THE DREADED WRITERS’ LURGY
I mean, of course, Repetitive Strain Injury (RSI). Even now there are some who refuse to believe that this condition exists, but, having suffered for well over a decade, I can assure them that it does. Although it tends to come and go, RSI is incurable, and becomes worse as you grow older, because the damage to your body is incremental and exacerbated by age-related arthritis. Please note that I, Rosemary Johnson, am not a doctor or a practitioner in a discipline ancillary to medicine. What I write below is based upon my personal experience as an RSI patient.
RSI and the Law
In the UK, the Health and Safety (Display Screen Equipment) Regulations 1992 as amended by the Health and Safety (Miscellaneous Amendments) Regulations 2002 require employers to safeguard the health and safety of employees using computers. By and large, this means safeguarding them from RSI and visual problems. The Regulations apply to staff working at home and the self-employed; this means they cover full-time freelance writers, but not those of us with a day job, who write in the small part of the day not taken up with work and family.
Symptoms – Is What I’ve Got RSI?
Is It Just A Computer Thing?
No. Anybody who carries out repetitive actions in their work or daily life is likely to suffer and, in days gone by, we used to get ‘writers’ cramp’ – an earlier version of RSI, perhaps. Nowadays, however, RSI is almost always computer-induced, and, of course, it is not confined to writers.
Fingers, hands and arms. You feel discomfort as you click the mouse or press the spacebar with your thumb. For an hour or more after you stop using the computer, your fingers, hands and arms continue to ache. Certain actions – such as picking up a towel to dry your hands – may cause excruciating pain like your dentist accidentally catching a nerve with his drill. Joints may click and your hands may weaken, so that you can’t turn keys in locks or twist tops off jars.
Shoulders and neck. Your shoulders and neck ache as you type, so much so that you cannot concentrate on your writing, and, again, this will continue for about an hour you stop. You go to the doctor convinced that your glands are swollen and to the dentist with toothache, only to be told by the doctor to visit the dentist and by the dentist vice versa. Sleeping becomes difficult because you can’t get your neck in a comfortable position.
Back. Your back may ache, either between your shoulder-blades, or lower down, especially when you ‘go for a walk’, and you feel exhausted and generally unwell.
Stress exacerbates all RSI symptoms, by prompting your nervous system to release stress hormones (including adrenalin and cortisol) which, among other things, cause muscles to tighten. Tight muscles are achy and painful muscles. Another trigger is pregnancy; many expectant mothers experience ‘carpal tunnel syndrome’ (pain in the hand and fingers) caused by hormonal changes and build up of fluid. Although it is supposed to right itself after delivery, it didn’t in my case!
Take Breaks. Flex your shoulders every few minutes. Take your hands away from the keyboard and shake them. A two minute loo break will relieve your muscles as well as your bladder. After an hour, take a longer break; the Display Screen Equipment Regulations state that no office worker should work at a computer continuously for a period exceeding one hour – and neither should writers.
Sit in a Comfortable Posture at Computer
This man sitting-safely-at-the-computer comes courtesy of the Display Screen Regulations. This is how he does it:
- Feet flat on the floor. As his legs are slightly too short, he has a footrest.
- There are about six inches of space between his knees and the bottom of the desk, so he can adjust the position of his legs.
- He sits in an upright position, his chest at a right angle to his legs and supported by the backrest of his adjustable chair.
- His elbows are at right angles when he uses the keyboard.
- His line of sight to the monitor points downwards ever so slightly. (Not everyone agrees; the accepted wisdom is that line of sight should be horizontal.) The monitor is ‘up and down’ adjustable and tiltable to allow him to find a comfortable position.
- His computer is positioned straight in front of him, not at the side or diagonal.
Sit on Appropriate Chairs
For Desktop Computers
The Display Screen Equipment Regulations require that office workers using desktop computers be provided with expensive, adjustable chairs, which adjust all over the place – seat height, seat angle, back rest angle and other ways you can’t imagine. If you use a desktop computer for your writer’s office at home, the most important considerations for your chair are that the seat height and back rest are adjustable and that it has wheels to enable you to move small distances (say, to the printer). It should not have armrests, as leaning upon them could encourage you to adopt an unnatural posture with your shoulders raised or hunched. You don’t necessarily have to spend a lot of money – about £40 – although for an orthopaedic version specially designed for an RSI sufferer, you might. Office chairs, however, are delicate flowers: the levers to adjust the seat height and back rest jam, fall off and get lost and the seat therefore remains locked in the same setting for ever and ever; back rests become floppy and provide no support at all. Recognise when the thing has reached its ‘best before end’ date. And you really wouldn’t use your computer from a dining chair, would you? By the way, some people have used squashy exercise balls very effectively as a way of maintaining good posture at the computer. (I’ve never tried it.)
Use The Keyboard More Effectively
As the keyboard is much kinder to your hands than mice or touchpads, use it as much as possible. Fortunately for we writers, inputting massive amounts of text is the computer activity least likely to bring on RSI. For editing and navigating, use keyboard shortcuts. Check out these sites for them:
- Windows – http://support.microsoft.com/kb/126449
- iPad (not so good)- http://www.labnol.org/software/keyboard-typing-shortcuts-for-iphone-ipad/13564/
Special equipment for Computer (for desktop machines and laptops.)
