Thumb-struck by texting too much?
Author: Vinita A Shetty
Bangalore, The Times of India, May 18, 2005
The use of handheld wireless communication devices is peaking.
So is the damage from overuse
Thumb-dextrous you may well be. But it could get your digits
into a twist. If you're dashing off SMS, e-mailing or punching
numbers and alphabets using nothing but your thumbs, you too
could be suffering from overuse syndrome and related injuries.
Orthopaedicians and Repetitive Stress Injury (RSI) experts the
world over are reporting an increasing incidence of overuse
syndrome, primarily Text Messaging Injuries (TMI), among the
hitech generation. In Bangalore too several youngsters have
been noticed sporting casts on their thumbs, to restrict use
while being treated for TMI.
How serious?
It seems quite grave. In fact, the American Society of Hand
Therapists (ASHT) has issued a consumer alert cautioning that
overuse of handheld wireless devices can lead to overuse syndrome.
The society has stated that handheld electronics are causing
an increasing number of carpal tunnel syndrome and tendonitis
cases. An international mobile major has even launched a safe
text guide with exercises for avoiding injury. The guide is
backed by the British chiropractic association and an RSI association.
Matthew Bennett, spokesperson for the chiropractic association
has stated, "Text messaging regularly, over a long period of
time, could cause repetitive strain and lead to injuries in
later life."
On the rise here?
Dr Deepak Sharan, RSI specialist, says that they have encountered
increasing cases of TMI in Bangalore and other Indian cities
over the past two-three years. "We have treated 15-20 cases
such cases. Almost all our TMI patients have been teenage college
students or IT-BPO professionals in their early 20s." Occupational
therapist Bharti Jajoo says, "Text messaging is on the rise;
it is a cheap, convenient way to communicate. People are also
sending more messages -- as many as 100 a day. Often, it is
the awkward position that the person takes while texting that
causes the problem. Using the wrist to hold the phone and tiny
repetitive movements of the thumb cause friction of the tendon
and its covering, leading to inflammation of muscles." How do
such injuries manifest? It usually starts with pain in the thumb,
wrist or forearm. Says Jajoo, "People can experience swelling
in the thumb, wrist or forearm. There could be difficulty with
fine movements of the thumb, a lump kind of feeling in some
muscles or discomfort, numbness or burning."
TMI will spread:
The popularity of handheld electronic devices is bound to grow,
say experts. "They're being made for convenience and speed and
are capable of heavy-duty messaging. More people are buying
them every day," says techie KR Somesh, who is being treated
for TMI.
Get help:
Like other types of RSI, TMI, which is a part of overuse syndrome,
can be treated. "We treat TMI by myotherapy, trigger point therapy,
myofascial releases and soft tissue and articular mobilisation
techniques, along with home stretching and technique analysis
and re-training," says Dr Sharan.
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Repetitive Strain Injury hits techies
Bangalore, The New Indian Express, March 2, 2005
BANGALORE: Repetitive Strain Injury (RSI) is becoming an increasing
cause for concern, particularly among techies working in the
City. ''It's alarming to see the increasing number of computer
professionals affected by RSI,'' said Dr. Deepak Sharan, Director,
RSI and Soft Tissue Clinic. ''Already about 75 percent of computer
professionals in Bangalore are affected by RSI,'' he said.
As many as 30 people, who visited his clinic, between the age
group of 20 and 35, have lost their jobs because of RSI in the
last five years. In three years, the clinic has treated about
8,000 computer professionals affected with RSI.
RSI, also known as Work Related Musculoskeletal Disorder (WRMSD),
is an umbrella term for a number of over-use injuries affecting
soft tissues like muscles, tendons and nerves of the neck, upper
and lower back, eye, shoulders, arms and hands. ''This disorder
is caused by constant work in a static posture. A large number
of computer professionals report symptoms associated with it,''
said Sharan. If neglected, he warned, early symptoms like aches
and pains in the neck and shoulder, shooting pain down the arm,
numbness, tingling, weakness and cramps may become crippling
disorders. The clinic lists the common causes of RSI as incorrect
body posture, fixed posture without any breaks, resting elbows
on hard surfaces, incorrect workstation set up, improper design
of chairs, general stress, repetitive or monotonous work with
no variation.
The treatment for RSI includes therapeutic massage, myofascial
release, trigger point therapy and yoga. The major services
offered by the clinic for prevention comprises consultation
in office ergonomics, ergonomic assessment at work places, on-site
RSI clinics for corporates and treatment using ancilliary modes
like yoga. The clinic also does research to identify the causes
and results of treatment of RSI. The clinic, Sharan said, is
a multi-disciplinary medical clinic specialising in the assessment,
treatment and research of RSI and other soft tissue disorders
like myofascial pain syndrome and musculoskeletal disorders.
