Repetitive Stress Injuries and mounting frustration

[StrangeAlchemist]

I've never been a huge fan of threads where people spill their guts, but I feel compelled to post this in hopes that someone can offer some meaningful advice.

I've been drawing and painting my whole life. It's always been my passion, and I've never had a doubt in my mind that I would eventually make a living through my art. It's the only career path I can imagine that wouldn't drive me completely nuts. I love the creative process, and pursuing something that yields new and exciting results each time is ideal for me. Besides, it's just what feels natural.

This past year I took a year off from school, where I'm studying illustration, because of the financial pressures involved. I had been working part time and attending classes, and it became too much to juggle. I got a full time job at an art store so that I could save money for my living expenses when I got back in school, and to build up my arsenal of art supplies using my discount.

Over the course of the year I began to get pains in my arm and shoulder, but at first they were slight and would go away if I rested my body for a few days. Over time, at first almost imperceptibly, the pain got more intense, and more frequent. It wasn't until it became chronic that I realized that it wasn't something that would simply pass on its own. When I questioned my manager about how to pursue help, I was given bogus information several times, and continued to work for weeks through a lot of pain because of it. It wasn't until I asked my assistant manager that I received any meaningful information on how to proceed with workman's comp.

I went to a doctor who diagnosed me with several repetitive stress injuries. I have tendonitis in my elbow, both lateral and medial, as well as in my shoulder, and carpal tunnel as well. The result of these conditions is that heavy lifting is nearly impossible, and when I draw or paint (or use my hands for just about anything) my fingertips fall asleep, my forearm stiffens, and I experience a sharp pain on the inside of my elbow where my ulnar nerve pops back and forth over the bone.

After mounting tension at work over my ability to perform certain duties like lifting or extended shifts at the register, my manager said that I couldn't work unless I was able to perform any and all tasks associated with my position. Fortunately I had already reported my injuries and begun workman's comp, otherwise I almost certainly would have been fired flat out. I have been on temporary disability for about 6 months now. I began cautiously optimistic, believing that a few weeks rest would set things straight. But recently I have been getting more and more nervous as months pass and I continue to experience pain whenever I try to work on my art for more than 30-45 minutes. I have made slow progress in some respects, but I still cannot do 80% of what I used to take for granted with my right arm. Even typing this out right now is painful. I am trying to adjust my diet, level of activity, posture... all of which helps slightly, but none of which seem to "do the trick".

This past Tuesday I had an appointment with my doctor who reviewed a recent MRI of my shoulder, revealing that I have permanent damage. Two of the four tendons there are partially torn, and there is no method for fixing the problem outside of surgery, which isn't recommended unless the pain is intolerable. There is a second MRI of my elbow, which I have not received the results of yet, but I am filled with nervous anticipation.

The diagnosis of my shoulder is confirmation of my worst fears; that I've sustained injuries that permanently affect my ability to work on my art for extended periods of time. I am hoping that I will receive more positive news regarding my elbow, but I am starting to have serious concerns over whether I will able to ever function normally when creating my art. I've tried approaching it positively and trying to find ways around my limitations, but sometimes during weaker moments the pain and frustration involved borders on crushing.

It's already difficult to make a comfortable living in the arts without having ever-present physical limitations. I can't conceive of how to make ends meet through my art when an hour and a half of using my hand is pushing it to the max, and affects me for hours, or even days afterwards.

In a community of artists I suspect there are others who have had to fight repetitive stress injuries in one form or another, perhaps even overcome, or at least come to grips, with them. If anyone has any useful information or advice, I'm all ears. I am pursuing as many options as realistically possible, such as occupational therapy, acupuncture, and Qi Gong. In my search for a way to deal with these difficulties I am open to just about any feedback. So please, feel free to share any knowledge you have on the subject. Any help at all is appreciated.

-Chris

[WildSpruceMoose]

Dude, I feel for you. I'm really sorry to hear about this, I've always been worried some pains I had in my arm while working at a bakery would later come back and haunt my artwork :/ Well best of luck trying to find alternative treatment. Can you use your left arm? Perhaps you could train your left arm, it sounds like you love art enough to learn a whole new arm to do it. I really hope the eblow tests come back with more positive results. Again this is a tragedy, but it looks like your searching for work-arounds and I'm sorry I don't have any ideas about how to rectify the situation. I wish you the best in finding away to continue arting-- never give up :)

[Blahm]

go to the gym and try to work it out. Have you ever done much extreme acitivty ( like weight lifting, dirtbike riding etc..) or had a job where you do manual labor? . pain is teporary glory is forever.

