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Lose those negative thoughts

Maastricht RSI research

A good posture and taking regular breaks remain important, but the patient’s character seems a decisive factor in RSI complaints. A perfectionist or anxious nature is by far the greatest hazard. This is one of the outcomes described in rehabilitation specialist Marjon van Eijsden's thesis, for which she received her doctorate last month. 

During the past few years, it has become clear that physiotherapy and awareness of one’s posture are not enough for those who suffer from arm, neck and shoulder complaints. Van Eijsden concludes in her thesis that many of them need a psychologist or a behavioural therapist. The reason is that in a stressful environment, it is often the perfectionists who bite the dust.

“These are the workers who want to do everything well, who cannot distance themselves, who wish to meet all requirements. They are actually your best people. Thirty years ago, they would not have gotten into trouble, because there was always enough time, but now they have to make choices, set priorities. For example, this e-mail will have to wait until tomorrow because today other issues need attention. That is something they need to learn with the help of a psychologist.”

Anxious people are also more likely to end up in the danger zone. Van Eijsden compared a group of 88 patients showing the first signs of physical complaints with a control group that had no problems. What she discovered was that the latter group also had lot of people with complaints; they just didn’t make a fuss about it.

“Especially those who ‘catastrophise’ the pain and have extremely negative thoughts about it, have a problem. They feel a slight pain and immediately think ‘O my God, help, before I cannot do anything anymore.’ They avoid the pain and restrict themselves in what they do. Their brain is also off course and interprets the pain incorrectly. It is what we call non-specific pain, without any visible physical disorder, such as a tennis elbow or a trapped nerve. This applies to three quarters of the patients. Send them off into the mountains for a week and they feel no pain whatsoever. But as soon as they get behind their desks again, even before they touch the keyboard, they feel something in their wrist. What they need to do, is to lose all those negative thoughts. This can be achieved during cognitive behavioural therapy.”

Van Eijsden also recommends that general practitioners and company doctors use a simple questionnaire to determine whether the patient scores high on perfectionism or ‘pain catastrophising’, and so either needs to see a psychologist or a behavioural therapist. “This prevents people from shopping around and not receiving the most suitable treatment. In that case, most perfectionists will end up with a burnout sooner or later. I have already seen this happen a lot.”

Repetitive Strain Injury (now officially referred to as WRULD, or Work-Related Upper Limb Disorders) is a less popular topic than it was ten years ago, but that does not mean that the incidence has decreased. On the contrary, as more people work with computers, the number of complaints is rising. Today, 40 per cent of all computer workers are affected by it.


Maurice Timmermans





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