Talk:Repetitive strain injury

Remove this

This is not science. This is based in fabrication, disinformation, panic and greed. This article should be removed, now. Historygypsy (talk) 14:25, 7 November 2010 (UTC)

Nonsense. This is a genuine condition, recognised by many medical professionals and organisations around the world, including the UK's NHS - see http://www.nhs.uk/conditions/repetitive-strain-injury/Pages/Introduction.aspx

Because a clear physical often cause cannot be found, it seems that people jump to the "all in the mind" conclusion. This ignores the possibility of physical causes which are hard to detect. Dr Andrew Dilley and others have been carrying out research into subtle differences in how the median nerve moves in RSI patients vs controls. Some details and links to medical papers can be found here: http://www.unisoneastern.org.uk/documents/en/RSI/RSI_Action_Newsletter_Issue_13__-_June_2010.pdf Arganoid (talk) 15:56, 4 February 2011 (UTC)

Reply The UK NHS recognises it?, Wow! ""Makes it official then". (apologies to Geoffery Rush).Historygypsy (talk) 18:26, 17 May 2011 (UTC)

What is more relevant is that the World Health Organization recognises this as disorder and has classified it in ICD-10 under category M70. Beeswaxcandle (talk) 06:47, 5 July 2011 (UTC)

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Response to Arganoid

Please do not use intemperate epithets like "Nonsense", it is rude and not helpful. The President of the Royal Australian College of Physicians made an unprecedented statement that RSI was not a genuine medical condition.

I can name dozens of "Conditions" once thought to be genuine that are no longer accepted. The WHO is not an organization of treating doctors, but a vast bureaucratic organization that creates mountains of paper but never sees a single patient. As a doctor who has taught medicine in 3 universities in 2 countries and who knows who fabricated, promoted and profited from this non-disease, I stand by every word. Repetition was never quantified, and injury was simply assumed because the claimant was a worker. Some of the so-called causes were not even repetitive. Strain was never demonstrated, some of the so-called causes are not strenuous and injury was simply assumed to fit into the left wing views of judges, lawyers and unions in Sydney, Australia where the condition was fabricated. It spread from work-place to work-place and then from industry to industry, but seldom access the border into other similar work places in other states. The spread followed the epidemiological pattern of an infection, but in this case the carriers were not insect borne microbes but media and Union borne scare mongering. The unions were simply doing their job, the media were beating the drum with scary, uninformed and misleading publicity that we all recognize as an every day event when they have a "Good story that will run". The lawyers, some tied to unions, did what they are paid to do, represent the claimant. The doctors who promoted and benefited disgraced their profession. I read of "Experts" under oath say such unbelievable nonsense as to beggar the imagination.

The epidemic occurred when the Australian economy (especially small business) was under siege, with companies downsizing, amalgamating, moving location, outsourcing and dissolving. The government civil services were being scaled down due to the advent of desktop computers that removed such jobs as filing clerks, archivers and type writer operators. Factories were installing computer operated machinery to remain able to compete with cheaper imports. The workforce, many immigrant and uneducated, semi or unskilled, had no hope of another job. Many were women, holding the families second and vital source of income, sometimes the only source. The panic that was caused by lurid scare mongering caused these desperate people to accept anything that would save the family from destitution. Unions had seen a mass departure of membership once compulsory unionism was banned and collective bargaining allowed. They now moved in with relish to promote a cause, and added fuel to the fire. They demanded (and got) "RSI co-ordinators" in every work place and whenever a worker's job was threatened, the Union Doctor came in and asked if they ever had pain. Of course the answer was yes, if it was not, they were advised to think again. A claim was filed including the nebulous concept of damages for "Pain and suffering". The Union of Labour Lawyers dominated the workers' Compensation courts, both as advocate and judges. Huge damages were awarded and as a result, insurances for companies soared. Companies were forced out of business due to the campaign of terror and massive payoffs, as well as "Contributions" to unions to keep the peace, as well and rising insurance premiums. This added to the growing unemployment, and a vicious cycle ensued. Union representatives visited their "Comrades" overseas, but only after it was pointed out that RSI was unheard of outside of Australia and rare outside Sydney. A prediction was made that the Unions would pick this up and export the problem, and within months, that is exactly what occurred.

Regretfully, some patients were actually coached to fabricate an injury, in order to get a payout when they were made unemployed. This led to a weird collection of bizarre presentations that were clearly not medical, but still, the courts accepted them an the testimony of "Expert" witnesses. Further, if the worker was unable to get another job. I was approached more than once to "Help" someone who stated clearly that he or she perfectly healthy, but "need the money". I refused.