[darth massacre]

Blahm, I dunno if you're trying to be funny or just joking to lift up some spirits.

RSI is very real. The animation lead in the company I used to work for had the very type of surgery strangealchemist mentioned and it wasn't funny. I admit I don't think much about his work nor his talents. But I cannot deny working late nights with the fella (he sits next to me) and seeing him stop work thru pain. Sure he caused a lot of problems for us when he went thru the op to fix the tendons, but he did it thru his own pocket. Singapore has little to no laws protecting the employee in such ways and it will take a while before they happen. Therefore our employer paid nothing....and the bastards even demanded he take unpaid leave because he couldn't function as an animator while he recovers from the operation.

I don't think anyone can doubt the pain caused by RSI unless they've experienced it or seen the effects of it. It may look like nothing, but the pain it causes is crippling. Even small tasks are a challenge for someone with severe RSI.

[Blahm]

Blahm, I dunno if you're trying to be funny or just joking to lift up some spirits.

RSI is very real. The animation lead in the company I used to work for had the very type of surgery strangealchemist mentioned and it wasn't funny. I admit I don't think much about his work nor his talents. But I cannot deny working late nights with the fella (he sits next to me) and seeing him stop work thru pain. Sure he caused a lot of problems for us when he went thru the op to fix the tendons, but he did it thru his own pocket. Singapore has little to no laws protecting the employee in such ways and it will take a while before they happen. Therefore our employer paid nothing....and the bastards even demanded he take unpaid leave because he couldn't function as an animator while he recovers from the operation.

I don't think anyone can doubt the pain caused by RSI unless they've experienced it or seen the effects of it. It may look like nothing, but the pain it causes is crippling. Even small tasks are a challenge for someone with severe RSI.

yea, i dont mean to make fun. It just sounded to me like this is sort of like DVT (deep vein thybrosis (spelled wrong probly). That you get from sitting down for long periods of time. ANd i know that he is talking about a problem with his nerves and tendons. But it sounded to me like a sickness along those lines. I am probly still making no sence.

[darth massacre]

Hey dude...no problem man. I hope strangealchemist don't take offense too.

RSI happens when you work for too long. Usually it doesn't happen in huge movements, but the little ones like typing and writing or drawing and painting. The little back n forth movements that take place when you're typing or drawing (cross hatching usually) moves your tendons back and forth over the bones of your body, usually in the wrist, fingers, elbows and shoulders. Everytime it happens too often, the friction will cause the tissues in the said areas to swell up. It happens on a daily basis, we all get it. But if there wasn't adequate rest, or if your body cannot recover in time before you repeat the process again, the swelling will eventually cause pain.

The pain will usually go away thru rest. But if you continue to work thru pain (usually most people who don't understand RSI take painkillers for it) you will start to wear down the tendons like what happened to Strangealchemist. Then you'll need an operation to repair the worn out tendons before you break them. The surgery may not guarantee 100% recovery and as usual, parts on our body will break down more easily if they've been broken before.

[Ilaekae]

You actually have two different problems. One is affecting the tendons, which is a bitch and will probably need surgery at some point if it doesn't improve.

The other is carpal tunnel. That's what's causing your hand to go numb. There is a nerve that goes through a space in your wrist that gets squeezed if the tissue around it becomes inflamed. If you don't immobilize your wrist, it may get worse. DON'T let anyone talk you into surgery to correct the carpal condition until everything--and I mean EVERYTHING--else fails. It could take as much as 6 months for it to clear up. I had a bad case of it this year, and one of my doctors suggested taking a couple hundred mgs of vitamine B-6 a day, which really helped. I had absolutely no sense of touch at all in my right palm and across the thumb and three fingers for over three months, but it gradually came back to normal. The reason I don't suggest the surgery is because they usually don't tell you that it only works about 80% of the time because the tissue never heals properly.

