All too easily we ignore the symptoms of Repetitive Strain Injury. Here one secretary gives her very personal story of how she developed excruciating pains in her hands, pains she says could have been prevented if she had heeded the warning signs.

The first indication of problems started very early on, within a few weeks of returning to work 10 years ago. I developed difficulty in "twisting" my hands - in other words, lifting heavy pots and pans, turning the front door key in the lock, or even simply picking up a teacup, was excruciatingly painful and my hands were stiff. My GP referred me to a course of physio at local hospital where tendonitis was diagnosed, and things steadily settled down.

However in early 1996, I became aware that my fingers felt quite bulky (I used to describe them as "sausage finger!"). I found it hard to make a fist and the sensation in my fingers just didn't feel quite right. It was all very vague so I did nothing about it until I woke one night feeling as though my right arm was in a vice. I had pain radiating from my wrist up as far as my elbow and any movement of my hand resulted in worsening pain for anything up to half an hour before it reduced to a dull 'throb again. I consulted an Orthopaedic Surgeon who diagnosed carpal tunnel syndrome (the nerves passing through the carpal tunnel running from my wrist into my hand were being compressed due to inflammation). Some patients experience pain, others have tingling and numbness in the fingers, unfortunately I had both sets of symptoms at the same time. I had an injection of local anaesthetic and steroid preparation into the palm of my hand, about an inch from the base of my wrist, and once I had got over the initial pain from the injection itself my symptoms disappeared completely for almost 9 months.

Reduced to tears
Unfortunately things deteriorated again. The pain in my right hand returned and a further injection was required. This time the pain relief lasted only 3 months. The pain was so bad it would wake me at night: I was unable to move my hand because of it, and some nights I only managed a couple of hours of sleep with my arm dangled over the side of the bed to achieve some small measure of relief. I was reduced to tears on more than one occasion. Depressingly I also began to experience symptoms in my left hand albeit to a much lesser degree.

Eventually the decision was made in November 1997 to carry out a carpal tunnel decompression on my right hand. This involved opening the carpal tunnel through an incision into the palm of my hand, freeing up the nerves, and allowing more room for their passage through the carpal tunnel. A month later I returned to work the pain having settled almost completely. 1 have been left however with weakness of power / grip and some residual pain, discomfort and tingling, especially after a busy week at the keyboard. This has occasionally required physiotherapy for further pain relief.

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