Source: E. Pascarelli, D. Quilter (1994) 'Repetitive Strain Injury: a computer user's guide'

Repetitive strain injury (RSI) is an umbrella term for many separate ailments affecting the hand, wrist, arm, neck, upper back, and shoulder. Medical professionals also use the phrases "occupational overuse injuries" or "cumulative trauma disorders" for this condition, which can result from intensive hand use (see risk factors for RSI).

Symptoms of RSI include numbness, tingling, lack of endurance, tremor, clumsiness, lack of sensation, a feeling of heaviness and pain. These warning signs can appear anywhere along the hand, arm, shoulder or neck.

Muscles, tendons and nerves can all be affected. Common injuries include: carpal tunnel syndrome, cubital tunnel syndrome, epicondylitis, DeQuervain's disease, trigger finger, bicipital tendinitis, rotator cuff tendinitis, cervical radiculopathy, thoracic outlet syndrome, Raynaud's disease, and others.

Deborah Quilter is a New York City-based writer, consultant, fitness professional and author
read more >>

1. Ignorance of the warning signs or risk factors for injury
2. Over two hours of computer use and/or other repetitive hand movement per day
3. Binge or marathon computer use (i.e., video games, deadlines, quarterly reports)
4. Lack of frequent, regular breaks
5. High stress work
6. Lack of control over pacing or workload (rush work, deadlines, quotas)
7. Boredom, anger or lack of assertiveness
8. Poor posture
9. Sitting for long periods
10. Static loading (holding still for long periods, as in holding a mouse while staring at a computer monitor)
11. Keeping elbows bent for long periods
12. Poor technique (twisting or resting wrists, forearms or elbows while using a keyboard or mouse)
13. Improper workstation setup (i.e., keyboard too high, monitor too high, low or off to one side)
14. Inadequate seating (i.e., chair too high, low, or lacking lumbar support)
15. Awkward positions (i.e., typing while using the telephone, reaching for the mouse)
16. Long fingernails
17. Smoking
18. Obesity
19. Overly flexible joints
20. Weak or tight muscles
21. Lack of regular exercise
22. Cold hands
23. Improper eyeglass prescription or undiagnosed vision problem
24. Arthritis, diabetes, thyroid disease, pregnancy, menopause, and other medical conditions
25. Hand-intensive hobbies, such as playing a musical instrument, gardening, carpentry, needle crafts, bowling, throwing or racquet sports and playing video games

Repetitive strain injury (RSI) can affect the neck, shoulders, upper back, upper arm, elbows, forearms, wrists, thumbs or fingers. Warning signs of RSI can appear in any of those areas.

1. Weakness
2. Fatigue
3. Lack of endurance
4. Tingling, numbness or loss of sensation
5. A feeling of heaviness
6. Clumsiness
7. Difficulty opening and closing hands
8. Stiffness
9. Difficulty using hands (turning pages of books or magazines, turning doorknobs or faucets, holding a coffee mug)
10. Reluctance to shake hands
11. Difficulty carrying things or holding bus or subway poles
12. Hands fall asleep
13. Waking up with wrist pain or numb hands, especially during early morning hours
14. Lack of control or coordination
15. Cold hands
16. Frequent self-massage
17. Difficulty buttoning clothing or putting on jewelry
18. Tremors
19. Avoidance of activities or sports that were once enjoyable
20. Pain or soreness (RSI is not always painful, though)

1. Cut down on computer use: leave voicemail instead of sending e-mail. Go for a walk or see a movie instead of playing video games. Look something up in a book instead of searching the Web. You are in the danger zone for injury if you use a computer for as little as two hours a day.
   
2. Adjust your workstation properly. Make sure your monitor is directly in front of you, with the top of the screen at eye level. Be sure your keyboard and mouse are low enough to allow you to relax your shoulders.
   
3. Sit up straight. Make sure your chair supports your spine in an erect position.
   
4. Practice proper technique: never rest your wrists on the desk, wrist pad or armrests while you are typing or using a mouse or trackball.
   
5. Pace yourself. Take a 5-to-10 minute break every 20 minutes and limit your overall time at the computer.
   
6. Get regular cardiovascular exercise.
   
7. Do appropriate upper-body strengthening ans stretching exercises.
   
8. Stretch frequently while at the computer.
   
9. Do not work at the computer or other hand-intensive activities if you are experiencing pain, fatigue or soreness.
   
10. Avoid using the mouse and trackball whenever possible. Use keystrokes instead.

A good and most effective way how to learn about RSI/CTS, scientific results and suggestions you can find on www.tifaq.org/information.html

Deborah Quilter is a New York City-based writer, consultant, fitness professional and author of The Repetitive Strain Injury Recovery Book (Walker, New York 1998) and coauthor of Repetitive Strain Injury: A Computer User's Guide (with Emil Pascarelli, M.D., John Wiley & Sons, New York 1994). The latter book has received hundreds of reviews and mentions in the national press. Amazon.com calls it the "bible" of RSI; Jane Brody, health columnist for the New York Times, called the book "a comprehensive guide dealing with many repetitive stress injuries." Readers call the book "the best and most complete guide on this subject."
Ms. Quilter has lectured about repetitive strain injury at the New York Times, Time Inc. (including People and Life magazine staff), and various business, medical and lay groups around the country and abroad. Ms. Quilter trains clients in her special exercise techniques, conducts workshops on relaxation and coping skills for people with RSI, and performs workstation evaluations and technique retraining for private and corporate clients. She also wrote a monthly column on ergonomics for Computer Currents, and has been interviewed on NBC News, Fox News, New York 1, and national and international newspapers, magazines and radio shows. She was the keynote speaker for two conferences on RSI in the Netherlands in November 2000 invited by Backshop Healthy Computing and the RSI society.

Ms. Quilter studied Ergonomic Guidelines for Computer Use at the Harvard School of Public Health, and the the Biomechanics of Human Movement at Massachusetts Institute of Technology and is a certified fitness instructor and personal trainer, (American Council on Exercise and Marymount Manhattan College). She is listed in the current editions of Who's Who in American Women and Contemporary Authors and is a member of the Authors Guild.