I also have tendon and muscle damage up my right arm, but nowhere near as bad as yours...result of a near-fatal run-in with a tree I was chainsawing. It seems to have settled into a dull permanent pain in my upper forearm muscle and a los of strenghth when I extend my arm. Your condition sounds so severe that I would definitely check with a specialist equivalent to Dr. "Freddy" Fu in Pittsburgh. He specializes in sports and professional dance injuries.

[dindon]

Wow, this serves as a warning for everyone to not ignore their health. It appears that your manager is an ass for making you work even though you were in pain (and saying he would fire you for not being able to work), however it was also your decision to continue working.

All I can say is take care of your arm, and do not over exert it under any circumstances. I've sprained my wrists 3 times (not from art...), and as far as I know, using the injured area for more that what it is capable is a bad idea. Wear some sort of brace... though the doctors said the injuries are permanent, so I don't know if it will help too much. Can't hurt though.

You'll find a way. I saw on TV this guy who was born without forearms/hands, and without lower legs/feet. Yet he plays football without legs, and is able to write and type as fast as an able-bodied person, without hands. Perhaps try learning to draw and whatnot with your left hand, or alternate between hands.

[jetpack42]

If you're still on track to be an artist for a living, you might want to seriously think about drawing with your other arm. I don't have much personal experience, but I've been told by a few people who have done it, at least to a moderate degree (they weren't required, but wanted to develop the ability some) that it can be done. All of the information in your brain, all of your observational skills, it should all carry over, after time. It would be frustrating at first, but if you want to let your other arm rest, which I also agree would be the wisest, this would be the best way to go. Art all starts with your eyes and your mind, you'll just have to develop the dexterity on the other side to allow it another outlet.

Another thing I'd recommend right away would be to find another job where you don't have to lift virtually anything, and could use the right arm as little as possible. First thing that comes to mind would be hosting (at a restaurant). Heaviest thing you should have to lift there is menus or a marker. Pay isn't so hot to start, I think, but you could always work up after you get some experience to some better restaurants...

While the disability might lower your overall abilities, potential, or expectations, really that will depend on how much you let it, and how badly you want the prize (some opportunity and destiny never hurt). There are many examples of people with a disability exceeding everyone on the planet without. The one off the top of my head is Bruce Lee, who had a weak, sickly childhood, was a man of unusually small stature, but became one of the mightiest warriors the world has ever seen. (That's no joke). A chinese man who, when hollywood was casting asians for only bit parts, determined to be the highest paid actor in hollywood in a year, and did. (Recommended Reading "Bruce Lee: Fighting Spirit" by Bruce Thomas)

Good luck.

[darth massacre]

I believe, IIRC, that Hayao Miyazaki also had the same problems of tendonitis and RSI. He switched arms.

But how many has the patience and latent ability to be ambidextrous is really an unknown factor.

[Mr. Pale]

I'm currently going throught the same thing. Don't know if this helps, but I get a lot of relief with ice packs, anti inflamitories, and I switched from a mouse to a trackball and wacom tablet for my computer work.

The trackball really helped the most, get the kind that you move the ball with your fingertips not your thumb and wear a brace. Takes a lot of stress off your wrist and elbows.

Hope that helps

[Professor Az]

My phsical therapist highly recommends a simple exercise for Carpal Tunnel:

Relax your hand, and extend the fingers.

Apply backwards pressure on the thumb, keeping the hand and wrist as straight as you can.

Hold it for five to ten seconds.

Repeat twice more. Do this a couple times an hour while working.

This is supposed to relieve the pressure on the tendon that supports the thumb, which is the one that gets the most inflamed when an attack of CT comes on. So far, it works for me.

Pain is no laughing matter, I still get attacks now and then, I'm just happy my company pays for most of my physical therapy (about 80%).

Hang in there, strangealchemist, we're rooting for you. :yayca:

[redFIVE]

Well, I find this whole topic really WTFish in nature, for my case anyways. I've gone through several doctors, phsyical therapy, message, MRIs, and ancupuncture trying to relieve some problems I had that started back in the day with the shoulder. Roughly everyone gives me a different answer to what is causing pains in my arms and shoulder, but the one thing I've found that is consistent is BAD POSTURE, mostly relating to problems with my neck. If I spend most of the day with my neck hunched over and my shoulder pulled foward it ends up pinching a vital nerve that ends up causing alot of knots in my arms and popping, and eventually pins-and-needles if I don't take care of the knots.

