RSI in the workplace: Don't fall victim to the keyboard curse

Use a computer, and you risk a strain injury. But new software can provide relief

For all the wonders and ease that have been brought to us in the liquid crystal glow of the information age, there is one stubborn blight that affects more of us every year - repetitive strain injury (RSI), caused by overuse of computers. But a new type of diagnostic computer program being launched today may offer a cure.

Caught early, RSI can be resolved with quick and simple exercises, but nearly half a million cases still arise each year, with five million working days a year lost to it. And the number of cases continues to rise, by 10 per cent from 2002 to 2005.

Employers have a duty of care towards their staff but interpretations differ as to how much treatment that covers. The cost of RSI to employers was brought home again in May when The Guardian made an out-of-court settlement of £37,500 to Andrea Osbourne, a casual night-shift editor at the newspaper, who spent much of 2002 and 2003 crippled by RSI.

The slow deterioration seen in her case is typical. Stiffness and pain in her elbow left her unable to lift a kettle. A cortisone injection from her GP gave relief but, by March 2003, she was in constant pain and unable to bend her elbow. She had to stop work. It took nine months of physiotherapy before she could work at a computer again. The Guardian settled the case without admitting liability.

Under health and safety law, once a complaint is made, bosses have to respond. But union solicitor Marion Voss, of the law firm Thompsons, says cases should not get that far in the first place. "You shouldn't have to wait for a complaint," she says. "Work should be taking the initiative. But quite often it's the doctor who is the first port of call because work hasn't trained or informed people. But the onus is on work; it's their responsibility."

So, what's going wrong? The TUC has accused employers of a cavalier disregard for the health of their employees.Voss says she sees a stream of personal injury litigation against neglectful employers. But most RSI cases do not end in litigation; staff seem to accept it as part of the job.

They should not. Health and safety law exists to protect employees. Employers must assess their risk of RSI, provide equipment which is least likely to trigger it and train them in ways to avoid RSI.

The key is getting the right equipment and teaching employees how to use it properly, says Bronwyn Clifford, a physiotherapist who runs the London firm Physio at Work. That bit is relatively easy; education and early treatment are more difficult.

"Everyone's different and everyone's had some problems," Clifford says. Meeting their different needs is time-consuming and expensive. And by the time a complaint is made, it is often too late to prevent an injury. "Early intervention is really critical," Clifford says.

"As many issues take years to develop, they go undetected in the early stages," says Dr Russ Hornstein, a neurophysiologist specialising in musculoskeletal disorders. RSI is easiest to treat before it has become painful. Dr Hornstein has developed a program, Desk Doctor, that can detect and treat RSI even before users are aware of the problem. He came up with the idea in frustration at how far patients' condition had to deteriorate before they were referred to him.

Computer programs already exist to help office workers avoid RSI, but until now they have often been fairly basic affairs, forcing employees to take breaks every 20 minutes and offering some exercises. Desk Doctor is the first program to include an assessment, using orthopaedic tests. For the first time, a program can tell you what is going wrong and how to fix it.

As you work, a health score monitors your risk of RSI, according to how much you use the computer and how often you do your exercises. "It's like having a physiotherapist and a doctor at your desk," says Dr Hornstein. He has been surprised by the results coming back from trials. "Everybody we tested this on has had something going wrong," he says. "If people didn't do these tests, these things would go on and become a condition."

Lawyers, physios and doctors agree that employers must pay more attention to this kind of prevention. Whether that means closer regulation by the Health and Safety Executive, more in-house physiotherapists, or using programs such as Desk Doctor, one thing is certain; it will be cheaper than being sued.

For information on Desk Doctor, see www.einspine.com