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Still a touchy issue

By Timothy Cocks Science and the world 04 Feb 2014

This recent piece in The Conversation ignited quite a heated debate. It’s well worth reading through the whole article, especially the comments.

Repetitive strain injury: is it real or imagined?

“Repetitive strain injury, or RSI, is a term which was developed to describe an epidemic of work-related arm and hand pain reported in Australia in the 1980s. While work-related arm and hand pain was and still is common, this particular epidemic was unusual in that it involved workers not previously considered as being at risk.

Studies undertaken at the time showed that the incidence of RSI was not related to the number of hours worked per week (with both full-time and part-time employees affected) or to total length of employment. In other words, there was apparently no link between the number of keystrokes performed and the likelihood of suffering from RSI.

What was found, however, was that those who reported being satisfied with their work experienced much lower rates of injury compared with those who did not. Perhaps even more significantly, higher levels of job satisfaction were seen to have a protective effect even when workplace ergonomics was poor.

The identification of job satisfaction as an important factor in the development of RSI highlighted the need to consider what are now call psychosocial (or non-physical) risk factors.”

In 1998 I started work in a private practice that had a high volume of workers compensation patients. The epidemic of RSI was over by then, but I can remember the term still being used; not as a diagnosis but as a form of insult. I can understand the perspective of the commenters who raised the matter of stigmatisation of people in pain.

In March 2010, the National Pain Summit was held at Parliament House, in Australia’s Capital, Canberra.  The key outcome of the summit was The National Pain Strategy, a comprehensive report which set out a number of approaches to “improve the assessment and treatment of all forms of pain”.

Goal 1 of the Strategy; “People in pain as a national health priority –  Recognition and optimal management for people in pain will be pursued as a national health priority” included as a priority objective “De-stigmatise the predicament of people with pain, especially chronic non-cancer pain”.

Are we getting there?

What’s your experience out there in the world regarding stigmatisation of people in trouble?

What more can we do individually and collectively?



  1. Hi Tim,

    The title of the research article itself is absurd! “Is it real or imagined?”… as if it matters! Pain is pain. If I’m asleep in bed and dreaming I have broken my toe and it’s hurting like hell, wouldn’t I be thankful if someone woke me? While I’m in the dream the whole thing is imagined, and yet I suffer.

    Aside from that, it seems likely that all of reality is imagination anyway.

    Row, row, row your boat…

    1. timcocks0noi

      I don’t think I’ve ever dreamt pain. I’ve woken and immediately been in pain but that’s a different thing. What is dreamt pain like? Is it different to “awake” pain?

      Agree with the absurdity – I’m not sure that one can actually imagine pain at all.

  2. Simply listen to the patient and hear their story……their truth will emerge if we are courageous enough to care about them as people and not pathologies…..I will never cease to be amazed about how the brain has a limitless capacity to embody suffering in the, sometimes most bizarre ways imaginable. If the brain concludes that it is serving the purpose of it’s own survival then it will create whatever to meet that end…….

    1. timcocks0noi

      I’m reminded again of Pat Wall’s comment “To begin with, we are evolved animals….. evolved, challenged by certain historical problems in how to remain alive”. If only more had listened.

      1. If only…….I was listening when he said it …. But it’s never to late so let’s not forget that which has already been said and not always strive to reinvent the wheel ….

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