This is a follow-up to my first article on RSI, where I describe how I got wrist pain after using computers for a long time, and how I recovered. It helps to have read that to understand the context. Late this spring I had the first major relapse of my wrist pain in over ten years, and I want to write a little bit about how I handled it.
Let me start by pointing out what I also pointed out in the article, that my condition is not RSI (repetitive strain injury) at all, but a psychosomatic disorder. But it’s strongly related, and the name that most people know it by, that’s why I use it in the headline.
It’s been 13 years since I recovered. Since my recovery I’ve had a few small relapses, which only lasted a day or two, but all were within the first three years or so. In the ten years after that, I have not had any relapses at all. That doesn’t mean I’ve never had any pain. This would be abnormal. It is common to have pain from time to time for a variety of reasons, many not related to computer work. But these have not been persistent, and anything lasting more than a few moments could usually be associated with some heavy activity I had been doing earlier.
What happened this spring is that I had a pretty intense work schedule in front of the computer. This is not remarkable on its own; I’ve had several quite intense periods since I recovered, and it has been just fine. But without going into the details, I’ve also been stressed out about my work situation. And this is a typical scenario vulnerable to psychosomatic pain: Heavy work and long-lasting stress.
I think it started in a way somewhat similar to my first injury: I did in fact overexert myself a bit, and importantly, I wasn’t working out enough to build resilience in my muscles. It started as a soreness in the tendon of one of my fingers, and this got worse over several days and weeks. Several factors contributed to me not dealing with this very well to begin with:
- I had been through pain before, and knew that it was not particularly dangerous, so I sort of ignored it.
- I was stressed out about my work, and did not want to stop because I was focused on trying to finish it.
- I thought I had it “under control” because I know exercises to deal with it, but I was doing those exercises very infrequently and inconsistently.
One day I realized that the pain was pretty bad, that it was not going away, and in fact it felt more like I was reinforcing it. That was the point when I started to panic a bit. “Am I back there?”. I felt strangely bewildered at this point. I knew that I had learned all about what this was, and how to get rid of the pain using the exercises and cognitive techniques I had learned 13 years ago. But I still felt powerless, like it wasn’t working.
I knew it was psychosomatic though. I recognized the patterns like pain that would move around from day to day. And it would start happening when sitting down at the computer, even before I did anything. Still, I couldn’t shake it.
But I took a deep breath, and calmed myself down. “You are not doing this properly. Focus.” I thought. It had been so long since I had any issues, that I really sucked at dealing with it!
So I started by reading my own article, which reminded me of a lot of the things I had forgotten. And it gave a confidence boost; I felt like that power of knowledge was coming back.
The first thing to remember was to actually take a break. Yes, the issue is psychosomatic, but it almost always starts with some real inflammation, even if it’s only mild. So I forced myself to take a break of several days, and doing something else. This is a kind of gate opener to make the rest of the treatment work.
In this period I was also careful to start working out the muscles at and around the pain area both to strengthen them, and to convince amygdala that nothing is wrong in the area (as described in the original article). But I did so very lightly and carefully; it should not be overdone at this stage, or the pain is very likely to come back and be reinforced rather than diminished. The key is light load, many repetitions, and frequent sessions. I would do it several times a day. This was in addition to my normal exercise schedule where I would lift heavier weights, but during these workouts I would not be focusing on the pain area specifically.
Once my break was over and I started working a bit again, that familiar pain started to come creeping back. This is when I once again applied “the yoga trick” (again see original article), of holding my breath for a while, and then letting it out once I need air, forcing myself to breathe deeply and slowly. All while keeping my hands on the keyboard and mouse. Being more experienced than I was the first time many years ago, I could immediately feel a difference. The pain did not go completely away, but I could feel it dying down, like a bonfire that is reduced to just glowing embers. Starting to work would slowly fuel the fire again, but I just needed to repeat it.
An extra exercise I also did which I invented this time around, was to make extra movements beyond those required to press keys, particularly on the mouse. Instead of keeping my finger stationary and making a tiny movement to click on a button, I would sometimes make big, stretchy, exaggerated movements to reach that key. This is all part of the motion-is-lotion mantra. By moving around a lot I would both be proving to amygdala that there really is nothing wrong (a serious inflammation would hurt then), and I would neutralize the super-sensitive nerve sensations that tend to develop when you keep your hands very still and try to detect if there is any pain. Instead of trying to carefully sense a small pin needle, I just bulldozed over the whole area by moving the finger throughout most of its range.
At this point I was taking care not to work too long sessions. It’s not that I couldn’t physically do it, but doing it for too long would make it difficult to keep convincing the amygdala. Inevitably I would lose focus as I got tired, and this would allow for more of the pain to creep in, with too little of the positive stimuli to counter it.
Over the next few days and weeks, I quickly gained both strength and resilience. I could do both heavier exercises, and the pain would be considerably less than when I started. Which then calmed me further down and contributed to the positive feedback loop.
And that was really all it took. Recovery was far faster than the first time I had this; just a few weeks. I was more experienced, had a much bigger belief in the method to begin with, and I don’t think I had gotten as deep into it as the first time (at one point back then I was even wearing a sling!).
It’s easy to become complacent as time goes by after recovery, and to take one’s health for granted. In a sense this is healthy; going around worrying about your health is not good for you, and taking it for granted is a sort of blessed happiness. And in the case of pain, this blessed happiness is part of what helps fix the problem. But there’s a balance, and it’s worth remembering both to do good things for your health in everyday life, as well as to remember that nobody will ever do all the right things all the time. I thought I had it under control, and once I realized that I didn’t, it was just because I had forgotten some of the things I did back then. It didn’t feel necessary, so it slipped into obscurity. So my conclusion is: Life is constantly about learning, even the things you’ve already learned, apparently!