A team of six therapists under Sharan serve five hospitals in
the City including Sagar Apollo, Apollo Clinic, Bangalore Heart
and Orthopeadic Hospital, Bangalore Children's Hospital and
Maharaj Agrasen Hospital.
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Quite a handful
Author: Kavita Bajeli-Datt
New Delhi, The Week, November 28, 2004
Repetitive strain injury: Don't wait for symptoms to aggravate
to seek medical care
It was last October that Richa Sharma (name changed) first
experienced pain in her arms and neck after sitting at her computer
workstation for long. The working mother from Gurgaon, employed
with British Airways for 10 years, ignored the discomfort till
a few months ago when she could not even hold a pen.
"I found that my neck muscles would lock, and my eyes found
it difficult to adjust to the twin monitors," said Richa, who
was diagnosed with repetitive strain injury, where damage to
tendons, nerves and muscles occurs because of bad ergonomics,
stress and repetitive motion. "My fingers became swollen and
at times they would itch or go numb. There were times when I
could not hold a plate or eat." As in Richa's case, permanent
structural damage to the affected part is often the consequence
of neglecting symptoms of RSI. "Ignoring the symptoms is the
biggest blunder that most people commit," said Dr Deepak Sharan,
Bangalore-based orthopaedist who is leading multi-disciplinary
research on RSI and has treated over 4,000 computer professionals
with the condition since 2001. Work-related symptoms, he said,
are common in (but not exclusive to) computer users who work
at a stretch in the same posture and type continuously. Treatment
includes massages such as myotherapy, trigger point therapy
and neuromuscular therapy.
Though Richa spent around Rs 50,000 on treatment, including
physiotherapy, ayurvedic massage and electric stimulation, she
cannot perform tasks tougher than making tea. Her company doctors
told her to look for a non-computer job, and upon her request,
her employers offered a post at the airport. "I couldn't accept
that offer because my husband has a touring job and my daughter
is too young," said Richa, who lost her job. British Airways
corporate affairs and human resource manager of south Asia,
Cyril Daniels, said, "We have a reputation of being a caring
employer. We offer support to our staff when they have a personal
crisis. But it would be inappropriate to discuss any specific
details in respect of any staff."
Sharan's survey shows that at least 25 IT professionals of
20 to 35 years have lost their jobs since 2001 because of advanced
RSI. "There is no legislation in India that holds employers
responsible for providing safe workstations and training their
staff in healthy computing techni-ques," said Sharan. "Indian
computer users underestimate RSI and many are unaware that it
can cost them their jobs. People believe that ergonomically
correct practices are necessary only for those in pain. Indian
employers see RSI as an individual problem, rather than as a
collective problem that is an outcome of the work processes."
Utsav Baijal had a more considerate employer-consultancy firm
McKinsey-who let him stay off work for treatment under Sharan.
Sunil Bhardwaj, a computer programmer in Delhi, too, is now
back in office after treatment. But he takes a break every half
an hour to stretch his back.
K. Ibotombi, a 54-year-old busine-ssman from Imphal who initially
tried to manage with painkillers, rushed to Dr Yash Gulati,
senior orthopaedic consultant at Apollo Indraprastha hospital
in Delhi, only when his neck started hurting. "If a person comes
too late then it becomes difficult for us to offer a cure,"
said Gulati, who gets at least three patients with computer-related
injuries every day. "The problem could become chronic."
Back to links
At risk in the office
Author: Geetha Rao
Bangalore, The Times of India, July 27, 2004
A staggering number of workers face strain injuries and disorders
because offices neglect ergonomics.
Bangalore is said to have 3 lakh software professionals, many
of them women. But many companies haven't got their ergonomics
right. In some cases, this has blighted promising careers due
to work related musculo-skeletal disorders. And with many women
also having to do housework, it aggravates the problem. Also,
India has no guidelines or legislation in place.
Says Dr Deepak Sharan, consultant in orthopaedic surgery and
rehabilitation, "In a survey of 3,200 professionals suffering
from the problem, 40 per cent were women. In the recent past,
20 professionals between 20-35 years have lost their jobs due
to an advanced condition." Last week, a 24-year-old woman professional
complained of a numbing pain in the wrist and neck. The cause
was office furniture. Yogesh Sharma, 24, a medical transcriptionist,
had been using a plastic chair and a steel table on which the
computer and the mouse were placed. Crippled with pain, but
in dire need of the job, he used his foot for the mouse. After
treatment in Bangalore, his condition improved relatively.
Says Dr Sharan, "In Europe, the US, the UK, Canada, there are
specific ergonomic guidelines for users of Visual Display Terminals
(VDT), and ISO guidelines too. India does not follow any guidelines
nor is there any legislation in place." Instead, "Many MNCs
rely on advice from parent companies abroad and use furniture
made for bigger and taller people. Indians' anthropometric characteristics
are different. Indian office tables are usually fixed at a height
of two and a half ft irrespective of the user's body dimensions.
We are shorter and smaller; so women are forced to use chairs
that are bigger, hence don't provide back support, and tabletops
that are higher than necessary. So, they sit on the edge. This
puts a lot of strain on neck and shoulder muscles, resulting
in Thoracic Outlet Syndrome, a severe form of Repetitive Strain
Injuries (RSI)." Again, as many Indian IT companies depend on
a company doctor, usually a general practitioner with little
RSI experience, most cases remain undiagnosed or diagnosed incorrectly
as spondylitis.
When employees sit in corners of L-shaped workstations (in
order to accommodate more workers in offices) with either no
tray or only a small or only a small tray for the keyboard with
the mouse placed on the tabletop, this hampers arm movements
and encourages hunching up of shoulders and placing wrists and
arms on the edge of the table; thus putting strain on the neck
and shoulders. Such offices show a disproportionately high incidence
of thoracic outlet syndrome, says Sharan. "What is discouraging
is that companies do not allow an audit of their furniture."
Office Specifications:
geetrao@indiatimes.com
Back to links
Driving's a pain in the neck
Author: Geetha Rao
Bangalore, The Times of India, July 16, 2004
Got a new set of wheels? Go easy, or you may get a new set
of ailments to go with it. Specially in Bangalore, with potholes,
speedbreakers and traffic jams all over. And if a software engineer,
your problem may be worse as you are prone to repetitive strain
injury (RSI) anyway.
Says Dr Deepak Sharan, consultant in orthopaedic surgery and
rehabilitation, "Driving-related injuries can include neck pain,
eye strain, headache, wrist pain, back ache, thigh, knee and
ankle pain."
He adds, "With new professionals moving to the periphery of
Bangalore, many software professionals travel long distances
to work. Even if they travel by the company bus, they fall asleep
in unnatural positions during the journey; when the bus goes
over a speedbreaker, it may cause injury to the back."
Many software professionals also suffer from RSI, caused by
incessant work in a static posture with highly repetitive actions
such as typing on a key board. Driving can aggravate the problem.
But anyone who drives for long periods, apart from professional
drivers, can develop problems. For example, outstretched hands
on the steering wheel, drooping forward of the shoulders, and
frequently turning the neck to look behind can lead to neck,
upper back and shoulder pain.
The solution? "Hold the steering wheel without having to fully
extend the arms, with the elbow bent, and comfortably reach
the foot pedals without having to stretch the legs. Also, the
forward and backward linear adjustability of the seat must accommodate
drivers of different sizes," says Dr Sharan.
Besides, neck pain may occur because short drivers lean forward
in the seat; and tall drivers bend the head down due to insufficient
headroom in compact vehicles. The trick is to adjust the seat
distance from steering wheel; or use add-on headrest. Tall drivers
should avoid small cars.
As for wrist pain, Dr Sharan suggests holding the steering
wheel gently and maintaining correct and relaxed posture of
neck, shoulders and upper limbs. "Remove hands from the steering
wheel; stretch the hands and wrist frequently when the car is
stationary."
* Fixed position of the knees for prolonged intervals can result
in thigh and knee pain. One solution is to move the knees regularly
(when the car is stationary) and avoid sitting with legs crossed.
* An automatic car with power steering is better for someone
with a bad back.
* Whole body vibration beyond 4-5 Hz makes the low back vulnerable
to stress and injury. Automatic transmissions and power steering
lessen twisting of the spine and strain to the low back.
Back to links
CEOs and employees must be trained
in RSI prevention
Author: Roopa Sylvia Radhakrishnan
Straight Answers
Bangalore Times, The Times of India, February 24, 2004
Interview with Dr. Deepak Sharan, Consultant Orthopaedic Surgeon,
on the significance of RSI International week from February
23 to 29
Q. What is RSI and why is it important to inform people about
it?
A. RSI or repetitive strain injury is an overuse disorder involving
the muscles, tendons, nerves and bloodn vessels. RSI is a very
common problem and the number of RSI cases are on the rise.
Companies should take it seriously. They look at it as an individual
problem and hence take no preventive measures. About 55 per
cent of those in the computer-related sector have developed
RSI within a year of working. CEOs, employees and fresh recruits
should be trained by specialists in RSI prevention techniques.
Q. What are its symptoms?
A. Aches and pains in the neck and shoulder, shooting pain
down the arm, numbness, tingling, weakness and cramps are some
of the symptoms. There are no tests that can be taken to diagnose
it, the only way to detect a case of RSI is through clinical
examination.
Q. What causes RSI?
A. Some of the common causes are incorrect body posture, fixed
posture without any breaks, resting elbows on hard surfaces,
incorrect workstation setup, improper design of chairs, general
stress, repetitive or monotonous type of work with no variation.
Q. Who is most prone to RSI?
A. Nearly 75 per cent of regular computer users are affected.
It can however, affect anyone, even those who are not computer
users.
