Review of It's Not Carpal Tunnel Syndrome: RSI Theory & Therapy for Computer Professionals 780 Words If your arms ache after a hard day at the computer keyboard, It's Not Carpal Tunnel Syndrome: RSI Theory & Therapy for Computer Professionals is a new book that might be just the medicine you're looking for. Written by a veteran technical writer who suffers from a repetitive strain injury (RSI), and a physical therapist who has specialized in treating such injuries, it offers a new perspective on problems such as carpal tunnel syndrome and tendinitis (inflammation of tendons). Estimates and opinions vary widely on the true scope and severity of RSI in the workplace, but with the recently announced OSHA regulations there should be no doubt about the number of people looking for answers. In a nutshell, authors Damany and Bellis explain that most repetitive strain problems are improperly blamed on one spot such as the wrist or elbow, when in fact the solution can only be found by addressing the entire upper extremity. It's Not Carpal Tunnel Syndrome is written in a very non-technical style, but builds a fairly strong case for their theory by describing the anatomy of the whole arm, alternative theories, and the traditional range of diagnostic techniques. They lay out their theory with the goal of finding common denominators among all computer users. In the authors' eyes, it doesn't make sense that so many different diagnoses-carpal tunnel, tendinitis, tenosynovitis, trigger finger, and so on-are all used as targets for treatment, when one activity, computer use, seems to have caused them all. Only by properly identifying the cause do they feel that a diagnosis can be made that will lead to a successful course of treatment. And precisely what cause do they cite? They identify a chain reaction involving workload, personality, ergonomics, repetition, fatigue, posture, and aging. Their theory starts with what they call the number one physiological truth of RSI: "Muscles, tendons, and bones (collectively the musculoskeletal system) will adapt to almost any habitual posture and activity. Unfortunately, they will do this with no accommodation whatsoever to the nervous system, which has no such adaptability. Your nerves may merely be the messengers of the deteriorating state of affairs, or the actual recipients of the damage." The chapter on predisposing factors lays the groundwork for their theory, identifying personality traits and job circumstances that typify high-risk RSI sufferers. These include work obsession typical of computer pros and high stress, deadline driven environments. From there, they openly profess to generalize quite a bit, suggesting that most chronic RSI cases start with fatigue and the poor posture that results from it. With years of such a trend, this leads inevitably to either or both of two physiologic phenomena: muscles in a constant state of spasm or fibrous tissue accumulation-adhesions-on nerves. To combat the disease, they spell out a combination of massage therapy, exercise, and ergonomics. Drawing on Damany's experience treating RSI patients with massage therapy, they tell of patients that had unsuccessful surgery, but were ultimately helped by massage and other non-surgical techniques. Approximately half of the book describes therapies and recommendations, with a good portion devoted to ergonomics. Here, as elsewhere, they have a fairly non-conformist slant, suggesting that the only good ergonomics is what's good for your individual body. Their Golden Rule of Ergonomics dismisses industry guidelines in favor of any configuration that enables you to work in "neutral positions," those with your wrists straight and your posture balanced. Their emphasis is not on a mythical, ideal position, but avoiding any incessant position, keeping in motion, and minimizing muscle tension. This theme is supported in their detailed discussion of alternative keyboards, key layouts, mice, and all aspects of workstation hardware. Throughout the book, Damany and Bellis support their ideas with several patients' histories and comments. For those experiencing symptoms, these comments will probably be the most important reading, perhaps inspiring you to get serious about obtaining professional help. Other sections include an extensive listing of resources, advice on setting up a prevention program, and considerations for students. It's Not CTS stops short of trying to be an exhaustive technical analysis of the state of the art in RSI medicine. For instance, on two topics it doesn't provide the level of detail that some readers may desire: their treatment of biofeedback is just a mention, and they don't provide a list of specific massage therapy practitioners. It's clear that the authors have instead chosen to present a readable, innovative picture of RSI treatment at the expense of "cutting edge" details (in more ways than one). When those aches and pains don't go away after a good night's sleep, It's Not Carpal Tunnel Syndrome is where serious RSI sufferers are turning for answers. .... It's Not Carpal Tunnel Syndrome: RSI Theory & Therapy for Computer Professionals Available at Amazon.com Suparna Damany and Jack Bellis Published by Simax, Philadelphia, PA ISBN 0-9655109-9-9 www.RSIRescue.com This review is available electronically at: http://www.rsirescue.com/promo/