There was a time when Padmashree C.G. Rida could not tear a piece off a roti with her hands because of chronic pain and inflammation. It got so bad that the 29-year-old Singapore-based molecular biologist had to stop working. After knocking at the doors of several orthopaedic specialists, she located Dr Deepak Sharan in Bangalore. He diagnosed it as repetitive strain injury (RSI), in this case to her hands, and prescribed myotherapy (an advanced form of physiotherapy) and contrast baths (hot and cold water alternated).
Two years later, Rida is back to handling the micropipettor, which had originally caused her RSI. But today, at her new workplace in the US, she is conscious about taking breaks between work. “Even if I feel the slightest pain, I stop and do stretch exercises,” she says. She also takes care to avoid tasks like grating carrots so as not to put pressure on her vulnerable hands.
Rida’s is not an isolated case. An increasing number of lab workers, call-centre employees and computer professionals in India are landing up at the rehabilitation clinics of RSI specialists like Dr Sharan, consultant in orthopaedics, ergonomics and rehabilitation. Dr Bharati Jajoo is an occupational therapist and certified ergonomic assessment specialist in Bangalore, and Dr Venkata Ramana Rao, a myotherapist and ergonomist based in Hyderabad.
Industry estimates peg nearly 20% of all computer users worldwide as suffering from RSI. “By this yardstick, over seven million Indian computer users must be having RSI,” says Dr Sharan.
RSI is a group of overuse disorders affecting the muscles, tendons and nerves of the neck, upper and lower back, chest, shoulders, arms and hands. They start out as aches, pains or numbness, but can progress to become crippling disorders. Says Dr Sharan: “RSI is usually relentlessly progressive and some untreated cases end up with a dreaded complication called reflex sympathetic dystrophy, after which patients pretty much lose the use of the hands.”
This happened to K. Vijay Kiran, a young Hyderabadbased freelance computer professional, who designs and hosts websites. He found that he could not even lift a spoon. “I couldn’t grasp anything. My whole body hurt. I couldn’t stand, sit or sleep. It was living hell,” he says.
After an intensive rehabilitation programme at Dr Sharan’s clinic, Kiran is slowly getting back to a normal life — though he does not work on the computer now. Doctors have told him it will be another two years before he can get total relief from the pain. According to Dr Sharan, over 50 IT/ITES professionals in India, aged between 20 and 35, have had to quit their jobs because of advanced, neglected RSI.
Preliminary results of an ongoing study (2001-2007) of 18,000 computer professionals by Dr Sharan’s outfit, RECOUP, shows how serious the problem is. Over 75% of those surveyed reported musculoskeletal symptoms related to work. About 50% were afflicted within a year of starting their first computer-dependent job. The commonest areas affected were the neck and upper back (60%), followed by the lower back (40%) and the upper extremity (30%). Carpal tunnel syndrome (chronic wrist pain in which the median nerve gets affected) accounted for less than 0.5% of all cases.
In the last six years, RECOUP has treated 20,000 RSI patients — most of them have developed the condition either due to bad posture or poor office ergonomics. The problem is compounded because many are initially misdiagnosed.
Dr Bharati Jajoo, who is cofounder of Ergoworks Inc., an occupational health and safety company, stresses that companies need to start selecting chairs for individual employees, based on their body dimensions. “An employee who’s 6ft tall and one who’s 5ft cannot use the same chair,” she says. In addition, the employees need to be trained in the correct computing posture. Ergoworks provides advice on better design of office products, and offers onsite consultancy on ergonomics to prevent work-related musculoskeletal disorders.
Bangalore has seen the maximum corporate action on eliminating RSI, with several companies addressing the issue head on. Take MindTree Consulting, which has rolled out an ergonomics intervention programme. Puneet Jetli, vice-president, People Function, MindTree, describes how every two weeks, batches of 40-50 people are made to attend orientation workshops on occupational health and safety. After this, an injury risk analysis is done on the participants and those identified as being at risk undergo an evaluation of their workstation habits. Based on this, intervention — which could be in the form of early RSI treatment, changes in the workstation and posture — is undertaken. “Team by team, we hope to address all our 3,500 employees in Bangalore,” says Jetli. In addition, MindTree has a nurse on call at the office and a doctor visiting every alternate day.
But such comprehensive programmes like the one introduced by MindTree, which ranks among one of the most caring employers in India, are still rare. “To be frank, most HR people in India do not know what ergonomics means. They focus on furniture and such things,” says Dr Rao of RSI Health Care. Rao describes how he did a round of offices in Hyderabad and Chennai last year to ask companies to initiate training programmes. But very few took it forward. Dr Sharan echoes this: “Since RSI is not a compensable illness in India, ergonomics is considered a luxury by managements.”
However, with the first cases of RSI litigations against corporates emerging in India, more and more awareness drives (this week in Bangalore saw free RSI camps and workshops) and the emergence of RSI support groups, things are changing. Also, as Dr Jajoo points out, while companies do not really want to change the design of an existing office, they do tend to pay heed to the issue when they move to larger premises in the suburbs. Take NIIT Technologies’ new campus coming up in Greater Noida, which promises to be an ergonomically designed facility. “It will provide for enough break-out areas, activity rooms and mini gyms on each floor. A joggers’ path and a swimming pool will help NIIT-ians unwind and relax,” says CEO Arvind Thakur.
While companies may do their bit, it all finally boils down to individual workers taking necessary precautions. With newer gadgets getting invented, the strain is likely to shift to different body parts. As strategic communications counsel Sanjiv Kataria points out, he switched to a Blackberry-enabled phone a few months ago to overcome neck problems arising from continuous use of the laptop during travel. But as his neck gets back into shape now, he dreads a Blackberry thumb!
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