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RSInetwork#7/August 92
======================
For People Concerned About Tendinitis, Carpal Tunnel Syndrome, and
Other Repetitive Strain Injuries
Produced by:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
(crose@applelink.apple.com)
Apple Computer is in no way affiliated with this newsletter.
This document is in setext (structure-enhanced text) format.
To index, browse, and copy from collected setext documents,
use Easy View, written by M. Akif Eyler, Bilkent University,
06533 Ankara, Turkey
(eyler@trbilun.bitnet).
Setext formatting by:
Craig O'Donnell, Assistant Sysop, MacWEEK Forum on ZiffNet
(72511.240@compuserve.com).
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH. Easy View is in the "Applications" library at
the same location under filename EASYVW.SEA.
Statistics
----------
RSI-related statistics from the U.S. Bureau of Labor Statistics
are reported differently in different places. In Issue 6 I said
that 87,000 people in private industry reported RSIs in 1990. On
June 8, that number was reported in the New York Times as 180,000,
which is more like it! Here, finally, are the definitive BLS
statistics:
Year # of cases % of all illnesses
1978 20,200 14%
1979 21,900 15%
1980 23,200 18%
1981 23,000 18%
1982 22,600 21%
1983 26,700 25%
1984 37,700 28%
1985 37,000 30%
1986 45,500 33%
1987 72,900 38%
1988 115,300 48%
1989 146,900 52%
1990 185,400 56%
Survey Of CTS Sufferers
-----------------------
A survey to determine which treatments work best for sufferers of
carpal tunnel syndrome is being conducted by Maureen H. Parke, a
freelance writer of medical articles. The results will be made
available to participants and used as reference materials. The
survey, which asks only ten questions, is completely anonymous;
you need not give your name. To participate, send a self-
addressed, stamped envelope to CTS Study, 235 Glenview Circle,
Vallejo CA 94591.
Iontophoresis: Hope For RSI Sufferers?
--------------------------------------
(From Dow Jones) Iomed Inc. of Salt Lake City said an independent
study has found evidence that the use of electrical currents to
deliver anti-inflammatory medication is highly effective as a
treatment of CTS. The patients received three treatments of
iontophoresis, minute electrical current applied to an electrode
to transport drugs through the skin, for a week. After the
treatment a majority were symptom free, and three months later 63%
continued to have no or minimal symptoms. Iontophoresis has
already been approved by the Food and Drug Administration for
treatment of CTS. The company said iontophoresis eliminates the
pain and complications of steroid medication and costs less than
surgery. Iomed projects the total cost for treatment to be $200
compared to the $2,500 that would be charged for surgery.
(Editor's note: The physical therapist who is treating me for my
new ailment, tendinitis in my shoulder, tells me that
iontophoresis also works well for tendinitis, in her experience.)
S.F. Bay Area Ergonomics Showroom
---------------------------------
A new showroom, The Ergonomics Lab, opened on July 1 in Mountain
View CA to demonstrate and sell to both individuals and companies
"the latest in ergonomic seating and office accessories,"
including chairs, cushions, arm and palm supports, and lighting.
The back and seat supports "can be adapted for use in the office,
at home, in the car." The showroom, at 2672 Bayshore Parkway, #520
(in the Shoreline Office Park Plaza, between San Antonio and
Rengstorff), is open from 9 to 6 M-F, and by appointment on
Saturday. To schedule an appointment call Patricia Hilaire at
(415)969-6306 or 964-3135. The lab is run by the Ergonomic
Sciences Corporation of Sunnyvale (Steve Marshall, Director),
which does consulting and can provide "ergonomic master plans" to
companies.
Pain Relief: Aqua-Relief Pads
-----------------------------
The Aqua-Cel Corporation makes two pain-relief pads of soft,
heavy-duty waterbed material that can be heated or chilled. The
cervical Aqua-Relief pad is 6" x 30" and fits around the neck and
shoulders (or can be wrapped around limbs), and the back pad is
12" x 13". The large pad takes two quarts of water (add hot water
or heat in a microwave, or add cold water and chill in the
refrigerator). Opening the valve may be difficult for people with
severe hand injuries, but the water can stay in the pad once it's
filled, or you can heat or chill the pad itself by setting it in
hot or cold water (it has foam inside). Some massage therapists
carry the pads, or they can be ordered directly from Aqua-Cel. The
pads normally sell for $19.95 ea. If you identify yourself as a
member of the RSI Network, Aqua-Cel will make them available for
$14.95 ea + $2 shipping (in CA add 7.75% sales tax): POB 26827,
Santa Ana CA 92799, (714)962-2776.
