Repetitive Stress Injury / Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a is a repetitive stress injury (RSI) of the median nerve in the carpal tunnel as it passes through the wrist area. This nerve controls the feeling and movement of the thumb and first three fingers. It causes a variety of symptoms that range from tingling on up to weakness and tingling. Eventually, it causes more severe weakness and pain.

DISCLAIMER: This article should not be considered medical advice! If you have concerns about your health, see a qualified physician.

An RSI is an injury caused by prolonged repetitive motions, generally (but not always) under some form of resistance. Over a period of time, the injury forms, typically with pain and swelling. Common types of injury are tendonitis and bursitis. Tennis elbow is a form of repetitive stress injury.

RSIs have a significant economic impact on companies in the actual costs associated with medical and legal payouts. There is also the morale issue associated with having the perception of an injury prone workplace or being an uncaring employer.

There are two main ways to combat RSIs in the workplace. The first is to focus on the ergonomics of a job. In effect, you are attacking the ‘S’ in RSI. The less strain that is put on the body, especially when that force is repeated at a high rate, the better off the body is, exercise notwithstanding. Exercise allows that part of the body to rest, recover and rebuild. Jobs don’t.

There is a whole industry of experts who can help design ergonomic friendly processes. The cost can be high, though, especially in a workplace that does frequent improvements. But the layman can also take common sense action. Don’t make people move in unnatural manners, especially with high repetitions, or under load (i.e. lifting stuff). Look for people who are uncomfortable in their jobs. Adjust those jobs. But seek a medical expert for any people who are feeling pain.

The second way is to try to rotate people in their jobs when possible. A good way to avoid the repetitive motion is to remove the repetition. Shuffle people around among several stations. This will require cross training and a good daily management system to make sure your teams are responsive enough to handle the frequent movement of people and the potential for production problems that can result as you gear up on your rotation plan.

Technology and RSIs

There is a common belief that CTS is associated with frequent use of a keyboard and mouse. The data on this is mixed, though, and there is not a definitive connection. That data does not mean that there is no risk—just that there is not an elevated risk compared to the general population, and again, the data is mixed. It is still a good idea to provide people with ergonomic equipment that makes their jobs as easy as possible.

In addition, a new term, “Tech Neck” or “Text Neck” is starting to make the rounds from people getting neck pain because of looking down at their phones excessively. This falls into the same genre as RSI’s and may lead to early arthritis or other ailments. While an employer is not responsible for a person’s personal choices, they do have to consider those choices when creating processes. Having people look down at steep angles may compound other problems.

Continuous Improvement and RSIs

Continuous Improvement efforts can be both bad and good for RSI.

First off, tasks that take muscle and contortion to complete also tend to be extremely inefficient. They get attacked early in the CI process. That means jobs typically get easier, strain wise, after improvements.

When designing workstations during the improvement process, keep ergonomics in mind. Try to limit long reaches, and repetitive motions. Use automation, or at least power tools when appropriate. An air ratchet is not only more efficient than a manual one, but it reduces muscle fatigue and the repetitive movement. Tool balancers can be used to support some of the weight of tools, further reducing strain.

The flip side of improvement, though, is that being more efficient at something means you can do that thing more in a shorter period of time. That means that the repetition rises. As you make improvements, be sure to address this issue. Job rotation is the best approach. It keeps people from doing the same task over extended periods of time.

You’ll need to dial in the timeline between rotations. As good as CI makes processes, people are creatures of habit, and the more they do something, the better they get at it. If you rotate jobs every day, you may have a ‘re-learning’ period where people ramp up to a good level and may never get to the period where performance gets dialed in at an extremely high level.

But wait too long, and the RSI risk rises, they forget how to do the other jobs, and they get bored. Experiment until you find the best mix of benefits with the lowest costs in your job rotation.