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Randall van der Woning has suffered from repetitive strain injury in his hands for two years.

Mr van der Woning, who has an extensive Web site chronicling his life in Hong Kong, has found his right hand - with which he uses his mouse - aches, tingles and then falls numb after a long periods at his home computer.

'When the hand begins to tingle, then I know it is way time to stop,' he said.

He is worked to reduce the problem by buying a chair with arms, an ergonomic, track-ball mouse, a split keyboard and other equipment. He combines these with massages and occasional stretching.

Mr van der Woning is not Hong Kong's only victim of repetitive strain injury, more commonly known as RSI. Increasing numbers of people are falling victim to RSI - with its ensuing wrist, neck and back pain - as they spend longer hours on computers at work and at home.

For Mr van der Woning, the problem includes constant mouse work to design a Web site.

The nerves become irritated and the connecting tendons inflamed. Then the muscles linked to the tendons start to contract involuntarily when the person is at rest, so the muscles become tighter and shorter.

Proper care could clear up RSI in several weeks, but left untreated it could cause permanent damage, said Sun Lai, clinic manager at the rehabilitation clinic at the Hong Kong Polytechnic University.

Mr Lai believes the number of RSI cases has risen since the clinic opened in 1997. It sees a handful of RSI patients each month.

Janice Morton, a physiotherapist who heads the Hutchison House clinic of Byrne, Hickman & Partners, agrees that RSI is more prevalent.

'It has reared its ugly head more and more as people are more tied to the computer,' she said.

The clinic would see between 20 and 40 patients a day, and about 20 per cent of them had RSI, Ms Morton estimated.

She attributes the pain to bad habits, both at work and at home, and poor ergonomics as many companies set up job stations without paying attention to the bodies that use them.

'People here are more worried whether the fabric of the chair matches the carpet,' Ms Morton said.

Employees also did not do enough to help themselves, she said. People often sit in front of their desk but look sideways into their computer screen instead of straight ahead. Or they slump in a chair that does not have proper back support.

Then, they might go home and spend hours surfing the Internet, sleeping on their stomachs with their heads twisted to one side, or watch television in bed with their chins on their chests, she added.

Treatments include gentle manipulation of the tender areas, an assessment of the person's workplace and the implementation of new habits. The patient must take breaks and regularly stretch the neck and arms, experts said.

Ms Morton once gave a talk about proper habits at a television station, and 45 minutes later she found people slumped in their seats.

Mr Lai said about half of the rehabilitation clinic's RSI patients returned after a few months.

RSI affects not only office employees, but also workers in other jobs ranging from musician to bus driver. It does not even spare new mothers, who repeatedly lift their babies.

The Hong Kong Government has statistics on people suffering from tenosynovitis, or the inflammation of tendons that connect muscles to bones to work body joints.

Under the Government's Employees' Compensation Ordinance, tenosynovitis of the hand or forearm has been prescribed as an occupational hazard for which the patient could receive compensation, said Dr Mandy Ho, a senior occupational health officer at the Labour Department.

According to statistics from the Labour Department, the number of confirmed patients suffering from tenosynovitis jumped to 81 last year, from 54 in 1999.

Dr Ho said the sharp increase was due to expanded coverage by the Employees' Compensation Ordinance to include elbow pain in the definition, and the launch of a health clinic in Shamshuipo in May, 1999.

Two Labour Department clinics - at Shamshuipo and Kwun Tong - run workshops and seminars on RSI and related illnesses.

The Government had drafted legislation to deal with RSI, which simply said employers needed to provide a safe and healthy environment, said Mr Lai.

'Sooner or later, if they get more compensation claims, more injuries, they will have to face the problem,' Mr Lai said.

Graphic: poss20gwz



Experts find cases of repetitive strain injury are rising as more people take to the keyboard