Reading Hands-free: The Able Table
----------------------------------
This product allows you to read hands-free in almost any position,
even lying in bed. The lightweight, portable table has one
vertical and two horizontal elastic straps for holding reading
material, an 18" x 20" top, and plastic legs. It can be used at
almost any angle and is easily adjustable. For orders of six or
more the Able Table Co. (Santa Cruz CA) will supply them directly;
call (408)425-5767 ($29.50 ea; $27.50 for packs of 12). Individual
tables need to be ordered from medical catalogs, such as Fred
Sammons (Chicago), Maddak or BelArt Products (NJ), American
Foundation for the Blind and Lighthouse for the Blind, and North
Coast Medical (San Jose CA). North Coast products must be ordered
by health professionals; 1-800/821-9319. Their "wholesale" price
is $39.95 + tax/shipping.
Mouse Relief For Macintosh Users: Easy Access
---------------------------------------------
A member of the RSI Network very highly recommends Easy Access for
RSI sufferers and RSI avoiders alike. Here's what he has to say
about this Macintosh software:
Easy Access is available on every Macintosh system version from
6.0 onward, and may go back even further. You install it as a
control panel, and you arm it by simultaneously hitting Command,
Shift, and Clear. Once armed, Easy Access redefines the ten
numeric keys of the numeric keypad at the right of the keyboard,
plus the decimal-point key on the keypad, to have special mouse-
control meanings. The eight keys surrounding the 5 key serve to
move the cursor in the direction that the key lies from the 5
key for example, 8 moves the cursor up. You can hold down a
cursor-move key to get continuous motion, or you can tap on the
key repeatedly to move the cursor in little steps.
The 5 key on the numeric pad is a synonym for the mouse button. I
keep my mouse to the left of my keyboard, and use the mouse only
for positioning, never for clicking. I do my clicking on the
numeric pad, hitting the 5 key. This results in very much less
stress on my mousing hand, since it's doing only stress-free
positioning, never also pressing the button down. The relief is
huge when it comes to dragging.
Another neat feature of Easy Access that I use often is that the 0
key on the numeric keypad means "press down the mouse button and
hold it down"; the mouse button will be thought of as remaining
down until you request that it come back up by hitting the
decimal-point key. This makes dragging a dream, a real convenience
even for non-RSI sufferers.
There is another aspect to Easy Access that I don't use you arm it
by hitting left-Shift five times in a row and you get the ability
to hit modifier keys (such as Shift or Option) before the keys
they are to modify.
Publications
------------
Soft Tissue Pain and Disability (2nd ed.)
by Dr. Rene Cailliet (F.A. Davis).
Available from North Coast Medical, 1-800/831-9319,
order #NC74501, but must be ordered by a health professional.
Treat Your Own Neck
Treat Your Own Back
both by Robin McKenzie (Spinal Publications New Zealand, Ltd).
Also available from North Coast, order #NC89009 and NC89008,
respectively.
Listen to Your Pain
by Ben E. Benjamin (Penguin, 1984).
Stretch and Strengthen (exercise program)
by Judy Alter (Houghton Mifflin).
Legislation
-----------
OSHA Reform
The "Comprehensive Occupational Safety and Health Reform Act"
(S.1622) introduced by Senators Kennedy and Metzenbaum needs
citizen support. Republicans are opposed to it (allegedly because
it will cost employers money) and President Bush has promised a
veto. Briefly, the bill, in 12 titles, sets timeframes for OSHA to
set national ergonomics standards and standards for work in
confined spaces, and would require employers to establish safety
and health (s/h) programs to reduce hazards and prevent injuries,
and to establish s/h committees and select employee s/h
representatives; would extend coverage to public employees; would
set permissible exposure limits for toxic materials and regulate
exposure monitoring and medical surveillance; would protect
employees from discrimination and give them rights to participate
in proceedings; and would require state plans to conform. The act
would become effective 90 days after enactment. Copies of the bill
are available from the Senate Labor & Human Resources Committee,
Washington DC 20510-6300.
