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How ironic that computers, the very technology celebrated for making office work easier, would cause such harm. By now, nearly half the U.S. work force -- some 45 million workers -- use computers (though not all spend hour after hour punching keys). "We thought technology was going to help us, which it does. But we did not consider that we would also have to adjust the workplace at the same time," says Barbara Silverstein, research director of Washington State's department of labor and industries.
RSI involves not just one but an array of ailments resulting from tugging, pounding and straining crucial tissues in the upper body. It usually begins innocuously. "People think they've had a particularly hard day or that they're getting old," says Frank Fernandez, an Oakland, California, attorney who has filed suit against several computer manufacturers on behalf of RSI sufferers.
But as the hands continue to be overworked, symptoms worsen. Tendons, which are like long pulleys directing the movement of the fingers from many places in the hands and arms, can swell up, producing painful tendinitis. Soreness can also result from the inflammation of sheaths surrounding the tendons. Muscles in the forearm that control the movement of fingers may become irritated, a condition called myositis. As tissues become inflamed and swollen, they can press on nearby nerves, causing tingling and weakness in the fingers. Sometimes scar tissue develops in the area. All together these injuries, if not treated, can result in diminished coordination and strength: patients may literally lose their grip and have trouble managing simple manual tasks.
AMONG THE MORE EXTREME -- and less common -- cumulative traumas is carpal tunnel syndrome. It develops when tissues in the palmar side of the wrist swell, squeezing a vital nerve that runs through the area. Carpal tunnel syndrome can cause crippling pain for months or years, though surgery can sometimes help.
It is hard to conceive how the gentle patter of fingers over a computer keyboard could do such damage. People have, after all, been typing for decades, and computers would seem to be an improvement over clunky ) typewriters. But word processors pose special problems. They allow workers to sit with their fingers flying across the keyboard at 240 strokes a minute for hours without a break. A typewriter, by contrast, forces workers to pause every so often to move the carriage or change the paper. The amount of time spent at the keyboard is critical: a study in Australia found that people who typed for more than five hours a day at a computer had 12 times as great a risk of developing RSI as those who spent less time.
Workers at computer stations may position their hands over the keyboard with the sensitive wrist cocked upward or downward, compressing the tendons, ligaments and nerves that run through its narrow confines. People working with typewriters are more likely to hold their hands suspended straight forward, the wrists flat. Old-style typewriter keys also generally have a certain amount of spring, while computer keys often strike against a hard, unforgiving base. "These simple things sound trivial, but they are not when you're locked into one position, working all day long," says Marvin Dainoff, director of the Center for Ergonomic Research at Miami University, in Ohio.