Finding the Right Doctors for RSI Treatment?

Yabulda asks: "Does anyone know of good online resources when trying to find an experienced, knowledgeable, and useful health care professional for the treatment of repetitive strain injuries caused by computer use? This is my profession - and my arms are killing me. I can't find a good doctor who has treated this before... and i need help! I live in Philadelphia, PA, USA, so if any of you know of a competent doctor in the metro area please let me know." Where do you go when you need to handle your repetitive strain injuries, what did you think of the experience, and how did your wrists/arms/other appendage fair after the treatment?

Comments

Check with musicians

[Ratbert42]

I don't have online resources, but especially in Philly, try checking with some professional musicians. They network pretty well about this topic.

If you have squeezed nerves try vitamin B12

[Anonymous Coward]

Try a vitamin B12 supplement. Don't take too much (e.g. 16 microgrammes should be enough, but 3 microgrammes probably won't do anything, and before you try 30-50 mcgs ask a doc :) ). It's NOT a cure, it just helps squeezed nerves. B12 is pretty safe anyway, but it could mask other B vitamin deficiencies, e.g. B6 deficiencies.

However the trouble is usually the B complex supplements tend to give a tad too much B6 - for the B12 you want to take.

Thing is it might actually help the squeezed nerves last long enough for your limbs to adapt.

Of course your problem could be different or far more severe. If the B12 works it should take effect in less than a week.

If your current doc isn't helping, get some help from another (don't have to abandon your current doc - like in all professions some docs are just better at some things and not as good at others).

Re:If you have squeezed nerves try vitamin B12

[BluedemonX]

I'll agree with this and add something further.
If you live in Canada or some other place that allows B-12 to be sold without a perscription, get some cyanocobalamin (subcutaneous) and a subcutaneous/intramuscular syringe. I am NOT a doctor, find out from one how to do this kind of thing properly. I am NOT responsible for infection, edema, or any other weirdness as a result of NOT following this advice. Inject thyself with a standard dose (listed on the package) monthly. Ingesting B-12 is for all intents and purposes useless. Either inject it, pay someone to inject it if you're american, or shove it up your nose (intranasal - looks like a thick red syrup). Sublinguals might also work.

I used to do this monthly, and have never had any kind of B-12. I had to stop when I went to the States (what? you actually want to take care of your own health? ILLEGAL!) and am now experiencing RSI. I've been typing, the wrong way, since the age of 8 (now 29) so I can say at least anecdotally there's some connection.

Finding resources

[Cato]

Try finding a local RSI support group - they will know the best local doctors. Some good sites are www.tifaq.com and www.rsi-uk.org.uk (UK based but has some good info). If you don't have a local support group, try email lists, but people are often more forthcoming in person or on the phone.

The most important part is usually finding a physical therapist (physiotherapist) who understands RSI - ask them about adverse neural tension (ANT) and adverse mechanical tension (AMT), and how many people with RSI they've treated. Also, investigate complementary therapies such as Alexander technique, tai chi and chi kung.

What you want

[www.sorehands.com]

You want a physiatrist as a base point. You will also want see about an EMG (not fun) to check for CTS or nerve entrapment. Also, have your elbow x-rayed, there can be an entrapment there that an EMG won't pick up.

Also, see if the person knows about accupuncture. That can help.

Check out my site.

try a different chair!

[Anonymous Coward]

I was experiencing tremendous RSI pain during my Junior year of high school. The pain would not go away with rest. The soreness would take a long time to go away after using the keyboard. I went on a 2 week trip in China and found myself in pain as soon as I returned to the keyboard.

I saw several kinds of specialists and none could help me. I saw a neurologist and had some sort of electical conductivity test done on the nerves in my arm. He told me that I did not have CTS.

But I still had tremendous pain. I felt that my personal and professional interest in computing was doomed.

And then I got a new kind of chair.
http://www.rybo.no/english/br2.htm

I still have to take regular breaks from typing, but I never feel the pain and soreness that I had before. This chair was recomended to me by someone who was having similar problems. I know that many companies offer similar chairs, but this is the only one that I have tried.
This chair may not be suited to your particular problem, but it was what worked for me after seeing 4 doctors who couldnt't help.

A year ago I wasn't even posting messages like this one to slashdot as it wasn't worth the pain.

I wish you the best of luck. I don't normally have time to post to slashdot, but I am particularly sympathetic to your situation.

For me, the my physical inability to type even led to psychological problems. I found it emotionally strenuous to think that I was incapable of doing what I do best: working with computers.

Get well soon!

Forget Acupuncture

[PD]

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OK, that's enough. You can probably find more yourself. Bottom line: Lots of people would love to believe it works, but despite many years of investigation, the evidence that it works is scant. One would think that if acupuncture was as effective as its proponents claim, the evidence would fall solidly in favor of acupuncture. The fact that it does not ought to tell you something.

Re:Forget Acupuncture

[cmowire]

You also have to remember that you can make things very much worse with Acupuncture. Part of Acupuncture's mistique is the placebo effect. You convince yourself that you've gotten better.

Now this is all fine and good if you have really gotten better. But if you think you are fine even when you aren't, and keep going on as if nothing's wrong, you'll end up with a massive case of RSI, worse than if you had done absolutely nothing.

RSI

[Anonymous Coward]

I am a doctor, so treat my comments with a fistful of salt.
1.Be aware that RSI is a dodgy diagnosis. There are a lot of reasons for this, which we cannot go into here. It does not mean that you have not got pain. It does not mean that your symptoms are not real. It is just that making the diagnosis of RSI necessarily implies causation, and there is no good quality (i.e. large, well conducted) studies which support the diagnosis.
2.I agree that you will probably neeed an EMG (stick needles into your nerves and check they are working ok)
3.Go to a sympathetic physiotherapist, but beware one who is too sympathetic- remember, you want to get better. Try accupuncture. Avoid surgery around your nerves unless done by a neurosurgeon.
4.treat RSI self help groups with caution. My (limited) experience of these is that they tend to be full of nutters with a lot of other problems (e.g. irritable bowel, chronic fatigue syndrome, multiple allergy syndrome) whose entire existence is focussed around these supposed ailments.
I hope you find something which works for you.

Hello Everybody

[Procrasti]

Try Doctor Nick Riviera, Hollywood Upstairs Medical College. I'm sure he has all kinds of stuff for RSI sufferers.