Repetitive strain injuries are a major issue in the work world -- for the musician who sits and moves in the same posture day after day... the sign language translator whose hands are always in motion... or, as is most typical, the person who works at a computer. The cost of these injuries is approximately $20 billion per year in worker's compensation -- then there are the missed days from the job and the sometimes excruciating pain that intrudes on a person's livelihood. Now researchers have come across a surprising finding that might improve the situation: They have discovered a subtle early symptom that, when recognized, opens the way for intervention before the problem becomes acute.

For the study at Temple University's College of Health Professions, study authors Ann Barr, PhD, and Mary Barbe, PhD, put a group of laboratory rats to work performing repetitive motion tasks, the type of activities that lead to carpal tunnel syndrome, tendonitis, tennis elbow and similar neural and musculoskeletal injuries. Much to the researchers' surprise, weeks before the rats showed signs of pain, they began to develop psychosocial symptoms. They slacked off from their tasks and eventually some of the rats started curling into a ball to sleep between chores. This behavior, the researchers realized, was comparable to the malaise, fatigue and depression that define "sick-worker" syndrome. The researchers believe the common link has to do with inflammatory proteins called cytokines. Chronic low-force, highly repetitive work triggers cytokines that then go into the bloodstream and tissues around the peripheral nerves, causing nerve injury. It appears that cytokines in the bloodstream also find their way into the brain causing, yes, malaise, low-level depression and lethargy.

MALAISE SELF-DEFENSE

I consulted with Dr. Barr on how people can put the information gained from this study to use. The primary message, she says, is that people who are vulnerable to repetitive strain injury for any reason, including their work situation, must pay attention if they begin to experience feelings of malaise. She says you'll recognize them because they are similar to how people usually feel in the early stages of a cold -- a sense of being sluggish, out of sorts and tired. This is the body's warning system, a way of telling you that you need to take action. It's important to understand that repetitive strain injuries come about from activities that require either low force/high repetition (e.g., typing) or high force/low repetition (e.g., skydiving) and that if what you do demands high force and high repetition, she says you are really setting yourself up for trouble. The key to self-defense is to modify your actions so that you break the cycle of repetitive activity by taking regular breaks from the activity. Evaluate if you are pushing yourself too long or if you need to decrease the intensity of the way you are performing the task.

Interestingly, while exercising too much outside of work is a possible trigger, say by lifting weights without resting your muscles between sessions or by using weights that are too heavy, for the most part, exercise can be beneficial. Dr. Barr speculates that aerobic exercise in particular can help because it strengthens the immune system, which means a healthier inflammatory response. Investigate as well if there are ways to intervene ergonomically. In other words, make changes in the physical motions of the task itself that will reduce the intensity you need to accomplish it, or alter the workstation to position you in a more healthful way. If you have been experiencing malaise and consequent pain for more than one month, she says, have your doctor do an evaluation for a referral to a physical or occupational therapist for additional help.

SELF-DEFENSE THE NATURAL WAY

I also called naturopath Mark Stengler, ND, for his advice concerning repetitive strain injuries. He agrees that they are important to address in the earliest stages possible. His first suggestion is methylsulfonylmethane (MSM), a nutritional supplement used to address the pain and help heal muscle and tendon/ligament/joint injuries. Patients are often prescribed 3,000 mg to 5,000 mg a day, though doses of up to 8,000 mg per day are typically taken until pain and inflammation begins to recede. Bromelain, an enzyme extracted from the stems of pineapple, reduces swelling and can also help heal a strain -- 500 mg three times daily may be ordered between meals, but it is medically contraindicated with blood thinners. The homeopathic Ruta graveolens is frequently prescribed at two pellets of 30C potency twice daily for seven days. For additional help in healing injured tissues, 1,000 mg of vitamin C twice a day may be added to the regimen.

By being alert to the symptoms of malaise, you may be able to avoid the serious physical and financial strain of repetitive motion injuries.

Be well,

Carole Jackson
Bottom Line's Daily Health News

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