From Deseret News archives:

Repetitive stress injuries: Diagnois is out on whether wrist injuries are epidemic

Published: Saturday, March 8, 2008 12:07 a.m. MST
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NEW YORK — Can a workplace epidemic be cured?

With the personal computing boom of the 1990s came thousands of "repetitive stress injuries" or "repetitive strain injuries." RSI became the hip medical acronym of the keyboard era, with subset carpal tunnel syndrome the diagnosis of the day.

"At its height of diagnosis, anybody showing up at a doctor's office with wrist pain or hand pain was being diagnosed with carpal tunnel," said Carol Harnett, vice president of insurer Hartford Financial Services Group Inc.'s group benefits division.

Since then, carpal tunnel cases have plummeted, declining 21 percent in 2006 alone, according to the Bureau of Labor Statistics. Among workers in professional and business services, the number of carpal tunnel syndrome cases fell by half between 2005 and 2006.

What changed?

First, it may not have been the white-collar epidemic it appeared to be.

A 2001 study by the Mayo Clinic found that heavy computer users — up to seven hours a day — had the same rate of carpal tunnel as the general population. Harvard University headlined a 2005 news release "Computer use deleted as carpal tunnel syndrome cause."

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"Clearly, if keyboarding activities were a significant risk for carpal tunnel, we should have seen, over the last 10 to 15 years, an explosion of cases," said Dr. Kurt Hegmann, director of the Rocky Mountain Center for Occupational & Environmental Health. "If keyboarding were a risk, it cannot be a strong factor."

Blue-collar workers, especially those doing assembly-line work such as sewing, cleaning and meat or poultry packing, have a far greater incidence of carpal tunnel than white-collar workers, according to Bureau of Labor Statistics data.

That doesn't mean white-collar workers don't get carpal tunnel and related disorders. But it may mean such disorders were overdiagnosed when they were most in the news, resulting in an artificially high number of cases by the late 1990s. Most doctors have dropped the term RSI, calling them "musculoskeletal disorders" while government agencies like "cumulative trauma disorders."

Now, some experts think some of those patients had "referred pain" from trouble elsewhere, such as the neck. Other theories claim attention to ergonomics has prevented injuries or that they have become underreported because they lack the immediacy of a broken bone.

Recent comments

I had intense pain in my right wrist off and on for two years....

Bob | March 8, 2008 at 7:47 a.m.

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Orlin Wagner, Associated Press

Nurse Terri Janda, administrator of corporate health services at Blue Cross Blue Shield of Kansas, works with Sara Browning at the company's offices in Topeka. A program at Blue Cross has reduced the company's workers compensation costs by 62 percent.

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