrome (OOS).

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

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.
RSI accounted for 66% of all work-related illnesses in USA (1999).
A survey of 500 software professionals at Hyderabad in 2000 revealed that over 50% had symptoms of established RSI.
Preliminary results of our ongoing prospective study among over 13,000 Indian computer professionals (2001-2006) 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?

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.
RSI can seriously disrupt work and domestic life. We know of 40 young Indian computer professionals who have lost their jobs due to advanced, neglected RSI, since 2001.
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.
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

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.

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.

Conventional physiotherapy is usually ineffective (Ultrasound, Short Wave Diathermy, etc.) and sometimes dangerous (traction and isometric/resistive neck exercises).

Inappropriate surgery for a presumed diagnosis of Carpal Tunnel Syndrome or Slipped Disc, with disastrous consequences.

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)

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.

No significant attempts at identifying and correcting predisposing factors for RSI, e.g., ergonomic or postural problems.
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, when used appropriately (in the recovery stage rather than in the acute stage) and in a holistic environment, are beneficial in RSI.

RSI victims, on the lookout for a quick-fix requiring minimum effort and time off work, usually run from pillar to post seeking effective treatment and often fall victims to quacks. Inaccurate and unmoderated information abundantly available on the Internet is swallowed up by the gullible computer users, adding to their plight.