Repetitive strain injuries (RSI) can cost up to $48,000 per case. Newsday (Melville, NY) has experienced 150 cases. To combat it, they've disabled reporters' outgoing email capabilities. Editors can still send email, but reporters have to reply by phone. [Business Week, 6/3.]

C+HEALTH members have been discussing carpal tunnel syndrome (CTS). Jani Spede (jspede@nervm.nerdc.ufl.edu) passed along the following (9/13), from interviews with Dr. Thomas Wright, Dept. of Orthopedics, and Dr. Ralph Williams, Dept. of Rheumatology at UFlorida.

Some people are predisposed to CTS. Risk factors are low thyroid, pregnancy (but not use of birth-control pills), diabetes, fluid retention from heart disease, liver disease, rheumatoid arthritis, and lupus. Alcoholism is not a risk factor, nor are other known genetic traits. Only half of all CTS sufferers can trace the problem to repetitive motion, so you are not safe just because you seldom type. (Other repetitive activities include sewing, drafting, auto mechanics, and playing musical instruments.)

Symptoms are tingling, numbness, and weakness in the thumb or fingers, sometimes with pain and sometimes (in the worst cases) without pain. Early detection and ergonomic treatments do not always prevent CTS from developing. (Then again, they may. I saw one report of a recovery after a year in chiropractic therapy.) Carpal tunnel release, a surgical procedure, has a satisfaction rate of 90%. (I.e., 10% of the patients are unhappy with a persistent post-operative disability.)

Marilyn Everingham (mrln2@msu.bitnet) described her CTS therapy in C+HEALTH (9/16). She takes Motrin, wears hard wrist splints at all times, and has an hour of physical therapy three times per week. Her elbows are rubbed with ice for five minutes, then ultrasound is used for deep heating. This makes her forearms very sore, with a slight numbness that does not go away. She does a series of exercises with small weights (1, 2, and 3 pounds), including exercises to develop upper arm strength and shoulder flexibility. Then come five minutes of squeezing silly putty, plus ten minutes of ice packs if her arms hurt. She has seen no improvement in either wrist during more than two months of therapy.

Professional Safety (5/87) had an article on exercises to prevent carpal tunnel syndrome. Included were flexibility exercises such as whole-body and arm stretching, wrist circles, finger stretch, thumb stretch, shoulder shrug, and neck flexion. Other exercises such as thumb squeeze and finger squeeze then dealt with strength. [Michael Sauda (sauda@maine.maine.edu), C+HEALTH, 9/16.]

You can send for a packet of CTS information from the U.S. Department of Health and Human Services, Public Health Services, Centers for Disease Control, National Institute for Occupational Safety and Health, Division of Standards Development and Technology Transfer, 4647 Columbia Parkway, Cincinnati, OH 45226. [Ed Wilds (ehsadm3@uconnvm.bitnet), C+HEALTH, 9/14.]