Repetitive stress injury| Pain| Deep Massage

The rise of software programmers for computers and mobile apps and the users of computers, smart phones, smart pads and game boxes worldwide, will give rise to more individuals suffering from repetitive stress injury. Overuse of the hand muscles and overuse movements of the wrist to stabilize the hand movements usually results in pain and/or discomfort in the hands, wrists, forearms and elbow. The natural tendency is to protect the painful areas with wrist splints, forearms stabilizers and elbow splints. Although the pain may somewhat feel better from using the joint stabilizers, as one uses the same muscles again and again repetitively to type, the pain will not only recur but remain even though the hands are not in use. Medications may blunt the pain but are unable to relax the deep muscle spasms that have already formed. The pain will then become chronic and constant such that the individual can become totally disabled from pain.

The hallmark of nerve related muscle pain is pain aggravated by movements accompanied by stiff, swollen and sore muscles. There is also tenderness, tightness and taut muscles with a deep ache. This usually occurs because of a vice-like effect of the muscles on vein, arteries and nerves inside the muscles especially in the most terminal portions of these blood vessels where the nerves meets the muscle fiber. Also, the tight and stiff muscles will pull on underlying bone and joints increasing the pain resulting from poor circulation. The area becomes very tender to touch and a hard node, nodule or muscle band will form. When you flick or massage the area, a twitch response may occur. Deep pressure on this point may reproduce your own pain. This area is called a trigger point.

As the nerve is also involved, there will be sharp shooting pains with tingling and numbness. The pain may awaken you from sleep. If this occurs in the first three and ½ digits (thumb, index, middle and half of the ring finger), you will usually get a diagnosis of carpal tunnel syndrome after undergoing some nerve conduction tests. This is from irritation or entrapment of the median nerve at the wrist level. If the tingling and numbness is in the last 1 1/2 digits (the ring and little fingers), with tenderness of the nerve that gives rise to the crazy bone feeling on hitting the elbow, you may get a diagnosis of ulnar nerve problem at the elbow.

The best treatment is to treat it conservatively and not rush into getting local treatments to these areas with injections or even surgery. These procedures may resolve the symptoms temporarily but will recur again with repetitive use of the hands.

Compounding the overuse of the muscles is working with a poor posture. Most people work with a head forward position, rounded shoulders, unsupported forearms and wrists. One must type by aligning the head over the shoulders and sitting back in the chair so that back can be supported. Always keep the arms close to the side of the body, elbows slightly bent and wrists in alignment with the hands. Forearms and wrists need to be supported. Never work with the arms outstretched in space since this posture will overwork the neck and shoulder girdle muscles. As you age, the nerve roots in your spine are very vulnerable to injury and will get irritated more when the neck and shoulder muscles are overworked and will not only increase the pain but make the pain chronic and long-standing.

Heat, massage and stretching can be used on the hand and forearm muscles and the massage must include muscles of the neck and shoulder girdle. It is important that massage relaxes your muscles rather than aggravate the pain which can happen if the massage is deep and aggressive causing the muscle to spasm even more. Electrical Twitch-Obtaining Inramuscular Simulation (eToims) is state of the art deep massage therapy specifically designed for healing nerve related deep muscle pain due to trigger points.