Cal/OSHA Ergonomics Regulation
------------------------------
In California, Cal/OSHA's Ergonomics Advisory Committee has been
meeting to discuss issuing an ergonomics regulation for the
workplace. A group called WORKSAFE, (415)433-5077, asks that you
write Dr. John Howard, Chief of the Division of Occupational
Health, 455 Golden Gate Ave., San Francisco, CA 94102, urging the
Advisory Committee to adopt a strong regulation and to take to
heart the testimony of the labor representatives on the committee.
For a copy of the proposed regulation, call Cal/OSHA at (415)703-
4361.
Americans With Disabilities Act
-------------------------------
The Americans With Disabilities Act of 1990 requires employers to
make reasonable accommodations to allow disabled employees to
perform essential functions of a job. You're disabled if you have
a physical problem that restricts you in doing your job. So if
your job requires typing and you have an RSI that restricts your
typing, you qualify under this act.
The Pacific Disability and Business Technical Assistance Center in
Oakland CA has been set up to provide information on the Americans
With Disabilities Act. They offer information, referral, and
training to both businesses and the disabled. The center is funded
by a federal grant from the National Institute of Disability and
Rehabilitation Research. The hotline number is 1-800-949-4232.
Status of RSI Lawsuits
----------------------
A Federal judge in Brooklyn NY has decided to group together all
lawsuits blaming computer keyboards and other equipment for RSIs.
The suits contend that the equipment used was defectively designed
and that manufacturers failed to provide adequate warnings about
how the equipment must be used to avoid injury. (Incidentally,
Apple Computer now includes a booklet on that very subject with
all their computers.) Anyone using the Worker's Compensation
system is not allowed to sue their employers for injury caused by
negligence. People who aren't taking the lawsuit route may still
benefit from the resolution of these RSI suits for example,
improved working conditions for all people who work with
electronic equipment. (Source: New York Times, 6/8/92)
Letters From Members
--------------------
Please send in your letters, questions, or personal story. Other
members can reply to you via this newsletter or directly.
KB-Pillow
From Dan Kegel (dank@blacks.jpl.nasa.gov on the Internet, or phone
(818)797-4531): ERGO-NOMIC (1-800-488-3746, (213)438-8951) offers
something called the KB-Pillow which sits on your lap and holds
the keyboard. It supposedly lets you lean back, and reduces
wrist, neck, and back strain. Has anybody out there used one? I'm
also interested in finding an ergonomic way of using a computer in
an easy chair, with my head resting to avoid straining my neck
muscles. To this end, I have purchased a Private Eye head-mounted
display ($700), which frees me from having to look in any
particular direction.
Hormones and RSI
----------------
From John Erskine (reply to this newsletter): Dr. Dean Edell (SF
Bay Area radio/TV doctor) once mentioned an informal study of
women near menopause who also suffered from RSI in their wrists.
The women started estrogen therapy around the time of their
menopause and some of the women with RSI experienced vast
improvement in their wrists and arms. The implication is that
there is a relationship between hormones and how swelling and
similar functions are handled in the body. Have any other RSI
Network members ever heard anything about this or explored this
direction?
CTS And Nerve Compression
-------------------------
Lee Newman of Pennsylvania tells her story and asks some
questions. Feel free to contact her at (814)865-1818 (work), 241
Oakwood Avenue, State College PA 16803, or ewn@psulias.psu.edu on
the Internet. Please copy your reply to this newsletter if you
think others might benefit.
My problems started off with tingling and numbness in my right
hand and arm in May 1991, progressing to pain in the hand and arm.
I then started getting carpal tunnel symptoms in my left hand and
arm, followed by pain in my left elbow (diagnosed as nerve
entrapment there, too). Next I developed ulnar nerve compression
at both wrists in addition to the median nerve compression at both
wrists, and most recently, I've started getting nerve compression
problems in my right elbow. I've also had some problems with
nerve compression in my hips (particularly the left) which I'm
hoping will be alleviated by my nice new ergonomic computer chair.
I had carpal tunnel release surgery (and a release of the ulnar
nerve at the wrist) in my right hand in January. Unfortunately, it
hasn't helped I still have pain and the inside of my ring finger
is somewhat numb all the time. The last time I saw my hand
surgeon, he mentioned something about doing "remedial surgery" I
don't know what he meant. I'll ask him when I see him again, but
in the meantime if anyone out there knows what kind of surgery
might follow a failed carpal tunnel release, I'd appreciate it if
they'd share the info. I assumed if the surgery didn't help the
first time, you were stuck.
