REPETITIVE STRAIN INJURY OF THE HAND

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In today’s society there is a tremendous emphasis upon motion, physical activity and overall fitness.  Rightly so, given the benefits of physical activity to our health mind and body.

In the case of a repetitive strain injury of the hand continued activity can prolong the problem.  In trying to recover from an RSI the following principles need to be considered.

1.       examination of the work environment.

2.       less activity where possible.

3.       monitored activity.

4.       paced activity.

Understandably these concepts would seem incorrect given the societal emphasis upon exercise.  But the forgotten facts when continued activity is suggested (no pain no gain) include:

1.       the absence of rest periods with the advent of the computer and the hands free phone.

2.       downsizing workers in the work world.  Fewer workers means more work  and less time to complete the work.

3.       poor computer work stations. 

4.       contributions from an anatomical perspective include:

a) relatively small size of both muscle and tendon systems within the hand.

b) for some patients, relatively small skeletal framework for the hands
c) delicate balance of nutrition available to the tendon systems of the hands.

Given these environmental and anatomical factors, it is not surprising that RSI is one of the leading diagnoses for the Workman’s Compensation Board.  Systems failure is devastating in the business world.  Hand pain resulting from an RSI is equally devastating in the human world.

In trying to prevent and/or recover from an RSI, consider the following:

1.       ergonomic assessment of the work station is essential

2.       rests from the keyboard, from the mouse.  Thirty seconds will help to ensure adequate tendon, muscle nutrition.

3.       alternate tasks frequently through the work day.  Racing on the computer can be broken up by filing, by arm/hand stretches/by a walk around the desk.

4.       if RSI symptoms are starting and time from work is not feasible then home strategies can be useful.

For example,

1.       use of heat/ice.  Whatever works best for the patient is the guideline.

2.       alternate heat/ice to improve synovial/vascular nutrition.

3.       use of a glove/tensor wrapping where there is swelling.

4.       comfortable elevation of the hand, arm.

5.       gentle range of motion wrist/fingers.  No forced or sudden motion.  Abandon stretches in favor of easily available range of motion.  Avoid squeezing a “stress ball”.

Strategies at the office and at home can help to eliminate more time consuming measures such as visits to the doctor or to a therapist.

                                                                                           Gail Hamilton