Health Services First of all, when you see a doctor, either at Brown Health Services or a specialist, ask for a physician's note. It's good to have one to take to Disability Support Services, to show to professors in the case that you have difficulties due to your wrists.
Your first line of defense is to visit Health Services (401) 863-3953. They will check you out, possibly give you splints, and depending on the severity of your problem, write you a referral for a specialist. You must have a referral if you have Brown health insurance and want to see an outside provider.
Orthopedist If you have moderate to severe RSI, you will probably be referred to an orthopedist. This is useful because they will test you for nerve problems and will diagnose you. However, some of us have found orthopedists to be frustrating because they do not provide any suggestions for conditions that are not surgically treatable, such as tendinitis. Ask us or the ice list for suggestions as to which doctors we found to be the most helpful.
Physical therapy Many injured students, particularly those with tendinitis, have found Physical Therapy to be very helpful. A physical therapist can keep you from losing strength in the early stages of an injury, and help you rebuild strength later, as well as improving circulation and reducing scar tissue. Your physical therapist will guide you through strength training and stretches, use other treatment modalities, such as deep tissue massage, ultrasound, iontophoresis, and phonophoresis. You can get a referral for Physical Therapy from Health Services, but they have been told by the insurance company that physical therapy will not be covered. However, all students so far have been able to get insurance to cover treatment (as of the 2005-2006 policy year). For Physical Therapist suggestions, contact the ergo merc.
Massage Massage can be helpful because it helps reduce scar tissue, and increase circulation. Deep Tissue Massage appears to be particularly helpful for some as a treatment, but many people get pain relief and reduction of tension from other types of massage. Since RSI affects the entire upper extremity, massage of the shoulders and neck can be beneficial.
Yoga Some people find yoga helpful in dealing with RSI. Yoga strengthens and stretches all parts of the body, and can aid in relaxation. Some poses put more weight on the hands than is advisable for RSI sufferers, but good yoga instructors can accommodate limitations of their students by providing alternative poses and equipment. There are yoga classes offered through Brown Athletics, and there are a number of local private studios.
Integrative approaches RSI is more than just a problem of a particular point in your arms, and so any effective treatment will address your whole body. Being under stress causes your muscles to tense up, reducing circulation and increasing pain. Overwork leads to fatigue, which in turn causes people to modify their work habits to (slouching, or resting their wrists) cause damage.
"It's not Carpal Tunnel Syndrome!" by Suparna Damany, MSPT & Jack Bellis is highly recommended, because it discusses an integrated approach to healing and to understanding the cause of injury Dr. John Sarno suggests a theory that differs from the structural hypothesis. His name for what we call RSI is Tension Myositis Syndrome, pain resulting from a complex interaction between mind and body. His proponents argue that particularly if you have had RSI for a long time, you should consider his work. You can find more information about Dr. Sarno's work here and here, and also check out his book "the Mindbody Prescription."
Mental Health If you have been suffering from RSI for a while and it has strongly affected your life, it is normal to be frustrated, and depression to some degree is not uncommon. If you're feeling hopeless about your injury, contact Brown Psychological Services.
Self-care There are a number of things you can do to take care of yourself, but most of these things need to be done in consultation with a doctor to not make your injury worse. Ice reduces inflammation and can cause pain relief. Heat improves circulation and can also be soothing. Heat and ice can be used without worry of problems, but don't apply ice packs directly to your skin.
Painkillers may make your pain more tolerable, but unless a doctor prescribes them, they are probably not a good idea, particularly when combined with work. Painkillers just mask the pain, and do not address the deeper problem. However, if RSI is making it hard to sleep, using painkillers at night shouldn't be a problem.
Doctors often prescribe splints for their injured patients, but this is a tricky issue. Splints may be more comfortable and reduce pain, but while immobilizing your wrists allows them to rest, it also lets your muscles atrophy. Trying to gain functionality with weakened wrists is very difficult. Typing with wrist braces forces you to keep your wrists straight but it is better to keep them straight with your own effort. If you lose strength from using splints or if your wrists are already weak, strength training with light weights can help. However, it is easy to reinjure yourself if you're not careful, so only do this under supervision of a professional. The professional will start you with small 1 pound weights and work you up to a maximum of 5 pounds.
Stretching is something you can easily do for yourself. As long as you do not stretch to the point of pain, stretching can only be beneficial.
Lifestyle When we get busy, it is easy to not pay attention to our general health. However, it is important to take care of your whole self. Rest, exercise, drink plenty of water, eat nutritious food, and practice stress relief. back