Q. How can RSI be prevented?
A. A combination of training about correct and healthy computing
techniques, knowledge about how to arrange chairs and other
furniture, correct body posture and typing techniques, stress
mangement and preventive exercises can all help to prevent RSI.
Back to links
Computer-related injuries continue
to wreak havoc
Author: Sriranjan Chaudhuri
Bangalore, The Times of India, April 12, 2003
Consultant Orthopaedic Surgeon and Rehabilitation Specialist
Dr. Deepak Sharan should have been a happy man. However, the
increasing number of people coming down with severe Computer
Related Injuries (CRI) makes him uncomfortable. He has already
treated over 300 professionals in the weekly, on-site CRI Clinic
that he has conducted for Hewlett Packard at Bangalore, since
September 2001.
In addition, he has successfully treated over 700 CRI patients
and over 750 IT Professionals have attended his training programmes
on CRI Prevention at Bangalore (including employees of companies
like Compaq, Analog, IBM, and ISRO).
In the CRI Clinic at HP he carries out:
- Individual musculoskeletal consultation and appropriate
therapy
- Work site evaluation and advice from a medical ergonomic
perspective
- Ergonomic furniture and accessory recommendations
- Follow-up of treatment
- Additional facilities where needed, e.g., Yoga
- Periodic training programs
Says Dr. Sharan: “It is now recognized that recovery
from CRI depends entirely on the stage at which correct treatment
is started.”
These are:
Stage 1: Symptoms only during work. Responds within weeks
Stage 2: Symptoms that persists even after stopping typing
but relieved on rest. Might take a few months.
Stage 3: Constant symptoms. May take anywhere over six months.
Recovery might still be incomplete.
Dr. Sharan emphasizes that most companies using computers need
to change their attitudes. “Being an offshoot of a posh
MNC does not make one immune to CRI. The time to make a difference
is when new offices are being set up. Truly ergonomic furniture
coupled with practical training of the employees is a must,”
he says.
“Too much emphasis is being given to the aesthetic appearance
and cost in setting up offices and virtually no scientific thought
worth the name goes into the purchase and arrangement of computer
furniture. This is definitely true in almost all major IT organizations
in Bangalore, based on feedback given by my patients,”
he says.
“Also many are reluctant to admit having CRI fearing
retrenchment and feel uncomfortable asking for ergonomic modifications
to their workstations,” Dr. Sharan says.
Back to links
A pain in the neck?
Author: Anjali Prayag
Bangalore, The Hindu Businessline, March 24, 2003
A software engineer in Hewlett Packard, Bangalore, J. Suryakumari,
who has been in the IT industry for six years, started developing
sudden pain in her neck, back and shoulders last year. After
several visits to various doctors, her problem was diagnosed
as Grade II Computer Related Injury (CRI). She has been undergoing
trigger point therapy for about eight months now and is already
feeling better.
A similar but a much worse case is that of Aparna (name changed)
working for a software major in Bangalore. In 1999, her problem
started with neck pain that persisted even after undergoing
different kinds of treatments at various orthopaedic centres
in the city. The final blow came when she was at work at a customer's
site. "I was pounding on the key board when the back of
my hands went numb. I was shaking and felt as if I had an old
woman's hands," she recalls. Aparna's case was diagnosed
as Grade III CRI. Subsequently, she gave up her job and is now
undergoing treatment for the malady.
Dr Deepak Sharan, a Bangalore-based Consultant Orthopaedic
Surgeon and Rehabilitation Specialist, says that these are not
rare cases and that CRI is not such an uncommon affliction.
In his study of 700 people in computer-dependent jobs in Bangalore,
he found that at least 70 per cent of them suffered from early
symptoms of CRI. What are these symptoms?
Stage I symptoms are pain and stiffness of the neck, shoulders
and upper back only while the person is at work. Dr Sharan says
this can be corrected with proper medical and ergonomic intervention.
On the other hand, if ignored, it leads to shooting pain, burning,
numbness or weakness in the arm, forearm, wrist or hand, which
will take several weeks or months to be treated. The third stage
is when the pain is constant and even after proper treatment,
recovery may not be total.
The orthopaedic says he has come across six software engineers
in the age group 25-35 who had to give up computer related jobs
due to CRI symptoms. Similarly affected are also call centre
executives who have to be at the PC and the telephone constantly.
Workplace health hazards have posed a problem to companies
and individuals from as early as the 18th century when musicians,
novelists, typists and butchers suffered from what is now known
as Repetitive Strain Injuries (RSI). Even writers were known
to be afflicted with writers' cramps. CRI is a type of RSI that
was first detected 15 years ago in New South Wales, Australia.
At that time, medical opinion was divided about the cause of
the disease. While some insisted it was a purely physical condition,
others swore it was a psychosomatic disorder. Dr Sharan, who
has already treated 300 patients for CRI, says it's definitely
a physiological malady that, of course, is enhanced by stress.
And stress is not so uncommon in software jobs.