I'm a computer programmer and switching jobs will be a last resort
for me, so I'm open for any possible suggestions people have to
relieve pain. What kinds of physical therapy have people tried?
I've tried fluidotherapy, range of motion exercises, mild wrist
strengthening exercises, warm whirlpool treatments, contrast
baths, ice packs, and splints. It all just seemed to make things
worse. Anti-inflammatories (ibuprofen, Naprosyn, Prednisone,
Voltaren) haven't helped me either -- has anyone found anything
else that helped?
Has anyone out there had leg pain where you get pain going down
the outside of the leg (not sciatica, this is really the outside
of the leg) and down to the ankle? What have people done to
relieve it besides getting a computer chair with better back
support and getting up and walking around every so often? 800 mg
of ibuprofen 3 times a day seems to help somewhat with my leg
pain, but I don't want to stay on that forever.
Has anyone out there had surgery to release the ulnar nerve at the
elbow? I doubt that I'll have that done, but I'm interested in
what the success rates for that surgery are. I've heard that
they're lower than the success rates for carpal tunnel surgery.
Finally, can anyone out there recommend hand surgeons/specialists
in the PA/DE area? Has anyone had any experiences at the Hershey
Medical Center in Hershey PA that they can share?
From the Editor
---------------
As mentioned earlier, I now have tendinitis in my shoulder in the
biceps tendon and supraspinatus tendon, to be specific. I'm told
it's due to swimming (freestyle, 3 times a week for about 15
years) and has no relationship at all to the tendinitis in my
forearms and elbows (which is work-related, due to typing). If any
of you have experience with this type of tendinitis, I'd love to
hear from you.
I've been put on the anti-inflammatory drug Relafen. It's the
first anti-inflammatory that hasn't upset my stomach but that may
be because this is the first time I was told to take it not only
on a full stomach, but also with 8 ounces of water. The one time
it did make me queasy, I had drunk a small amount of alcohol that
night, which I'd forgotten is a no-no. Just thought I'd pass along
these bits of wisdom.
RSI Support Groups (California)
-------------------------------
San Francisco:
Judy Doane, (415)931-8780, or Yari Leski, (415)759-0140.
Alternate Mondays, 7:30 PM, at the California Pacific Medical
Center (3773 Sacramento St., at Maple, SF), rooms G and H.
1/18: Ilana Parker, physical therapist specializing in the
Feldenkrais method
1/4/93 and 2/1/93: no speaker, general support meeting.
East Bay:
Joan Lichterman, (510)653-1802.
Meets monthly, 7 to 9 PM, usually on the second Wednesday, at
CalARM 400 29th Street, #105 (at summit), Oakland.
1/8/93: Glen Kohler, Using Tai Chi to Prevent RSIs
North Bay:
Stephanie Barnes, (707)571-0397.
Tuesday evenings in Santa Rosa, 7 to 9 PM, Round Table Pizza 550
Montecito Blvd., between Middle Rincon and Mission Blvd.
South Bay:
Pat Roggy, (408)297-8725, or Petzoldt Hand Center, (408)261-
7660.
Los Angeles area:
Samantha Greenberg, (213)207-1653.
A "computer injury network".
Contributions & Subscriptions
-----------------------------
This newsletter relies on contributions from its readers: please
contribute your questions, stories, and any information that may
be of interest to people with RSI.
Where possible please submit contributions on diskette or via
Email. Xeroxes of interesting articles from anywhere are always
welcome. Mail disks or xeroxes to:
Caroline Rose, 970 Paradise Way, Palo Alto CA 94306
Electronic subscriptions are free.
Formatted setexts are found on ZiffNet/Mac via Compuserve.
Other issues of RSInetwork are available through ZiffNet/Mac
and Compuserve, in the "Reference" file library at location
ZMC:DOWNTECH.
For Internet mailing list distribution, send your Internet
address to:
crose@applelink.apple.com
and you'll receive the newsletter (plain ASCII).
[Ed. Note: Carolyn wishes to shift newsletter distribution to
electronic networks and Email. If you obtain the newsletter
electronically please pass it on in hardcopy or via your
local BBSes or LAN. Don't write to Carolyn for hardcopy of
the newsletter. -COD]
..