I'm hoping to try out the Alexander Technique when I get out of school and actually have some money. It's physical therapy that targets the ways you carry yourself and move when performing whatever common tasks.

[vigostar]

get yourself one of the those agronomical chairs for your desk (Aeron chair http://www.hermanmiller.com/CDA/SSA/Product/0,,a10-c440-p8,00.html) I have personally used one similar to this one...... totally eliminates body fatigue.... you can adjust every aspect of the chair to conform to your body.. they're expensive but worth it in your case.. good luck my friend....

[darth massacre]

From Yahoo News....following the other devastating blackberry report...


Blackberry Users Learning Painful Lesson

By ALICIA CHANG, AP Science Writer 2 hours, 12 minutes ago

LOS ANGELES - Chris Claypool was addicted to his BlackBerry wireless handheld. Like many users, he never thought twice about pecking away at lightning speed, replying to a wave of e-mails from clients around the globe. Last year, the 37-year-old agricultural sales director from Post Falls, Idaho, noticed a throbbing sensation in this thumbs whenever he typed.

He switched to tapping with his index finger, then his middle digit and finally his pinky. But his thumbs pained him to the point where he can't even press the buttons on his TV remote control.

After months of aching, Claypool took a break. Now he only uses his BlackBerry to send short messages — typing with the tip of a pencil eraser whenever his thumbs get sore.

"It affects business because I can't whack away on my BlackBerry like I used to," he said. "It's just too painful."

Repetitive motion injuries, which have long afflicted desktop and laptop computer users, are invading the mobile handheld world.

There's even an informal name for the malady — "BlackBerry Thumb" — a catch-all phrase that describes a repetitive stress injury of the thumb as a result of overusing small gadget keypads.

Business executives and tech-savvy consumers are increasingly using BlackBerries, Treos, Sidekicks and other devices with miniature keyboards designed for thumb-tapping to stay connected while on the go.

And that has some ergonomic and hand experts worried about injuries from overexertion.

"If you're trying to type 'War and Peace' with your thumbs, then you're going to have a problem," warned Alan Hedge, director of the Human Factors and Ergonomics Laboratory at Cornell University in Ithaca, N.Y.

No national statistics exist on how many people suffer from this type of thumb ailment, but some doctors say they are seeing an upswing in related cases, said Dr. Stuart Hirsch, an orthopedist at St. Joseph's Hospital and Medical Center in Paterson, N.J.

"It's mostly the road warrior who prefers to answer e-mails on a thumb keyboard," said Hirsch. "If all you did was just answer with a simple yes and no, it would not be a dilemma."

For as long as video gamers have been blasting aliens, so-called "Gamer's Thumb" has been a sore spot for them, as well. With tens of millions of portable video game machines on the market, lots of young hands risk digit abuse.

Games for such devices generally include some type of printed warning about injury risks from prolonged playing.

Earlier this year, the American Society of Hand Therapists issued a consumer alert, warning users of small electronic gadgets that heavy thumb use could lead to painful swelling of the sheath around the tendons in the thumb.

The group recommended taking frequent breaks during e-mailing and resting one's arms on a pillow for support.

A booklet that ships with the Nintendo DS handheld system advises a 10 to 15 minute break for each hour of play, and a break of at least several hours if gamers experience wrist or hand soreness.

"People tend to use just one finger over and over again and it's that repetitive use with one digit that could lead to problems," said Stacey Doyon, vice president of the American Society of Hand Therapists and a registered occupational therapist in Portland, Maine.

The BlackBerry, which debuted in 1999, employs a full QWERTY keypad for thumb typing to automatically send and receive e-mail. About 2.5 million people currently use Blackberries, more than double from a year ago.

An executive for Research In Motion Ltd., which makes the BlackBerry, said the company considers ergonomic factors when designing its keyboards.

"Of course, any product can be overused ... so people should listen to their own bodies and adjust their routine if necessary. But I would caution against confusing rare examples of overuse with the typical experience," Mark Guibert, vice president of marketing, wrote in an e-mail.

Musculoskeletal disorders, which include repetitive strain injuries, accounted for a third of all workplace injuries and illnesses reported in 2003 — the latest data available, according to the U.S. Bureau of Labor Statistics.

