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CRS: Computer-Related Syndrome: The Prevention and Treatment of Computer-Related Injuries. Richard Dean Smith, MD and Steven T. Garske, MS, PT.
Most writers today have converted to using the computer for their craft rather than pen and ink, or mechanical or electric typewriter. Ease of entering text, word-wrap-around, transferring blocks of text, ease of on-screen editing, access to information, and many other features as well as its relatively low cost have won over most writers to the computer. The conveniences and ease of use produced an increase in productivity in that the computer is faster than human agility of hand. The usual movements of the writer or typist have been reduced to a minimum with almost no need for the writer to stir from his or her chair for hours at a time. Numerous aids and supports are available that permit the writer to move even less. The combination of increased productivity, greater focus of attention, restricted movement of the arms and trunk posture gave rise to a new epidemic of computer related complaints.
At the same time, virtually every office, home, or business has or will soon have a computer, increasing the number of individuals at risk. Yet, the use of the computer need not be hazardous if basic principles are followed. While much attention has been given to the hands and forearms, writers and computer workers also experience symptoms related to the upper arm, shoulders, and neck. Any prevention or treatment must take into account the entire 'fore-quarter': the entire upper extremities, neck and head.
Tightness, stiffness, and pain of the upper extremities are common complaints of writers and computer users. Often, these complaints go unnoticed by the writer and computer worker until so intense that the discomforts interfere with the writer's ability to write or the computer worker to work. Management of companies that employ a number of people who work all or most of the day at a computer keyboard seldom become aware of the workers' difficulties until they have experienced complaints for long periods: weeks, months, and sometimes years.
In what has been called 'repetitive strain injury', 'cumulative trauma disorder', 'occupational cervicalbrachial [neck and arm] disorders', 'overuse syndromes', 'work related disorders', 'regional musculo-skeletal disorders', 'occupational disorders of the upper extremities', and more recently 'upper extremity musculo-skeletal disorders' ('UEMSB'), the number of names for these conditions alone illustrates the confusing nature and the state of development of understanding on the prevalence and importance of these difficulties of the writer and computer keyboard worker.
Our purpose in this book is to call attention to these common problems of computer use and to offer recommendations intended to lessen the risk of sustaining injuries related to posture, rapid movements, and positional errors common to writers and computer users. Although we focus our attention on the writer and computer worker, the same principles apply to other occupations at risk for injuries to the upper extremities.
Each anatomical area is treated separately in this book, but they are not separate. What affects the hand may affect the shoulder, and vice versa. For sake of clarity, each area has its own special considerations.
Our intent is to cover the practical considerations that we want all writers and computer workers to know. No book can cover every individual problem and all of the special considerations of each person. If any aspect of this book conflicts with your doctor's advice, be certain to have his or her approval before continuing any exercise or recommendation contained in this volume. Above all, be aware of discomfort or symptoms of the upper extremities and respect their importance to your ability to write.
1. The Problem
2. What the writer or computer worker feels
3. Clinical: What is Found on Examination
6. The Work Station
7. The Fingers do the walking
8. The Hand
9. The Wrist
10. Carpal tunnel syndrome
11. Other Nerve Entrapment Syndromes
12. The Forearm
13. The Elbow
14. The Shoulder
15. The Neck: "Up in the withers"
16. The TMJ: The Temporomandibular Joint
17. Relaxation Techniques
18. General Measures
19. The Exercises
20. Additional factors
21. Returning to Writing
22. Failure to Return to Writing
23. Where to Get Help
24. The Future