But what makes CRI worse than what it already is, is the fact
that most doctors are unaware of the cause and recommend inappropriate
medication such as intake of cortico steroids, antidepressants,
Botox injections, multivitamin injections, unspecified `health
pills' and the like.
Take the case of a 32-year-old patient from one of the top IT
companies, who developed numb and painful fingers due to improper
and excessive laptop usage. This patient had endured the entire
spectrum of inappropriate treatment modalities. "One centre
even advised him to get admitted for emergency nerve decompression
surgery," says the doctor.
In his on-going study, Dr Sharan found that 65 per cent of
those suffering from CRI were misdiagnosed as spondylitis, slipped
disc or tennis elbow.
Only about 20 per cent were told that they were suffering from
RSI. "And what is worse is that about 15 per cent of them
had undergone various blood tests, 10 per cent had nerve conduction
studies, and 15 per cent had MRIs and not even one person's
workstation had been evaluated."
He blames the Indian office tables where the heights are fixed
at 2.5 ft irrespective of the body dimensions of the user. "The
only adjustment you can make is with the chair which does not
work most of the times," he rues.
The other culprit is the way the keyboard and the mouse are
positioned, which is way too high. This leads to an uncomfortable
posture and the user is forced to type by hunching the shoulders,
propping the arms on the armrests and the wrists on the edge
of the table. "The result is myofacial injuries in the
neck and shoulder region leading to compression of nerves and
blood vessels in the neck, which manifests itself as referred
pain or numbness," explains Dr Sharan.
Today, when even an internal memo has to be electronically sent,
how does one prevent this scourge? The first step in the correction
process is to perform a workstation assessment, says Dr Sharan,
who has been conducting weekly CRI clinics at Hewlett Packard
for the last three months.
"It is necessary to teach employees and the HR department
the elements about healthy computing. The latter, particularly,
should realise that there is no correlation between the price
of the chair and its quality," he states.
He says many IT companies think twice about having ergonomic
programmes because they fear escalation in costs due to purchase
of new furniture or equipment. But research in the US has shown
that for every one dollar spent on ergonomic programmes, the
company realises a return of $17.8. "What they don't realise
is that it is possible to achieve corrections within the existing
facilities," he adds.
Dr Sharan has conducted awareness and prevention programmes
in leading IT companies such as IBM, Compaq, Analog Devices,
Ace Designers, and others. "We have even conducted workshops
on how to hold the mouse," he says.
Most of the times, an ergonomic correction solves the problem,
while in cases like that of Suryakumari's, the trigger point
therapy is administered.
The other problem with CRI is the fact that because the disease
is not recognised it is not taught in medical schools. "Some
doctors make their patients take strong pain killers and wear
splints while typing which is pathetic," he says.
He is also working on another pet subject: backpack injuries
of children. "Imagine a generation of people who are injured
when they enter the workforce community. We intend to educate
the kids about this problem and how to handle it."
Warning that those working in call centres are particularly
at risks, he advises people to stay away from misconceptions
associated with CRI that that aches and pains are common for
a working person. "My belief is that work should not hurt
and it's absolutely necessary to see a doctor before it's too
late," says Dr Sharan.
Response can be sent to life@thehindu.co.in
Back to links
'Repetitive Stress Injury Day
focuses on incorrect computer use'
Author: Kanak Hirani Nautiyal
Bangalore Times, The Times of India, February 28, 2003
Straight Answers
Dr. Deepak Sharan, consultant orthopaedic surgeon and rehabilitation
specialist, on International RSI Day (February 28) and its significance
Q. What is RSI?
A. Repetitive strain injury (RSI) is an umbrella term for a
number of overuse injuries affecting the soft tissues (muscles,
tendons, and nerves) of the neck, upper and lower back, eye,
shoulders, arms and hands. In India, it is also known as Computer
Related Injury (CRI) as it's caused by incorrect computer use.
Q. What is the significance of RSI Day?
A. International RSI Day Awareness Day is officially observed
worldwide on the last day of February. One goal of RSI Day is
to encourage computer users not to ignore aches and pains. Another
goal is to educate the establishment. Many employers, government
offices, banks, educational institutions and even doctors are
inclined to shrug off RSIs or to deny the obvious causes of
the problem. Our purpose is to raise public awareness about
Repetitive Strain Injury, to prevent others from being injured
and to promote understanding and acceptance for those with RSI.
Q. Who is at risk for RSI?
A. Anyone who uses the computer for more than an hour a day
is at risk. Software engineers, bank employees, and call center
staff are highly predisposed. RSI doesn't discriminate; it hits
a cross section of the population engaged in a variety of occupations.
Even children are at risk, if they use computers at workstations
designed to fit adults.
