Working with pain

If you suffer a work-related repetitive strain injury, often the only way to permanently stop the pain is to change your career....

If you suffer a work-related repetitive strain injury, often the only way to permanently stop the pain is to change your career. Nathalie Towner considers the implications for IT professionals.

David Dalgety was delighted when he started his first full-time job in Web development, little knowing that this was a career path he would soon be forced to abandon.

He had first started feeling soreness in his hands and fatigue in the arms when studying for his degree but the pain was not bad enough for him to seek medical advice. During the final year it got worse but Dalgety continued to ignore it.

It was when he became a Web developer that the pain in his hands and arms became so acute that he was forced to take four weeks off work. He started to feel better, but when he returned to work the pain came back.

"I completely ground to a halt," says Dalgety. "This was when I realised it was a chronic long-term condition and I had to come to terms with the fact that I would never return to where I was before."

Dalgety was diagnosed as having a repetitive strain injury (RSI). The condition is a result of repeated physical movements which damage tendons, nerves, muscles, and other soft body tissues.

The condition, if not properly treated, is not only extremely painful but can also lead to disability. In Dalgety's case it was caused by long hours of using his laptop when studying and playing computer games combined with bad ergonomic conditions - he did not have a desk or chair. Sitting in an awkward posture while using a keyboard increases the risk of injury because it requires additional muscular effort.

ITers are particularly vulnerable due to the fact that computer-based work using a keyboard and a mouse can be very repetitive.

The Trades Union Congress estimates that one in 50 workers in the UK - more than 500,000 people - suffer from RSI. Unfortunately for sufferers it is an invisible condition that until recently was not formally acknowledged by the medical profession. This is partly because the term RSI is not a medical diagnosis but describes a number of musculoskeletal conditions. Andrew Chadwick, chief executive of the RSI Association says, "The term RSI is more about how you got the condition, but it remains very widely used."

The RSI Association has been working to raise the profile of the affliction, but there is still an alarming lack of awareness about it. "The majority of us are at risk and there is no set cure - prevention is the only option," explains Chadwick. "Once you have it you have to try to work through it.

"Normally if your muscles hurt you stop but sometimes because of work pressures people don't and then the pain just gets worse."

As soon as the first symptoms appear it is essential to stop the action that is causing the pain and seek medical attention.
"It is no good for an injured marathon runner to just run shorter distances, he has to stop outright," says Chadwick. "It is possible to recover if it has not progressed too far but it is impossible to build up an immunity against it. It may be necessary to reconsider your career."

Physiotherapy is recommended but it has to be administered by someone who fully understands how to treat overuse injuries. There is a lack of consensus in the medical profession as to what exactly RSI is and how to treat it, so it may be necessary to ask around to find a sympathetic doctor, consultant or physiotherapist.

If after a period of treatment the RSI sufferer returns to the same job and the same conditions the pain will quickly return. To avoid a relapse a gradual return and a full re-evaluation of the work station are necessary. After a period of rehabilitation most suffers do improve but they have to make changes to the way they work and remember to take breaks.

Former IT contractor David Ruegg believes his condition deteriorated dramatically because doctors failed to diagnose what was wrong. "I didn't get my treatment early enough," he says. "If I had had physio then it might have helped. No one told me how to prevent it and deal with it."

Ruegg was working in IT support and was carrying out some intensive spreadsheet work when he started experiencing pain. "For me it came on very quickly, the pain appeared in a matter of days," he says. He was referred to a neurologist who was adamant that he did not have RSI.

During the next two years Ruegg went to Manchester University to study computer science. He was using a keyboard far less than before and the pain disappeared. However, he got a summer job in IT and was back on the keyboard. After just one day he woke up with extreme pain and numbness in his hands, shoulders and back. He was obliged to give up the job.

Ruegg was eventually diagnosed with RSI and realised he would never be able to do a job that involved intensive use of a keyboard. He is now an IT trainer. "I have had to change my career focus," he says. "I wouldn't want to be doing programming now because I would be desk-bound. I even find that driving can be a problem."

Ruegg and Dalgety both suffer from diffuse RSI, which means their pain is not focused on one area and can affect various parts of the body. "I was first affected in my hands and arms but then it spread all over and I even get to feel it in my feet," says Dalgety.

Dalgety had to give up on being a Web developer but with the help of a government initiative called New Deal he has embarked on a career as a travel writer. "They provided me with a PC, voice recognition equipment and gave me lots of training," he says. He now has a countdown timer to remind him to take breaks and get up to move around and do stretches.

"It is devastating for the people affected," says Dalgety. "Socially it has affected me really badly. I can only drive for 20 minutes at a time and I have had to give up fishing, cycling and squash.

"It is easy to ignore and just take painkillers but ultimately you are heading for trouble - take action straight away."

How to recognise RSI

  • The first warning signs are aches and pains, tingling and a feeling of warmth in the arms. At first these disappear after a night's sleep
  • If it is allowed to progress, recurrent pain, aching and tiredness in the hands, arms and upper body occur sooner in the day and last well into the evening
  • Eventually the sufferer will experience constant pain and weakness which can be irreversible. Even unrelated tasks such as chopping vegetables will become too painful to perform
  • n For more information contact the Repetitive Strain Injury Association:; Freephone helpline: 0800-018 5012.

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