Long hours at the keyboard can lead to a host of problems for IT professionals. Here’s a look at symptoms to watch out for, steps you can take to prevent injuries, and  treatment options for RSI.

By Kris Littlejohn, with Thomas Shinder, M.D.

We’ve all heard about carpal tunnel syndrome and other repetitive stress injuries. Ergonomics is big business, and worker’s comp claims for these types of injuries can cost companies big bucks. But what’s the real story? In this article, we take a brief look at what you need to know about such injuries and how you can avoid them by making a few changes to your equipment and work habits.

Note: This information is also available as a PDF download.

What is a repetitive stress injury?

The term repetitive stress injury (RSI) refers to a broad range of ailments that can result from long-term repetition of certain movements or actions. RSIs include:

  • Carpal tunnel syndrome (CTS) — Pain and numbness are caused by pressure on the median nerve in the wrist, usually because of swelling in the tendons due to excessive bending of the wrist, such as would occur with excessive typing, especially with poor form.
  • DeQuervain’s syndrome — Pain is caused by inflammation of the tendons that control the movement of the thumb, often thought to be caused by the repeated hitting of the space bar while typing.
  • Bursitis — Pain and swelling are caused by inflammation of the bursa, which are basically sacs that serve as cushions for our joints.

There are many others, including tennis elbow, golfer’s elbow, trigger finger, gamer’s thumb, and various forms of tendinitis. According to various statistics, RSIs cumulatively account for somewhere between one third and one half of all work-related injuries in the United States.

For computer users, the most famous of these disorders by far is carpal tunnel syndrome. But there is some debate in the medical community as to whether CTS is actually caused by computer activities, such as typing and mouse movement, or whether the injuries commonly resulting from those activities are actually some other disorder. From the perspective of the IT pro, however, it matters not at all what the injuries are called or how they are classified. What matters is that they are real, they can cost a business lots of money, and they are, for the most part, preventable.

Warning signs

RSIs are progressive injuries, meaning they get worse as you continue to strain the affected areas. Generally, the symptoms start off fairly mild, and if your activities are corrected early, they will fade away. So it’s important to recognize when you are starting to develop an injury and take action to fix it. The main symptoms are:

  • Recurring pain when typing or manipulating the mouse — mainly in the hands and wrists. Pain can also present in the forearms, shoulders, neck, or back.
  • Numbness or tingling in the same areas.
  • Weakness of grip and lack of endurance in the hands and wrists.

If you experience any or all of these symptoms, you should consult your physician immediately. As the injury worsens, the pain and numbness can become much more severe, and it becomes much more difficult to treat.

Treatment

Once you’ve been diagnosed with an RSI, your physician may recommend a variety of treatment options:

  • Simple hand rest — The easiest solution may be to give the affected hand or area time to recover on its own, by not using it for a period of time. Depending on the severity of the symptoms, this could take anywhere from a couple of days to many weeks.
  • Physical therapy — Massages, stretches, and exercises can stimulate the affected nerve tissue.
  • Medication — Anti-inflammatory drugs can help with the swelling that originally caused the problems.
  • Braces or splints — An immobilizing brace can be worn to keep the wrists from moving and force safe technique while typing.
  • Surgery – With the most severe cases, surgery is often the best option. Studies show that after surgery, up to 90% of CTS sufferers are able to return to their jobs.

Prevention

Better than treatment, of course, is preventing any injury from occurring in the first place. Preventing an RSI in the workplace where heavy computer use occurs requires a combination of three factors: proper posture and typing technique, ergonomically designed equipment, and frequent breaks from hand activity.

Posture and technique

Posture plays an important role in where and how the stress from typing affects you. When you’re sitting at the computer, your back should be straight and shoulders should be relaxed — don’t lean back or slouch. Your thighs and forearms should be level, meaning that your elbows and knees will both be forming approximately right angles. If your desk or keyboard tray is too high for this positioning, use an adjustable height chair to bring yourself up to the right height.

Your monitor should come in at or somewhat below eye level to maintain proper neck alignment. If possible, keep the area at least a little warm, as cold muscles and tendons are most susceptible to injury. In cold offices where you have no control over the temperature, consider wearing fingerless gloves to keep your hands warm.

When typing, your hands should come in naturally straightforward from the wrists. Wrists shouldn’t be bent back or to the side and should not be resting on anything. The palm/wrist rests on keyboards should be used only when taking a break from actually typing. When performing key combinations, such as those using Shift or Ctrl, you should use both hands instead of bending your fingers awkwardly to perform the combination in a single motion. Also, don’t slam down keystrokes. Each key should be pressed with the minimum force necessary.

Ergonomic devices

In the last 10 to 15 years, much effort has been put into designing more ergonomic keyboards and pointing devices (not to mention desks, chairs, and nearly everything else you find at your workstation). Some keyboards are completely split in two pieces so you can position them however you like. Some are concave; some are convex. Some come with built-in supports for you to rest your palms on between bouts of typing. Indeed, they now come in so many shapes and sizes that many pages could be filled just describing them.

But when choosing your devices, it’s most important to keep two things in mind. First, choose what is most comfortable to you. Second, choose what will help you maintain the proper posture and typing technique described above.

Take frequent breaks

Perhaps the most important of all the things you can do to prevent injury while working is to give your body enough time to rest. During any long session of typing, take many short breaks (rather than a couple of long ones). Every 5 to 10 minutes, take 30 seconds to a minute to rest and stretch your hands. During this break, walk away from the screen or close your eyes to alleviate eyestrain at the same time. Every hour or so, take three to five minutes to relax as well. If you can’t remember to take a break, you may want to download a free timer, such as Workrave, to remind you.

Cut back on computer use

If all preventative measures fail and you still find yourself developing an injury, remember what should be the most obvious answer: cut back. While the computer may be a vital aspect of your job, nearly everyone in the business has some measure of extraneous use they could live without, such as gaming or chatting. When you’re engaged in those activities, remember that they aren’t worth hurting yourself over.