Q. How common is RSI in Bangalore?
A. Preliminary results of our ongoing study among over 750 IT
professionals in Bangalore (2001-2003) suggest that over 75%
reported classic RSI symptoms. Typically arising as aches and
pains in the neck and shoulders, RSI can progress to become
crippling disorders that prevent sufferers from working or leading
normal lives. Since 2000, at least 6 IT Professionals in Bangalore
had to bid goodbye to their careers because of advanced RSI.
Q. What is your message to computer users on RSI Day?
A. RSIs are real injuries, they're work-related, and they can
be prevented with education and sensible (not necessarily expensive)
workstation design. It is critical to seek early, competent
medical intervention to prevent irreversible damage.
Back to links
CRI results in job losses
Author: Renjini Koshy
The Vijay Times, Bangalore, February 28, 2003
IT City Bangalore now faces a new threat: at least six software
engineers have been forced to abandon their careers in the last
18 months because of the 'repetitive strain injuries' (RSI),
popularly known as 'computer related injuries (CRI), occurring
purely because of wrong postures adopted at work.
Many computer users, particularly bank employees, call centre
professionals and students are falling prey to this syndrome,
revealed an ongoing study in Bangalore. Friday, February 28,
is observed the world over as 'International RSI Awareness Day'.
The study, covering over 800 computer professionals, reveals
that at least 75 percent have RSI in various forms. "RSI
results from a number of factors such as wrong sitting posture,
typing technique, lack of body flexibility, stress, sitting
in one position without a break for long," said consultant
orthopaedic surgeon and RSI Specialist Dr. Deepak Sharan.
"Indian offices use fixed tabletops at a standard height
(2.5 feet) irrespective of the height of the user," he
added.
Most Indian chairs do not permit adequate adjustability leading
to a distorted posture and the user is forced to type by hunching
the shoulders, propping the arms on armrests and the wrists
on the edge of the table. "The result is myofascial injuries
in the neck and shoulder region, which compresses nerves and
blood vessels in the neck. This manifests in pain or numbness
in the hands," the doctor added.
"Common early symptoms are pain and stiffness in the upper
back, neck and shoulders, which, if ignored leads to shooting
pain, burning, numbness or weakness in the arm, forearm, wrist
or hand. Stage 1 RSI (symptoms that appears only while working)
respond quickly to appropriate medical and ergonomic intervention,
whereas more advanced stages take much longer and are more difficult
to treat," Dr. Sharan added.
Many IT Companies hesitate to establish ergonomic furniture,
fearing escalated costs. However it is possible to achieve ergonomic
objectives by modifying existing facilities, he said.
Back to links
That darn computer is hurting you
Author: Kanak Hirani Nautiyal
Bangalore Times, January 17, 2003
Go take a break. Especially if you've been sitting on your
computer for hours.
For all you know, your chair might be too high, your keyboard
may not be placed right and the ergonomics of your workstation
may need some change.
When Bangalore-based orthopaedic surgeon Dr. Deepak Sharan
stated these facts at the 47th Annual Conference of the Indian
Orthopaedic Association at Patna, he came away winning the Gold
Medal Paper for best research of the year. Titled: 'Computer
Related Injuries (CRI): The Indian Experience', Dr. Sharan's
study involved 650 subjects computer-dependent careers in Bangalore,
with the youngest subject being only five years old.
"This is presently the biggest ongoing study on CRI and
I presented new findings," explains Dr. Sharan, also a
rehabilitation specialist. CRI is a constellation of work-related
symptoms in computer users, with symptoms ranging from neck
and shoulder pain to visual strain and numbness of the hand.
In his study, 47 per cent of Dr. Sharan's subjects suffered
from back pain and 10 per vent complained of weakness in the
hand. He adds that 60 per cent of those with severe injuries
recalled having chronic neck and shoulder pain and stiffness
that they considered normal for computer users and ignored.
"Some of the reasons of CRI included lack of appropriate
breaks, improper monitor height, mouse being too high, bizarre
leg positioning and resting the arm or wrist on a hard surface
while typing," says Dr. Sharan. Of his subjects, many had
been misdiagnosed with spondylitis, slipped disc, tennis elbow
and even arthritis. "Some were even prescribed anti-depressants
and vitamin B12 injections." Six software engineers between
the age of 25 to 35 even gave up computer-dependent careers
due to CRI symptoms. Therefore, Dr. Sharan now advises precautionary
measures, "The main problem is that many Indian computer
users work on a keyboard and mouse that's too high, and their
workstations don't permit adequate adjustability."
Dr. Sharan also conducts a Repetitive Strain Injury clinic
for some companies, where he has treated 250 software engineers
suffering from various stages of CRI. "Some of them suffer
from CRI because of stress in addition to frantic bouts of typing.
That can be harmful. People are aware but more needs to be done.
There should be practical training for computer users and more
importantly, neck and shoulder discomfort should not be ignored."