The entire epidemic of panic ended when the laws were amended to stop the nonsense, proof positive that this was panic, not injury.

But the damage has been done. Genuine illnesses and genuine injuries related to work (and there are many) are mis-labelled as RSI, causing incorrect treatment and giving a stigma to the worker that makes them unemployable. That is the real tragedy, a compensation system that was rightly created to protect an injured worker became so distorted that it ended up doing exactly the opposite.

An Australian prominent in the compensation field summed it up thus ---"The pain of strain lies mainly on the Brain" (a Parody on to Lerner & Loewe's My Fair Lady")

This Wiki article needs to be removed. It is not based on fact, but on folk lore.70.83.10.55 (talk) 16:18, 26 July 2011 (UTC)

Sorry for heated language but perhaps my frustration will be more understandable if you read my account of what I've been through with my condition over the last four years: http://argnet.fatal-design.com/rsi.php . Contact me on Skype if you like, email me via my site for details.

I also recommend reading recent comments below by Laguna Greg and Grevillea Arganoid (talk) 14:26, 31 August 2011 (UTC)

Text messaging

Editors may be interested in: Texting Can Be a Pain in the Neck, Shoulders. -- Wavelength (talk) 20:37, 26 November 2009 (UTC)

REPLY

SORRY, PAIN IS NOT STRAIN. NOR DOES PAIN AUTOMATICALLY BECOME AN INJURY Historygypsy (talk) 00:39, 28 July 2011 (UTC)

The Australian Epidemic of nonsense: a rant by HistoryGypsy

I lived through the creation of this nonsense, that was created and nurtured by Unions, Lawyers, people who were out of work, and I am ashamed to say, fellow doctors. The left wing media added fuel to the fire with uneducated and at times, fabricated articles warning of permanent crippling due to simple repetitive tasks, tasks that had been undertaken for prior decades without any complaint., let alone injury.

The "Epidemic" was largely restricted to certain sections of businesses who were either closing, re-locating, downsizing or being taken over. At the same time, workers doing similar tasks in the same company, or in similar companies did not report symptoms. Further, the epidemic was largely restricted to the city of Sydney, although, once the civil service started to be cut back, it appeared in the national capital, Canberra.

One cannot blame the workers who were facing retrenchment with no prospect of re-employment. At the same time, Unions, had suffered huge losses in membership due to laws that banned compulsory unionism, which became voluntary. Many left the Union movement due to high fees, intimidation and in some cases, mis-management. These were afforded the right of " Collective Bargaining" instead.

The Unions seized the opportunity, and published lurid, frightening booklets and leaflets claiming that "RSI" could led to crippling. The overwhelming claims were from women. Many of the process workers under siege were immigrants, not literate or articulate in English, and were frequently holding down the families second (and in some cases the only) source of income. The Unions appointed "RSI Co-ordinators" in companies, and scared the workers into claiming even minor fatigue aches. A union "Trade Workers' Clinic" compounded the problem by making claims that were not only outlandish, but clearly spurious. A "Workers' Compensation Court" was expanded, with a sizeable number of socialist judges belonging to a caucus called "The League of Labour Lawyers". The result was predictable, the epidemic spread like an infectious disease, jumping across oceans and land borders, but always selectively. The epidemic spread to other countries, after it was pointed out that the problem did not exist in other countries. It was at that time said that the Unions would hear of this, and would make sure that the problem would cross the oceans, and within a short time, that is exactly what happened.

No injury was ever demonstrated, not by organ imaging of any type, biopsy, electrical studies or by simple examination. Carpal tunnel syndrome, which was annexed heuristically to RSI is not due to strain. Further, most of the claimants were doing simple repetitive tasks that could be tiring, but each movement alone was not strenuous. If you do not strain yourself once, then you cannot claim strain to be repetitive, since you cannot compound nothing. On the other hand, there were some undoubted cases of clear cut strain injuries due to excessive or mis-applied force, and if that force was repeated, then the term RSI could be valid. The classic example is hitting a tennis or golf ball with an incorrect action, when, if repeated can lead to Golfers' or Tennis elbow". I had Tennis elbow from just this folly of not stopping at the first twinge of pain. In these and other cases, the nature and the site of injury was easily demonstrated in anatomic and physiologic terms.

