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Repetitive Strain Injuries


Back around Feb­ru­ary 1996 I was hard at work for Mind­Spring, writ­ing a soft­ware man­u­al and cre­at­ing web pages and so on. I was telecom­mut­ing because we’d run out of space at the office, and it suit­ed me just fine. I would get into a hyper­con­cen­trat­ed space and work for 10 or 12 hours with no con­scious­ness of any time pass­ing. I was annoyed that my left hand kept going numb for some odd rea­son, but if I stopped typ­ing and moved around the feel­ing came back, so I did­n’t think much of it.

I did­n’t think much of it until the day that I real­ized that the numb­ness was­n’t going away any more. In fact, my left hand had been numb for a week, and some­times my right hand was going numb, too. I men­tioned it while I was at my fam­i­ly doc­tor’s office being treat­ed for some­thing else and he did take it seri­ous­ly. In fact, he sent me to a neu­rol­o­gist. The neu­rol­o­gist did some tests and informed me that I’d dam­aged the nerves in my left arm, and that only about 10% of the nor­mal nerve impuls­es were get­ting through to my fin­gers!

Well, that was alarm­ing. Next was the hand spe­cial­ist, Dr. McBride. The offi­cial diag­no­sis was “left ulnar com­pres­sion neu­ropa­thy.” What that means for the non-med­ical major­i­ty: the nerves that con­trol the hand have to run down behind the elbow before reach­ing the hand, bun­dled togeth­er like the phone cable before it splits off to the hous­es in your neigh­bor­hood. That bun­dle of nerves was being squeezed at the elbow, mak­ing the out­er half of my left hand stay con­stant­ly numb (pinky to mid­dle fin­ger) and the rest of it vary from numb to painful, but always fair­ly weak and clum­sy. The more com­mon name for this prob­lem is cubital tun­nel syn­drome.

Dr. McBride insist­ed that I stop typ­ing at all with my left hand (one-hand­ed typ­ing was inter­est­ing, and not in the sense that some net reg­u­lars use the phrase!). He said I could have surgery right away or try “tra­di­tion­al ther­a­pies”, which meant a brace and rest and anti-inflam­ma­to­ry med­ica­tion. I chose not to have the surgery right away, hop­ing it would nev­er come to that. The dam­age to the right arm was­n’t too bad yet, so I sim­ply changed my work habits hop­ing to keep it fair­ly healthy.

Unfor­tu­nate­ly the non-inva­sive pro­ce­dures did­n’t work, and in April 1996 Dr. McBride did a surgery he called a “release” to avoid fur­ther nerve dam­age. (There is no way to repair the exist­ing nerve dam­age. Over time it may or may not get bet­ter.) The surgery involved cut­ting my arm open from about half-way between my shoul­der and elbow to just below my elbow and embed­ding that nerve bun­dle into the large mus­cle of my arm.

I now have a big ugly scar and per­ma­nent numb­ness in the left hand that may or may not get bet­ter some day. My right hand still goes numb from time to time, and both arms and hands ache like the dick­ens for no par­tic­u­lar rea­son much of the time. I’m told the pain comes from a com­bi­na­tion of arthri­tis and fibromyal­gia, and is fair­ly nor­mal for the site of any injury—meaning there’s real­ly noth­ing to be done about it.

In Feb­ru­ary 1997 I was final­ly released to return to work. I’m very care­ful about vary­ing my move­ments through my work­day, and I use voice con­trol soft­ware as much as pos­si­ble. I try to avoid typ­ing (real straight typ­ing, not peck­ing in some­thing while speak­ing with a cus­tomer on the phone) more than 15 min­utes at a time, or the numb­ness increas­es. I’m learn­ing to deal with the numb­ness and weak­ness most of the time, although I still think forc­ing any­one to lis­ten to the way I play the piano now might be a vio­la­tion of the Gene­va con­ven­tions.

TechnoMom’s Prescription to Avoid RSIs
or
Hindsight is 20/20

  1. Don’t spend 14 hours at a time at the key­board. Ok, at least move around and stretch and change posi­tions, go get some more cof­fee, what­ev­er, ok? Switch hands with the point­ing device. If you nor­mal­ly mouse around with your right hand, put it on the left side for a while. (Feels weird, does­n’t it? You’ll adjust.)
  2. Hav­ing the key­board, mon­i­tor, chair, etc. at the right height is good but not enough to avoid prob­lems if you abuse your body. There are far more enjoy­able ways to abuse your body so just intro­duce some vari­ety into your life.
  3. Do not lean on your elbows. Ever. This is much more impor­tant than keep­ing Mom from fuss­ing about your table man­ners. Appar­ent­ly lean­ing on your elbows is one of the worst things to do to the nerves in your arms.

The fol­low­ing resources offer much more infor­ma­tion:

  • Typ­ing Injury FAQ
  • The RSI Page
  • Break Reminder is a mar­velous bit of free­ware that reminds you to stop and rest peri­od­i­cal­ly.
  • Drag­on Nat­u­ral­ly Speak­ing — yes, there are oth­er voice recog­ni­tion sys­tems out there, but this seems to be the best over­all, which is why I’m inter­est­ed in it. I’d like to hear from any­one who has used this or sim­i­lar soft­ware in a real work­ing envi­ron­ment, too!.
  • “EASI (Equal Access to Soft­ware and Infor­ma­tion) is a non-prof­it orga­ni­za­tion, com­mit­ted to the belief that stu­dents and pro­fes­sion­als with dis­abil­i­ties have the same right to access infor­ma­tion tech­nol­o­gy as every­one else.” I fig­ured they said it bet­ter than I could. The stuff they deal with is way beyond what I need, but it’s a neat orga­ni­za­tion.