Treatment for Repetitive Strain Injury

Feb. 21, 2000 (Washington) -- While companies can adjust workstations and reassign tasks to reduce employee injuries, treating an injury once it occurs is not nearly as easy. For instance, computer-related repetitive strain injury, caught early enough, can be remedied or controlled with physical therapy, education about posture and body mechanics, and sometimes, time away from the keyboard. But if an employee keeps working without making such changes, he or she can wind up so disabled that performing even simple tasks like cooking, gardening, picking up a baby, or carrying groceries becomes difficult. Even if the problem never reaches that point, some employees are never able to return to their full capacity.

"Repetitive stress is essentially an overuse problem," says Russell E. Windsor, M.D., an orthopedic surgeon at the Hospital for Special Surgery in New York. "What happens is you usually end up tearing muscle fibers and they get to a point where they fatigue and, due to the repetitive motion, cannot recover.''

Most often, doctors tell patients to get adequate rest, take frequent breaks, do stretching exercises, vary their tasks if possible, and change the way they sit or move -- for instance, periodically hold or reach for something with a different hand. Some physicians recommend anti-inflammatory medication and using ice or heat on the injured area until the pain subsides. Many also refer patients for a range of alternative treatments, including chiropractic or osteopathic manipulation, acupuncture, or a method called myofascial release, which focuses on the soft tissue. Depending on the injury, surgery can help -- for instance, carpal tunnel release surgery in the wrist takes pressure off the medial nerve in order to preserve nerve function.

Since repetitive strain injuries are essentially the result of doing more than the body can handle, many doctors say the best chance for recovery lies in eventually strengthening the body's tissues. "In any physical therapy program for this you will cross-train the muscle [by] doing another activity that strengthens it beyond [what] is needed for daily activity," Windsor says. But "you first have to let things rest and let the muscle repair itself, until the pain issue settles down.'' "And then, in essence, you build up the muscle.''

How long does it take? "Usually with overuse problems you follow a person along for a good length of time," Windsor says. "Some people will still have some residual pain." And while "in most situations, the goal is to get people back doing the same job," he adds, "for many people that is a big decision. They have needed a lot of treatment, or maybe even surgery, for this overuse problem, and so they consider a different job."