Definition of RSI
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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).
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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).
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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.
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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 35,000 Indian computer professionals (2001-2008) 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. READ MORE
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 70 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 |
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Recruiting and training new staff |
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Retraining injured workers
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Decreased employee morale |
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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
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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.
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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.
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Conventional physiotherapy is usually ineffective
(Ultrasound, Short Wave Diathermy, etc.) and sometimes
dangerous (traction and isometric/resistive neck
exercises).
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Inappropriate surgery for a presumed diagnosis
of Carpal Tunnel Syndrome or Slipped Disc, with disastrous
consequences.
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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)
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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.
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No significant attempts at identifying and correcting
predisposing factors for RSI, e.g., ergonomic
or postural problems.
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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, Tai Chi and Alexander Technique,
when used appropriately and in a holistic environment,
are beneficial in RSI. READ MORE
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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
and in RSI Support Groups/Mailing Lists is often swallowed up by the gullible victims, adding to their
plight.
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