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Repetitive Stress Injury

The National Academy of Sciences estimates that thirteen million to twenty million American adults are plagued by repetitive stress injuries (RSIs), the nation’s number-one on-the-job hazard. Most RSIs involve the hands and wrists, and many cases are related to computer use. With more and more teenagers typing, clicking and dragging, it was inevitable that the epidemic would begin to make inroads in this age group.

All that time spent on-line has a cumulative effect on the soft tissues of the hands, wrists, elbows, shoulders, neck and back. (Another name for repetitive stress injury is cumulative trauma disorder.) Physicians are reporting growing numbers of pain complaints among cyberspace travelers in their twenties. The initial damage to nerves and tendons, however, was most likely sustained as many as five to ten years earlier, when they were teens.

Symptoms That Suggest Repetitive Stress Injury May Include:

Minor aches and pain in the affected area; if left unchecked, may progress to:

  • Sensations of tightness, soreness, numbness, tingling, burning, coldness in the hands, wrists, fingers, forearms and/or elbows
  • Loss of hand strength and coordination
  • Severe pain

How Repetitive Stress Injury Is Diagnosed

Physical examination and thorough medical history, plus one or more of the following procedures: (1) nerve conduction study and (2) X rays.

How Repetitive Stress Injury Is Treated

  • Immobilization: Mild cases of repetitive stress injury frequently heal just by resting the affected area. The young patient might have to be fitted with a lightweight splint or a more rigid brace temporarily. Be sure that he wears it as instructed; in a small study of people with carpal tunnel syndrome, researchers at the Medical College of Virginia in Richmond found that those who kept their splints on twenty-four hours a day improved more than the group that didn’t wear the splint.
  • Drug therapy: More severe cases of RSI may require over-the-counter or prescription oral non-steroidal anti-inflammatory drugs (NSAIDs), to reduce swelling. Examples include naproxen and ibuprofen.
  • Surgery: An operation is rarely necessary for treating bursitis, tendinitis and tenosynovitis. Carpal tunnel syndrome, though, does not always respond to nonsurgical interventions. If surgery is necessary, the surgeon performing the outpatient procedure cuts one of the ligaments in the wrist, to relieve the pressure on the median nerve.

Helping Teenagers Help Themselves

Repetitive-stress injuries are infinitely easier to prevent than to treat. Mom and Dad, you can help. The next time your youngster’s at the computer, check to see that she is observing the healthy habits below and write out a list of these habits, to be kept near the computer.

  • Sit up straight in the chair (which should have a back support), shoulders relaxed.
  • Keep both feet on the floor or on a small stool.
  • Eye level should be even with the top of the monitor screen, so that your head is tilted slightly down, not with the chin jutting out.
  • Keep your wrists straight and level with the keyboard. You shouldn’t have to stretch your fingers to reach the keys.
  • Don’t contort your hands while typing; the fingers should form a straight line with your forearms.
  • Wrist rests are for parking your hands only when taking a breather, not while typing.
  • The keyboard should be tilted toward you, but slightly.
  • Dance lightly over the keys, don’t stomp on them. Similarly, refrain from gripping the mouse too hard. If possible, learn as many keyboard command codes as you can, so that you don’t have to rely so heavily on the mouse.
  • Use both hands to perform combination key strokes such as CTRL-K or ALT-F8.
  • Both the monitor and the keyboard should be directly in front of you, not off to the side, forcing you to turn to see them.
  • When using the mouse, try to move it with your hand and arm instead of with your hand and fingers.
  • Don’t let the room get too chilly; cold temperatures contribute to muscle stiffness.
  • Don’t talk on the phone while you’re typing, with the receiver tucked between your shoulder and cheek. Invest in a headset or use the speakerphone function.
  • Take a ten-minute break every hour that you’re on the computer. Stand up and shake out your wrists. Step outside. If you get so immersed in your work or play that you tend to forget, set an alarm clock or watch.

If your teen complains of stiffness and other early signs of repetitive-stress injuries, consider purchasing a voice-recognition program, which allows the user to speak into a microphone and watch in amazement as his words appear on the screen.

Last Updated
Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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