I felt pain for the first time in July 2006, and I was just 20 years old. Not necessarily an age at which you would expect something like this to happen. During the nineties private households became much more "technical": computers, game consoles and cell phones, all increased the strain on our hands and fingers significantly. Meanwhile, I have experienced how painful these thousand-fold repetitions of muscles, tendons, joints and nerves can be.
Starting with Tetris on the Game Boy, I quickly switched to computer games: flight simulators, auto racing, strategy games and first person shooters. The Internet came over the analog phone line at snail's pace (if at all) and was expensive compared to today's prices. Wikipedia and Google did not exist, homework was still written by hand and cell phones were not common.
I want to clarify the fact that my hand strain from the age of 7 to 14 was still moderate (compared to today's children).
As a teenager I initially played intensely on the computer (often several hours a day). As time went by I discovered my enthusiasm for creating websites, so I predominantly switched to that kind of work in my free time. Furthermore I coded some software in computer science class and at home. At the weekends I worked at a local computer store. All my internships I completed involved computers in some form. Even in the 9 months of my community service (compulsory in Germany at that time) I was able to contribute my computer skills. I also started a small business for PC services and web design.
Up to this point I never felt pain in my hands or forearms after working on the computer. I had not thought about taking short breaks in between to give the body time to recover. If someone had made me aware of this risk, I probably would not have listened. I would not have been able to imagine the tremendous pain that could occur.
My hand strain from the age of 14 to 20 was above average at that time.
With the constant advance in technology in all areas of life, the average strain on our hands will increase significantly in the coming years and decades. Consequently my prediction is that hand-forearm discomfort due to repetitive strain (=repetitive strain injuries) will increase in the future. As a cure is much more difficult than prevention, I would like to be actively involved with this website to help avoid that kind of pain. Abstract warnings will probably fall on deaf ears with 99% of all people (I would not have reacted differently). Only those who already feel pain themselves will deal with this issue and take the risk seriously.
I hope to reach a few doubters with this personal story on my website. Even though I might only convince a handful of people to listen to their body and treat it well, the construction of this website will already have paid off!
The rest of this page deals with the chronological course of my injury. I don't mention all diagnoses and treatments, I limit myself to the most significant. Text passages in italic are retrospective comments.
At the end of a three-month internship I felt a slight pain in my right wrist for the first time. In the following days I continued to work normally, hoping that after the next weekend everything would be okay again - but it was not. Even switching the mouse to my left hand did not help significantly. The pain had intensified within a week and now both wrists were already equally affected. At the weekend both forearms swelled so much that the armband of my wristwatch was too short to wear it any more. My doctor diagnosed a tendon irritation and prescribed me diclofenac gel and ibuprofen 400 tablets. His prognosis: In one to two weeks everything should be back to normal.
RSI often does not develop that fast. Usually there are warning signs in advance in the form of temporary, mild discomfort.
After three weeks with tablets and gels the swelling had gone, the severe pain in both forearms remained (even with no workload). The former tendon irritation was now labeled tenosynovitis by my doctor. Cortisone injections in both elbows only brought relief for the same day.
I don't recommend cortisone treatments because long-term tissue damage is a risk and the positive effect on me was minimal.
Since the beginning of the pain I had hardly worked on the PC. Any additional activity using my hands was greatly reduced as well. This absolute rest had a significant negative effect on my physical fitness. Deep friction massages reduced the pain at times of rest. I had to stop weight training (as prescribed by a physical therapist) because of significant pain after the first exercises.
Strengthening exercises could have helped me, but only at a much later stage. If you still feel constant pain during rest, you shouldn't do strengthening exercises. Instead I should have gone out for a jog more often.
October - December 2006
In October I enrolled in university (business informatics). The pain had become less after wearing wrist braces and resting for the last two and a half months. I was still far from being pain free, but at least I was able to do some work on the PC.
The second orthopedist I consulted did not know anything more to help me but to send me to a natural health professional. She diagnosed a heavy metal poisoning and ordered a detoxification.
In addition to the stabbing pain I now felt slight sensory disturbances. Especially when the arms were poorly supplied with blood, I felt a strange feeling in both forearms. I had never experienced this feeling before. It was diffusely affecting the entire forearm: no real pain, but as a constant feeling it was very uncomfortable.
The detoxification was a waste of time and money (later performed hair and blood tests were negative). In addition I didn't inform myself further about the condition called "RSI" which I read about on the Internet.