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SMS leads 2 TMI
Times News Network
Bangalore Times, January 7, 2003
An SMS you send could brighten someone's day. And make your
life hell. Bangalore's soon discovering that sending too many
messages via SMS can lead to a condition known as Text Message
Injury (TMI). Which means that with every joke you forward or
every holiday greeting you send, you're close to becoming a
Repetitive Stress Injury (RSI) victim.
TMI is a newly recognized form of Repetitive Stress Injury
(RSI) caused by the excessive use of the thumb to type text
messages on a mobile phone. Symptoms include pain, cramps, numbness,
tingling, stiffness or fatigue in the hands, thumbs or forearms
of mobile phone users. Dr. Deepak Sharan, a city-based orthopaedic
surgeon with expertise in the management of RSI says that he
has treated at least five cases of TMI in varying age groups
over the past year. "They include students, housewives,
salesmen and software professionals. Repetitive, forceful, low-amplitude
movements of the thumb when operating the keypad of your mobile
phone causes TMI, also known as SMS thumb," explains Dr.
Sharan.
A recent case was a 45-year old businessman who complained
of a sore and numb thumb and shooting pain down his forearms.
After trying painkillers, balms and hotpacks without relief,
he sought specialist help, bracing himself for a diagnosis of
arthritis.
In the US and UK, TMI is a well-known fact. However, the perils
of excessive text messaging are practically unknown in India
despite the fact that there are six million cell phones in use
and approximately 10 million messages are sent every day.
Mobile phone companies in the UK like Virgin Mobile are so
worried by TMI that they have issued instructions for special
exercises along with their handsets. Customers are now being
encouraged to use abbreviated and pre-programmed messages, and
their phones are accompanied by a texterciser - a foam gadget
shaped like a mobile phone that allows users to exercise their
hands.
Dr. Sharan explains that a similar trend should be started
in Bangalore. "Making users aware of the injury risks is
a starting point. Mobile phone companies in Bangalore should
also start advertising strategies to prevent TMI." And
at a time like this, messages not getting through should be
the least of our worries.
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RSI-the downside of computer use
Author: Sriranjan Chaudhuri
The Times of India, Bangalore, March 8, 2002
February 28 was observed as International RSI (Repetitive Strain
Injury) Awareness Day. An umbrella term for a number of overuse
injuries affecting the soft tissues (muscles, tendons, and nerves)
of the neck, upper and lower back, chest, shoulders, arms, hands,
and even legs, RSI is a gift of IT to mankind who created it
and now believe life is impossible without it. Typically arising
as aches and pains, these injuries can progress to become crippling
disorders that prevent sufferers from working or leading normal
lives. And the sad news is that no one is immune from RSI.
THE BANGALORE ANGLE
Consultant orthopaedic surgeon Dr Deepak Sharan and his team
at Bangalore Children's Hospital and Research Centre have started
a study on RSI in Bangalore and the results do not make him
happy. Says Dr Sharan, "Regrettably, we have seen that
at least five former IT Professionals over the past 12 months
in Bangalore have their careers crippled because of RSI. Even
children and college students have been presenting with advanced
RSI symptoms with an alarming frequency."
IMPORTANT FINDINGS OF ONGOING STUDY
Giving details Dr Sharan says:
- Western literature suggests that RSI is more common in
middle aged and older age groups, and in those with pre-existing
medical problems, e.g., diabetes, heart conditions, etc. The
median age of the respondents in this study was just 27 years,
and less than 0.5% had predisposing medical disorders.
- Over 50% of them developed RSI within one year of starting
their IT Career. This clearly suggests lack of knowledge about
RSI and how to protect their body from injury.
" Western literature suggests that females are more predisposed
(perhaps due to hormonal influences or anthropometric factors).
In this study the Male: Female ratio was 4:1.
- Over 50% of patients who developed serious tendonitis of
hand or neurovascular compression reported having aches and
pains in the neck and shoulders, which they had considered
"normal" for computer users and ignored.
- The commonest symptoms were back pain (47%), neck pain
(35%), shoulder pain (34%), finger pain (26%), arm pain (22%),
visual strain (20%), tingling/numbness of hands (16%), and
weakness of hand (10%).
- The commonest predisposing ergonomic factors were lack
of appropriate breaks (86%), improper monitor height (60%),
keeping the mouse at a higher than recommended height (54%),
resting the arm or wrist on a hard surface while typing (42%),
and keeping the keyboard too high (40%).
- Out of over 400 subjects surveyed, 76% reported having
at least one established RSI symptom.
WHEN TO SEEK HELP
- Fresh pain that persists for more than a week after stopping
the activity that brought on the pain (e.g., new workstation)
- Weakness, tingling or numbness of hands or feet show up
- Symptoms worsen
- Symptoms begin to disrupt work or home life
WHY ONE SHOULD WORRY ABOUT RSI
Points out Dr Sharan:
- The U.S. Bureau of Labor Statistics notes that RSI (not
including back injuries) accounted for 60-70% of all reported
work-related illness cases since 1991.