There were increasing numbers of claimants that had been coached by unscrupulous professionals. The problem was that frequently the claimants either forgot, or were unable to reproduce, or just fabricated incapacity. This led to a variety of bizarre non-explainatory signs that, true to form, were than claimed to be "typical of, and diagnostic of, RSI".

Clearly, there were some genuine work injuries, but these were always in the category of well known afflictions. But the promotors of "RSI" in the Australian context were calling any pain, of any origin RSI. The problem was that strain was never demonstrated, repetition was never quantified and injury was simply assumed if the claimant was working. When it was pointed out that "RSI" had no diagnostic features, and fitted into no organ or physiological entity, the absurd claim was made that "The hallmark of RSI is that it has no diagnostic features"!! I had the experience of doctors telling me that they only diagnosed RSI "....because if I didn't, I would have no practice left". The tragedy was that the workers suffered. Many lost their jobs because companies were unable to afford escalating insurance costs, especially when a work place became a hotbed of claims due to fears of job loss. Such workers were then marked for ever as "suspect", and were locked out of the work force. This re-enforced the myth that RSI could cause permanent incapacity, a myth that the unfortunate ex-worker had to perpetuate in order to keep the compensation payments. This led to more bizarre and at times fabricated behaviour, since it was nigh impossible to remember how to maintain the illusion of injury.

The damage to the economy was enormous, due to companies failing, insurance payouts soaring and long term compensation payments reaching astronomic proportions.

Some doctors, lawyers, union and media folk are ultimately responsible for this tragedy which caused so much misery, which was initially motivated by a genuine fear held by hard working process workers, but fed by greed and power of those who knew better.

Finally, the epidemic died out. The demise of RSI as an epidemic was caused by a revision of the law, and by the loss of credibility attached to by those professionals who sought to capitalize on the epidemic for personal gain. doubtless, in the mad boom of the 1990's a resurgence of employment helped. But the myth lives on, and like a religion, it survives in the minds of those who do not know, or who do not wish to accept the facts. RSI is now an article of faith, and "It is harder to shake a belief than fact" , (a quote from the master of dis-information, Adolf Hitler) Readers are urged to read the writings of the eminent occupational epidemiologist, Nortin Hadler Historygypsy (talk) 18:34, 28 July 2010 (UTC)

Please move your Godwin to the first line of your diatribe to minimize lost time of wikipedia discussion page readers.98.240.67.27 (talk) 06:23, 10 July 2011 (UTC)

This article should remain. RSI has most certainly not died out; it has not in the U.S., Canada, or Europe. In fact, the Federal Bureau of Labor Statistics confirms that reported workplace injuries in this category are only slightly less per year now than they were in the early 90s, when the reported cases of the syndrome peaked. Yes, there is still some controversy as to the all-inclusive nature and tertiary stages of the syndrome, but the American Medical Association, the American Physical Therapy Association and countless other professional groups accept this as a bona fide medical condition and have for over two decades. Not to mention that the U.S. government funds numerous studies of the illness ever year, and major researchers in the field continue to study it and publish their results in peer-reviewed journals.Laguna greg (talk) 00:50, 27 August 2011 (UTC)

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• angls=120^-----Please note, I have [[Repetitive Strain Injury]] and find typing very hard. I use a form of shorthand, which may be difficult to understand. I can be contacted through MSN (sven70) or Skype (sven0921) if my meaning is unclear. (talk) 18:38, 9 August 2010 (UTC)

The "Psychosomatic?" Issue

Hi All. I have a problem with the emphasis in this article on the so-called "psychosomatic" nature of RSI, especially when this page gets almost 2k hits/day on a subject where information is generally lacking in the public domain. RSI/CTD has long been a recognized syndrome by so many medical groups, that I find it laughable that anyone would even be arguing this point any more. There is, quite literally, more than 100 pounds of studies I could cite, if I had the time, not only substantiating the syndrome but describing it histologically. So it seems highly prejudicial and slanted that such a topic, written in such a negative way, should be included at such GREAT length in an article about a vaguely related syndrome that is not under dispute any more. Any thoughts? And yes, if I have time, I will put together some corroborated information to include here, which the article is also sorely lacking. Cheers!Laguna greg (talk) —Preceding undated comment added 01:01, 27 August 2011 (UTC).

