Repetitive Strain Injury

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Repetitive Strain Injury

Stop Overuse Abuse

If you do something over and over again, you'll get better at it, right? Maybe, maybe not. Women who experience repetitive strain injury know too well that years of performing a task over and over, whether it be keying data into a computer all day, ringing up cash-register sales day after day, or knitting for hours in the evenings, can cause long-term pain. Worse, this kind of injury can interfere with on-the-job performance or continued employment.

Repetitive strain injuries now account for more than 50 percent of all occupational illnesses reported in the United States. The most common of these injuries is carpal tunnel syndrome, in which wrist, arm, elbow and hand muscles hurt from overuse.

The carpal tunnel is indeed a tunnel; it is a small, rigid space with nerves and tendons running through it. Carpal tunnel syndrome can occur when frequent use of your wrist causes the tendons to swell and compress the nerve that runs to your hand. And you feel pain.

"The pain is often worst at night, with numbness and tingling, particularly in the thumb and index fingers. And you may have trouble gripping objects," says Diana Carr, M.D., an orthopedic surgeon in private practice in Sebring, Florida.

HORMONES AND YOUR WRIST HEALTH

More than half the cases of repetitive strain injury occur in women. Researchers say that women between the ages of 30 are 45 are at twice the risk--for various reasons. A higher percentage of them work at clerical and factory jobs requiring repetitive motion. Typists, grocery clerks and even women who knit and crochet are particularly vulnerable to repetitive strain injuries.

Compounding the problem is that in women, the carpal tunnel is smaller, so that it takes less swelling for the problem to occur, making women more susceptible to the compression that causes pain, Dr. Carr says.

"Also, fluid retention during pregnancy causes the carpal tunnel to swell," says Mary Ann Keenan, M.D., chairman of the Department of Orthopedic Surgery at the Albert Einstein Medical Center in Philadelphia. When the rest of the body swells, so do the fluids in the carpal tunnel.

Who would have thought that hormones would have anything to do with wrist pain? According to women doctors, fluid retention prompted by shifts in levels of the female hormone estrogen before menstruation and during menopause also may put women at risk for carpal tunnel syndrome.

FREEDOM FROM REPETITIVE STRAIN

Luckily, there are measures that can bring relief for most women.

Take mini-breaks. "If you can take a break from the activity that's causing you pain, do so," says Dr. Carr. If you do needlepoint to relax at night, and you work at a keyboard for a living, try to take a rest from your leisure activities until your wrists feel better. At the very least, take mini-breaks of a minute or so every half-hour a day, and if you can, periodically switch to a different activity, she suggests.

Use a wrist rest. "If you type at the computer, always use a wrist pad to soften the stress on your wrists," says Dr. Keenan. A wrist pad helps soften the blow of repetitive motion.

Sit properly. "Your wrists should be in a neutral position on the keyboard--that is, neither flexed up or down--with your elbows at a 90 degree angle," says Margot Miller, P.T., a physical therapist in Duluth, Minnesota.

Stretch. Periodically flexing and extending your wrist and arm muscles will help relieve stress on your pinched nerve, says Miller. To limber up, open and close your fingers for a few minutes or slowly bend your wrists back and forth a few times (or do both).

When To See A Doctor If, despite self-care strategies, you have constant pain that interferes with activities for more than a week, see a doctor. If you have repetitive strain injury, the sooner you're treated, the lower the odds that you'll have to have surgery.

Splint your wrist at night. "One way to stop the pain is to wear a wrist splint--at night, or any time that you don't need to use your wrist," says Dr. Keenan. That will keep your wrist steady and prohibit the movement that causes pain. They're available from drugstores without a prescription.

Bandage tennis elbow. So-called tennis elbow is actually a form of repetitive strain injury. "If you have tennis elbow, you can purchase a special pressure bandage from a drugstore or medical supply store, which you can wear over your forearm to take the strain off," says Dr. Keenan.

(For more information on practical ways to manage tennis-related pain, see page 537.)