Specialists say the thumb — considered by many as an island because it is set apart from the other fingers — is among the least dexterous digit and is not meant to be rigorously worked out.

For people who insist on typing more than a sentence with their thumbs, external keyboards that connect to the gadgets may be a less painful alternative, said Dr. Jennifer Weiss, assistant professor of orthopedics at the University of Southern California in Los Angeles.

Treatment for BlackBerry thumb may include wearing a splint and applying ice to the affected area. If the pain persists, doctors may opt to inject the thumb area with a cortisone shot. Surgery may be required as a last resort.

John Orminski, a 44-year-old information technology manager from Pontiac, Mich., went to a doctor in the spring after feeling a strain in his right thumb.

On any given day, Orminski uses his thumb repeatedly to punch clients' telephone numbers, scroll through his address book and update his calendar on his BlackBerry.

Orminski already suffers from golfer's elbow — a form of tendinitis — from playing the sport. But unlike his elbow pain, which occurs in spurts, Orminski's thumb woes tend to flare up more often.

He recently started physical therapy for this thumb — receiving electrical stimulation and massage to relax the muscles.

"It can get sore and tender, but I'm learning to live with it."

[K-17]

I've never experienced numbness, but that muscle between my neck and my right shoulder, at times i've had pain in it that seemed like the muscle was gonna rip. This usually happened after a long time at the pc, using the tablet, or at painting classes. I got myself a new chair at home, for the computer, and made myself to use my wrist more than my arm. At painting classes, i've started painting with my left arm once my right started to hurt too much. I never dreamed it could get so serious though. I haven't had it in quite a while now, but maybe i'll check it up with a doctor.
As for you, all i can say is hang in there. There are lots of people out there, art business or otherwise, that managed to overcome all sorts of crushing disabilities and are now thriving. It always feels desperating when it's happening to you, but if you stay strong and preservere, it'll eventually change for the better.

[StrangeAlchemist]

Thanks for your replies everyone. I'm sorry it has taken me so long to respond. I was initially typing out a person for person response when my computer messed up, so I'll just say thanks for all your feedback and a special thanks to those who have experienced, or are experiencing similar difficulties; my heart goes out to you. I am looking into many of the numerous suggestions given so far, they're all much appreciated.

I have gotten the MRI results for my elbow and am happy to announce that despite having a very swollen ulnar nerve, there are no indications of serious permanent damage. I was relieved to hear that, after receiving the bad news about my shoulder. I am considering surgery on the tendons in my shoulder despite my doctor's advice to avoid it unless the pain is at a higher level, because I would rather address the problem now while I am young than have it potentially worsen and crop up again later in a more severe form. I still need to consult a few more physicians to get a broader view of the matter, but I'm taking a serious look.

I received a call from my insurance adjuster today informing me that I am expected to return to work at 9:00 tomorrow morning. Needless to say, I am anxious about the prospect of returning to the place where my injuries occurred. Although I have been told I will be given modified activities, my doctor's orders do not specify that I cannot be on the register, which is almost certainly the cause of the majority of injuries in my elbow and wrist. I have already made up my mind that I will not perform any duties which make my symptoms flare up. I have an uneasy feeling about where this will lead based on past experiences, but I am not willing to work through pain simply to be a "good employee" and make ends meet.

I'm a bit fed up with the way my insurance company has handled things during my time on temporary disability. Thier tactic has been to stall, stonewall me, and reject treatments recommended by a physician straight off my company's approved list of providers. In the approximately 28 weeks I have been on disability I have had a combined total of 12 treatments, receiving 6 at a time, which means that I often had to wait 2-3 months between treatments. Is it any wonder I have made slow progress? It's very frustrating to know that my time away from work was so poorly utilized because of bureaucracy and the less than sympathetic policies of a medical review board that didn't even bother to speak directly with my physician before turning down prescription after prescription. A hearty thanks to our novelty governor here in California who helped pass the legislation that makes it so easy for my insurance company to play tiddlywinks with my well being.

Anyhow, that's where the situation stands at the moment. It's funny how the natural physical ability to draw without pain, something which I have always taken for granted, has become a sort of holy grail for me. If nothing else I have learned to appreciate what I've got before I lose it, and rest assured, my full will is bent on recovering and creating a situation where I can sustain myself through my art alone, never to work another shitty joe-job where I put my health at risk for barrel bottom wages ever again.