- Recent studies suggest that 20 per cent to 25 per cent of
all computer users worldwide, both vocational and recreational,
have RSI symptoms.
- A survey of 500 software professionals at Hyderabad in
2000 revealed that over 50 per cent had symptoms of established
RSI.
IS THERE SOME TREATMENT
"Currently, the preferred treatment modalities include
a judicious mix of therapeutic massage, myofascial release,
trigger point therapy, yoga, biofeedback, Feldenkrais, Pilates
and Alexander technique, among others. Frequently a combination
of mainstream and complementary treatment modalities works.
Most are still unavailable in India." Explains Dr Sharan.
(Further details can be had from Dr Sharan on 3342035)
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RSI is a crippling disorder
Author: T.S. Ranganna
The Hindu, Bangalore, February 28, 2002
A recent study suggested that about 25 per cent of the computer
users in the world had symptoms of the disorder called repetitive
stress injuries (RSI). In 2000, a survey of 500 software professionals
in Hyderabad revealed that over half of them had the symptoms
of the disorder, according to Deepak Sharan, Head, Department
of Paediatric Orthopaedics and Rehabilitation, Bangalore Children's
Hospital and Research Centre.
Dr. Sharan said RSI had become a serious health problem, particularly
in the city and Hyderabad. RSI denoted a number of injuries
in the soft tissues such as muscles, tendons, and the nerves
of the neck, and upper and lower back, chest, shoulders, arms,
hands, and even legs, due to overuse. With pain in the affected
part as the initial symptom, these injuries developed into crippling
disorders that affected the lives of the patients.
He said an increasing number of children and college students,
who were using computers, in the city had advanced RSI symptoms.
Dr. Sharan, who, along with his team, successfully treated 500
RSI patients, said that preliminary results of an ongoing survey
conducted under his leadership among over 400 information technology
professionals working in IBM, Compaq, and HP in Bangalore suggested
that over 75 per cent of them reported RSI symptoms. The U.S.
Bureau of Labour Statistics noted that RSI (excluding back injuries)
accounted for around 70 per cent of all work-related illness
reported since 1991.
He said that despite its prevalence in India, workers, employers,
and the doctors did not understand the injury properly. The
doctors in the country were not usually trained to diagnose
or treat these injuries. The children's hospital and research
center, as part of the third annual international RSI Awareness
Day on Thursday, is conducting a poster discussion, and a panel
discussion on RSI at Chitrapur Complex, 8th Main Road, 15th
Cross, near MES College, Malleswaram. Entry is free.
For details, visit the website, http://www.ctdrn.org/rsiday.
Ph: 98440-50927/6650368. Email: deepaksharan@indiatimes.com.
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Pilot Seat Syndrome can hit highflying
computer pros
Author: Meghana Mathur
Bangalore Times, The Times of India, June 5, 2001
You shouldn't take this lying down. The Pilot Seat Syndrome
can adversely affect the health of people who sit or travel
for most part of the day. Doctors say that while this affects
mostly software professionals, others who observe sedentary
lifestyles are also potential victims.
Orthopaedic specialist Deepak Sharan says, "Software engineers
spend hours in front of their PC's writing programmes. They
get so absorbed in the work that they don't realize their legs
and feet are suffering." When you sit too long all the
blood moves to the lower parts of the body. Over a period of
time, the blood starts clotting in the veins leading to swelling.
Compression of thigh muscles will make you feel cold, swollen
feet, painful varicose veins and although rare, the advanced
stage is paralysis.
Another extension of the syndrome is Deep Vein Thrombosis (DVT).
This one is more fatal. The clot in the foot could travel up
to the lungs. The pressure could cause the bursting of the veins
there and lead to sudden death. "This is extremely sudden.
It happens in minutes. But the awareness of DVT is very low,"
says Dr. KR Suresh, director and consultant, vascular surgery
department, Mahaveer Jain Hospital. India has 15 experienced
vascular surgeons who are actively trying to increase DVT awareness.
Besides Suresh, there are three others in Bangalore. "The
worst part is people don't realize there's a problem. The only
symptom is a slight throbbing pain in the foot," adds Dr.
Suresh.
The Pilot Seat syndrome existed even in the 18th century. It
primarily affected people whose work demand repetitions such
as musicians, assembly line workers, butchers and typists. But,
according to experts, post surgery patients, those who take
too much bed rest, sit for too long or travel long distances
at a stretch also experience this.
There is no cure by drugs, except for blood thinners that aren't
for daily use. The only symptom is pain or swelling in the feet.
And the only remedy is exercise. As much as one can get of it.
"Many people who have ignored symptoms for long have had
to give up school or work when things got out of hand. Six out
of 10 IT professionals experience the syndrome," says Dr.
Deepak Sharan.
MY POSTSCRIPT: The correspondent has mixed up the terms Pilot
Seat Syndrome and Repetitive Strain Injuries (RSI). Most of
the quotes attributed to me actually refer to RSI.
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