Agreed. Seems to suggest physical causes are the minor aspect and that it's mostly just in peoples minds - the position of a number of 'specialists' in the medical profession employed to 'confirm' things by certain health insurance agencies. Some medical/professional references to balance this out would be good. Also, there are no links to fibromyalgia which I understand is the end result of untreated RSI. 121.254.85.166 (talk)

Last paragraph in the psychosomatic section

Here is the paragraph:

A common theme among different subtypes of RSI is a stigmatization and demonization of hand use. Illness concepts that stigmatize hand use have the potential to create more illness as well-documented in the experience with the Australian RSI epidemic. RSI was first diagnosed in Australia in the 1980s. (Only later was it diagnosed in the US and Britain.) In the early Australian experience, RSI cases increased rapidly over several years, leading to widespread media coverage and worker protests. After a widely publicized court case in which a judge ruled an alleged RSI victim had no bodily injury and could not receive damages, complaints dropped off rapidly, as doctors adopted alternative diagnoses such as tendinitis. Many observers felt that the media coverage and social mobilization against the epidemic had actually helped spread it by causing psychosomatic symptoms in worried workers. This pattern has been seen in other psychosomatic illnesses.

There's a few problems with this. I pulled up the article from the Journal of Bone and Joint Surgery and the resulting comments that it generated, and it doesn't support a lot of the statements that are implied here. The article itself actually says that the first major reports of these sort of problems were actually in Japan, not Australia. In one of the comments, a doctor looks at the same data sets and says "Thus, rather than “an epidemic of so-called work-related musculoskeletal problems,” the BLS data demonstrate a moderate and steadily diminishing number of cases, concentrated in just the sorts of jobs that one would expect: occupations requiring heavy lifting, gripping, and high-force/high-repetition work, which often are associated with awkward postures as well." Finally, one of the authors of the original article was a partner at the now-defunct firm Brobeck, Phleger & Harrison which represented companies in RSI-related lawsuits, and the language in the article is clearly not npov. General medical survey articles would be more appropriate sources. In any case, this part of the section is a mess. A13ean (talk) 22:03, 28 August 2011 (UTC)

Thanks to A13ean we now have a possible reason for the strong bias in the subsection on psychosomatic causes of RSI. The deleted paragraph is also logically flawed. Statements such as "This pattern has been seen in some other psychosomatic illnesses" are inappropriate. Firstly, parallel does not demonstrate relationship, especially when the author conveniently fails to consider other possible reasons for the pattern such as changed habits of medical diagnosis. Secondly, the statement as worded actually presumes that RSI is a psychosomatic illness, yet the earlier text makes it clear that this position is held by a minority of medical people.

With the current rise in RSI due to increased use of laptop computers (as ergonomics training courses present), it is important that Wikipedia make a useful and unbiased contribution to assist sufferers.Grevillea (talk) 05:32, 29 August 2011 (UTC)

Tablet Computers

This article says that tablet computers are useful for preventing RSI since they may be less straining than normal keyboards/mice. There are no references for this, and I was just listening to a story a week ago interviewing people who were saying that any extended use of tablets' thumb keyboards cause them pain. — Preceding unsigned comment added by 97.65.197.34 (talk) 13:25, 28 September 2011 (UTC)

I'm pretty sure they mean tablet computers where you can input text by writing with a pen, like the lenovo ones for example, rather than an ipad or the like. This should be clarified. A13ean (talk) 14:22, 28 September 2011 (UTC)

Whoops, just reread that section and it actually says ipad in there, dunno. A13ean (talk) 14:23, 28 September 2011 (UTC)

I put in a "citation needed" tag. If no reference is provided within a month, we can delete the section on tablet computers. -- JTSchreiber (talk) 05:02, 5 October 2011 (UTC)

Adding tendinitis and tendinosis (chronic tendinitis) to "see also" if that's ok

Repetitively hitting the keyboard has strained and inflamed my tendons (tendinitis), and neglecting it has lead to a chronic change in collagen composition (tendinosis – common injury in race horses, and treated with mesenchymal stem cells). When Cartman from south park yelled “carpal tunnel!” when playing Warcraft, he received an ice spray, which is actually indicative of tendinitis inflammation. There’s even an RSI book titled, “it’s not carpal tunnel”. I think tendinitis and tendinosis should just as much be on the “see also” section like carpal tunnel. Carpal = numbness and tingling. Tendinitis and tendinosis (chronic tendinitis) = aching and throbbing. — Preceding unsigned comment added by 68.149.158.238 (talk) 02:52, 6 February 2012 (UTC)