Alternatives to mice: tracker balls (upside-down mice, with the ball on top, which are more responsive to your touch than conventional mice); ergonomic mice (some contoured, others with buttons on the side which are more comfortable to click); small mice; large mice. Experiment with as many as possible to find the one that is most comfortable. The ergonomic ones tend to be expensive (£50-£100).
Gel pad. Place this in front of your keyboard, to give support to your wrists.
Voice Recognition Software. This enables you to input text and navigate around the computer screen, by speaking into a microphone. The most well-known commercial software for PCs is Dragon Naturally Speaking, although Windows Speech Recognition is available as part of the Windows Operating System (in other words, free if you have Windows). To access it, click on Start, then in the window immediately to the right of Start, search for Windows Speech Recognition. You will, of course, need to use it with an earphones and microphone headset. Voice recognition software is also present in the iPad (Siri) and many mobile phones (spoken straight into the device).
Although some business computer users are able to use voice recognition software very effectively and very fast, to my mind it is not compatible with ‘writing’ fiction, which is a much slower and more precise process, as you need to seek out the right words and phrases, change them, rearrange the sentence etc etc. The software does not ‘hear’ accurately and having to make so many corrections in every sentence distracts you from what you are trying to ‘write’. Moreover, being designed by Americans, it doesn’t deal very well with British voices, British phrases or British institutions. For instance, it will rattle off ‘Barack Obama’ but struggle with ‘Colchester Barracks’. It improves with practice – apparently – but I have never summoned up the patience to find out.
Pillow. Most ‘experts’ recommend that you sleep on foam and fibre pillows, which are non-allergenic – good for asthma sufferers, but maybe not so comfortable for your aching neck and shoulders. Try a memory foam pillow (which ‘remembers’ the shape of your head) and a triangular neck pillow – but don’t rule out the old fashioned feather pillow, the most squashy of them all.
Ring the Changes. Seeing as RSI is caused by repetitive actions and maintaining the same poor posture, change how you sit and use the computer. Do you use a desktop with a mouse at work? Use a laptop with a touchpad at home?
Treatment For RSI
What You Can Do… Apart from the Above?
Stop using the computer altogether. Drastic, I know, but it may come to that. Or… use a tablet with a touchscreen. Give your hands, shoulders and neck a break when you go on holiday… by not taking your computer. (All right. You can take your smartphone, or even your iPad.)
Take Painkillers. Ibuprofen (bought over the counter) may reduce inflammation in muscles and joints, but only in mild cases and not for very long. Oral painkillers are not recommended, because they don’t work very well, the temptation is to take bigger and bigger doses. Moreover ibuprofen is linked to IBS.
Apply Ointment to Affected Areas. Rubbing ibuprofen gel on to affected areas will help reduce inflammation eventually, but, although it does no harm, because it doesn’t go through the stomach, you won’t feel any immediate relief. Old fashioned menthol-based ‘deep heat’ (or ‘heat rub’) ointments contain no pharmaceutical drugs, but – despite the overwhelming odour – the warm glow they generate soothes and relaxes aching limbs.
Lay Wheat bag On Affected Areas. These are perfectly safe, provide instant relief and can be used repeatedly. Place the wheat bag in the microwave and heat it, following the manufacturer’s directions, then lay it on your neck or shoulders.
What Your Doctor Can Do
Prescribe (More Powerful) Oral Painkillers. There are various prescription drugs on the market, all of them souped up versions of ibuprofen. They may work, but should only be taken for short periods, as they are even more likely to give you IBS than the over-the-counter stuff. Moreover, the relief these drugs give may prompt you to carry on with the very activities that cause the RSI and further damage your muscles and joints.
Administer Anti-inflammatory injections. As they anaesthetise painful joints, these anti-cortisone shots will apparently ‘cure’ your RSI at once, but they are only effective for three to six months. The actual jab is absolute agony, as it has to be inserted into joints – for example, into the thumb joint or the wrist. If you can manage it, persuade an experienced orthopaedic surgeon to do the job, rather than your GP who may not have given one of these things for several years. Immediately afterwards your hand may be extremely painful (You’ll be wondering why bothered at this point.), so don’t expect to be able to drive home from the doctor’s surgery. (I had to do exactly that, twice.)
What Physiotherapist, Acupuncturist, Chiropractor and Masseur Can Do
Hands-on massage gives immediate relief and is absolutely safe, but will not, in itself, improve your RSI if you continue to adopt bad practices at the computer. Whereas therapeutic masseurs will massage you by hand, physiotherapists and chiropractors will do the same thing using machinery. All these practitioners will recommend exercises and it is certainly worthwhile taking their advice on what might be most suitable for you.
Some RSI-sufferers find acupuncture helpful. An acupuncturist claimed that he could cure mine… and failed.
RSI and IBS (Irritable Bowel Syndrome)
It is well-known that many RSI sufferers also experience the other medical acronym of the modern age – IBS. It is not clear why, although ibuprofen is known to aggravate the lining of the stomach. Another possible cause may be that patients with tight muscles in their shoulders, neck and back are also experiencing the same problem in their stomachs and bowels… which causes constipation, bloating and stomach ache.
For a writer, RSI is a debilitating and demoralising condition because it stands in the way of what you love and do best. I hope that some the advice above – based upon my own personal experience – is of some help. For some more conventional advice, try the following: