RSI quackery
The population of RSI sufferers consist of a growing numbers of
fairly desperate people with a serious, recalcitrant condition
who have difficulties in finding treatment that works. Some
are poor factory workers - but others previously had well-paid
jobs, and can afford to spend money on therapy.
It probably looks like a motherlode to healers and therapists -
another ailment like 'back pain' - and it appears that RSI has
attracted a substantial volume of therapists eager to cash in.
No doubt most of these are well meaning - but practically
everyone seems to think their therapy has something to offer
- and as a result RSI sufferers are faced with a large number of
well-meaning therapists who are not in terribly a good position
to help - but are nontheless willing to cash in on their
illness.
The following are what appear to me to be some of the main
offenders:
Pain in the mind
[John E. Sarno]
has developed an unusual theory of pain, which has come to be
known by the scientific sounding term
[Tension myositis syndrome].
This suggests that many types of pain are often the result of
emotional stress, mediated by lack of blood flow and oxygen
deprivation.
Sarno's psychological theories are not widely accepted by the
medical establishment - and his therapy does not appear to be
based on any scientific studies.
The idea that circulation problems contribute to the appearance
of RSI appears to be relatively untested - and could conceivably
have some truth to it. The idea that improving blood flow may
assist with recovery is not implausible - and has received some
tentative support from a small study of RSI patients who
underwent vasodilation hypnotherapy.
The study [Hypnotically-induced vasodilation in the treatment of repetitive strain
injuries] has details of that.
Trigger points
Others theorise that zones of induration in muscles cause the
pain in RSI.
According to Doctors Janet Travell and David Simons in their
widely acclaimed medical textbook, Myofascial Pain and
Dysfunction: The Trigger Point Manual, myofascial trigger
points (tiny contraction knots) in overworked or abused
muscles are responsible for most of the pain that accompanies
repetitive strain.
[http://www.triggerpointbook.com/repetiti.htm]
Very often, pain from repetitive strain is not felt in the
afflicted muscles, but instead is sent to some other site,
usually a nearby joint. This displaced pain, known as referred
pain, seems to fool everybody, including most of the public
and many of the professionals whose job it is to treat pain.
[http://www.triggerpointbook.com/repetiti.htm]
Muscular indurations are real and problematical for
some RSI sufferers. Such indurations are ubiquitous -
many people have them.
However, for others they have nothing to do with the condition.
Enthuiasts for so-called trigger points seem to me to
vastly over-state the significance of referred pain in
RSI. In particular, if you have sore forearms or hands as a
result of repetitive motion, my opinion is that the chances of
this being caused by referred pain from anywhere above the
elbow are minimal.
Even if you have both forearm RSI and upper-trapesius
muscular indurations (as a result of general overuse), I estimate
the potential for interaction between these disorders to be low.
Inflammatory and stress responses may affect both - and of course
work may aggravate both types of condition causing simultaneous
flare-ups - but that is about the extent of it in most cases.
Just because these conditions often present together, it doesn't
follow that one is a root cause and the other is an epiphenomenon.
Usually that is not true - rather both are caused by
aspects of the original stressors - in one case repetitive motion,
and in the other continuous tension.
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