Thanks again for all your replies, keep rocking those pencils.

[WildSpruceMoose]

Thanks for your replies everyone. I'm sorry it has taken me so long to respond. I was initially typing out a person for person response when my computer messed up, so I'll just say thanks for all your feedback and a special thanks to those who have experienced, or are experiencing similar difficulties; my heart goes out to you. I am looking into many of the numerous suggestions given so far, they're all much appreciated.

I have gotten the MRI results for my elbow and am happy to announce that despite having a very swollen ulnar nerve, there are no indications of serious permanent damage. I was relieved to hear that, after receiving the bad news about my shoulder. I am considering surgery on the tendons in my shoulder despite my doctor's advice to avoid it unless the pain is at a higher level, because I would rather address the problem now while I am young than have it potentially worsen and crop up again later in a more severe form. I still need to consult a few more physicians to get a broader view of the matter, but I'm taking a serious look.

I received a call from my insurance adjuster today informing me that I am expected to return to work at 9:00 tomorrow morning. Needless to say, I am anxious about the prospect of returning to the place where my injuries occurred. Although I have been told I will be given modified activities, my doctor's orders do not specify that I cannot be on the register, which is almost certainly the cause of the majority of injuries in my elbow and wrist. I have already made up my mind that I will not perform any duties which make my symptoms flare up. I have an uneasy feeling about where this will lead based on past experiences, but I am not willing to work through pain simply to be a "good employee" and make ends meet.

I'm a bit fed up with the way my insurance company has handled things during my time on temporary disability. Thier tactic has been to stall, stonewall me, and reject treatments recommended by a physician straight off my company's approved list of providers. In the approximately 28 weeks I have been on disability I have had a combined total of 12 treatments, receiving 6 at a time, which means that I often had to wait 2-3 months between treatments. Is it any wonder I have made slow progress? It's very frustrating to know that my time away from work was so poorly utilized because of bureaucracy and the less than sympathetic policies of a medical review board that didn't even bother to speak directly with my physician before turning down prescription after prescription. A hearty thanks to our novelty governor here in California who helped pass the legislation that makes it so easy for my insurance company to play tiddlywinks with my well being.

Anyhow, that's where the situation stands at the moment. It's funny how the natural physical ability to draw without pain, something which I have always taken for granted, has become a sort of holy grail for me. If nothing else I have learned to appreciate what I've got before I lose it, and rest assured, my full will is bent on recovering and creating a situation where I can sustain myself through my art alone, never to work another shitty joe-job where I put my health at risk for barrel bottom wages ever again.

Thanks again for all your replies, keep rocking those pencils.

Its good to hear the MRI results were promising. If you choose to go through with the shoulder surgery, best of luck man =) Anything that gets you back in the sketchbook. Yeah insurance companies have the retarded way of stonewalling, and stalling people. It allows some terminal patients who need a some new treatment right away to die before the paper trail is all finished =/ You almost sound sarcastic when thanking your governor, hehe.
I totally understand what your saying about your strong will to get outta the joe schmoe job and into a career in art. You have my best wishes in doing so, and get better soon, man!

[FLenG]

found some RSI yoga here RSI YOGA (http://www.mydailyyoga.com/yoga/rsi.html)

i too suffer from RSI in my right wrist, due to the amount of time drawing on the wacom with a table with no ergonomics to the alignment of putting wrist to use mouses and wacoms.. and also from playing musical instruments. in the beginning i thought it could be a way to exercise my wrist as i had fractured it when i was younger but RSI kicked in and now i take breaks in between and try not to injure it further.. but DAMNN THE XBOX AND PS2.. :( .

p.s darth massacre, it's damn true bout company (in Singapore) not covering major operations.. :(

[Evil_Sloth]

yeah i posted a thread about this earlier. I am young, and I had the early signs of RSI and carpal tunnel, i'm still not completley over it. It seems to only come back when i use my wacom tablet. I recomend to everyone to take breaks and get into the habbit of not sitting in one spot for hours on end doing the same thing with there arm, wrist and fingers. also yor eyes get screwed up aswell from starring at the monitor for too long.
ive also switched hands for surfing the web and ive given up ps2 and xbox. so watch what your doing.