January - March 2007
Both osteopath and chiropractor agreed that my arm pain originated from my spine. They carried out several spinal adjustments which always brought short-term improvements. I was also given a quick introduction into trigger point massage which proved to be helpful as well. They informed me about the importance of an ergonomic posture and showed me core strengthening exercises. My neck and back pain completely vanished. My main problem however, the severe pain during activities involving the hands (e.g. PC work or handwriting texts), did not improve.
In retrospect I cannot understand why no doctor showed interest in my hints about working intensively with computers. Instead heavy metal poisoning, too tightly curved cervical vertebrae, a minor bicycle accident or past sports injuries were pinpointed as probable cause. Why did no one see that the strain I was under doing office work simply was too much for my body to absorb? Apparently very few doctors in Germany know this condition, although RSI affects so many people.
April - June 2007
The discomfort in my left arm improved slightly, but not in my right arm. My muscles were weak. The one year long rest took its toll, my muscles cramped after just a couple of minutes working. I had largely abandoned note-taking in lectures. Instead I had to photocopy the notes of fellow students.
In addition to the pain sensory disturbances sporadically occurred (I could not see a link between office work and those sensory disturbances).
A doctor specialized in Traditional Chinese Medicine (TCM) was very surprised that none of the previous doctors had recommended stretching exercises for my forearms.
Since I wore wrist braces most of the time, my wrist mobility was greatly diminished. The stretching exercises he recommended were absolutely right, but I should have started more gently.
July - September 2007
Regular massages and stretching exercises helped to soften my forearm muscles. I now had returned to my own RSI diagnosis and informed myself in detail about this condition on the Internet and with the book "It's Not Carpal Tunnel Syndrome! RSI Theory and Therapy for Computer Professionals". The renowned hand surgery department of a hospital hadn't heard of RSI and showed no interest to take a closer look at the issue. They only referred me to another orthopedist.
I visited an orthopedics department of another hospital and was met with much more patience and kindness. A senior physician knew the term RSI, saw my office work as the cause and after more than a year confirmed my own diagnosis!
October 2007 - January 2008
With gentle strengthening exercises I could stop the progressive loss of muscle mass. However the pain in my right forearm was still stronger than in my left forearm and overall I felt no improvement. The visits to a pain therapist and a psychologist brought no new information.
February - July 2008
It was obvious that despite a correct diagnosis and appropriate exercises there was no improvement. As a consequence I quit university and reduced the PC work to give my body the proper time to recover.
Thanks to the advice of a former RSI sufferer I visited a Vojta therapist (also known as reflex locomotion). She helped me overcome my poor posture and we worked together on strengthening my muscles. Initially I saw her once a week, later every two weeks. I bought ergonomic equipment for my home office, performed stretching exercises, nerve mobilization, trigger point massages. I started doing a lot more sport activities, read everything I found about pain memory and other psychological factors. All that improved the blood flow and hence reduced my overall pain. Simultaneously I slowly increased the PC work and began creating the German version of this website.
RSI is a very complex issue that is influenced by many factors. With the extent of this website you can easily see that it is not possible for a doctor to give you all the essential information about what to do in the average five to ten minutes consultation. What you should expect however, is a correct diagnosis and a recommendation to other resources (books, websites ...). That would not only help the patient, but would also be in the interest of our expensive health system (at least from the point of view of a health insurance).
For me it was the right decision temporarily to stop working on a computer. Fortunately most RSI sufferers don't have to go that far because their pain is less severe and they can also start earlier with the proper countermeasures. Only if you are affected as long as I was, other diseases are ruled out and there is absolutely no improvement, you should think of the option I chose.
August - October 2008
Following the significant improvement in the summer, it was time to take up another university class. I chose a distance university this time to be able to take regular breaks and to divide my working time flexibly. I dismissed business informatics this time because I didn't want to push my luck and I chose business studies instead. With that degree I can still enter the IT sector later on if I want to.
November 2008 - July 2009
The last few months were very positive: pain at times of rest is almost completely gone. I can do pull-ups and push-ups again! Only after working on the computer for several hours my forearms remind me of the importance of short breaks. What I have noticed very clearly in this phase is that if you have not used your muscles for years it takes the same amount of time to fully regenerate. And as long as the muscles have not regained their original strength, we should not expect to be able to work long hours.
August 2009 - July 2010
For the past year I have been working on the computer for many hours a day. Pain at times of rest only occurred after I overdid things. My muscle strength is also back to normal. If you don't feel any pain, you easily slip back into poor posture and bad working habits.
August 2010 - September 2015
There hasn't been any significant pain since the last entry. After an entire day working on the PC my forearms feel a bit "different", but that could be due to my increased awareness of the issue. It doesn't restrict me at all.