Please to be recommending an RSI specialist who practices in San Francisco.

August 23, 2007 11:57 AM

Please to be recommending an RSI specialist who practices in San Francisco.

I've had what I would describe as muscle tension in my right hand and forearm for at least two years. If I try to spread my fingers wide, I can feel more pressure in the right hand muscles and tendons than the left. I can't pull my right hand back as far as I can my left. I can't make a tight fist with my right hand; it feels like I've got a pebble in my hand or something, with my index and middle fingers unable to close all the way. On the whole, this reduced range of motion doesn't bother me a lot, and there's no associated pain unless I do actually try to ball up my hand. On the other hand, it seems unwise to just leave it be.

I use a mouse timer on my computer at work, I take frequent breaks and stretch as I've been told to do. I have a trackball and a Goldtouch keyboard at the proper height (just above my lap), and I don't use the trackball much anyway. None of this has ever lessened my symptoms, so it seems clear I need a more professional medical opinion.

I saw one doctor about this a few months ago, and he gave me a cursory exam and brusquely prescribed Alleve and soaking the hand in hot water for 5 minutes, then cold water for 30 seconds, all while flexing it open and closed, twice a day. I had a followup with him a month later, and there was marginal improvement, but it seems to have plateaued. I'd rather not go back and see this guy, as I was underwhelmed by his attitude and his almost completely hands-off diagnosis.

I live in San Francisco, and would ideally like to see someone who practices in the city.

posted by autojack to health & fitness (7 comments total)

Ken Akizuki is a great orthopedist, although not an RSI specialist. He'd probably refer you to physical therapy.
posted by moonlet at 12:17 PM on August 23, 2007

Depending on how you feel about acupuncture, you could try Immune Enhancement Project. They did wonders for a friend's carpal tunnel.
posted by gingerbeer at 12:45 PM on August 23, 2007

I got a good diagnosis and treatment plan (physical therapy, not surgery) from a hand surgeon. If you can't get specific recommendations, then start looking into hand surgeons. Just beware the tendency to recommend surgery.
posted by grouse at 1:32 PM on August 23, 2007

I'm on the wrong coast, but RSI Find-a-doc for California. I see at least a couple in Berkeley and SF.
posted by callmejay at 2:46 PM on August 23, 2007

Just beware the tendency to recommend surgery.

Worth repeating.
posted by callmejay at 2:47 PM on August 23, 2007

RSI falls under workman's comp in California, and I highly recommend filing a claim. CA has one of the best and most comprehensive WC programs in the country. Go to HR on monday and get a workman's comp claims form, feel free to be descriptive in the "date of injury" section and note that it is aggregate stress.

After you submit, you'll get a claims advisor through your job's workman's comp insurance. They will point you to where you need to go, and everything will be paid for. You'll get a doctor, a therapist, an ergonomics specialist and it will all come out of the workman's comp insurance your employer already pays. Additionally, you will be on record in CA with RSI, so even if you leave your current job, if you have recurring symptoms you will be covered.

I know it's scary, but I wouldn't bother trying to find some top-notch RSI doctor on your own. Unless you have full blown CTS you'll be good as new with a few sessions of easy physical therapy from any good therapist. (if you do the stretching routine they lay out). I just went through this myself... I was terrified that my career was over. File the claim and you won't worry about RSI anymore (unless you leave CA... haha).
posted by muscat at 5:43 PM on August 24, 2007

Consider seeing a chiropractor. I've had several bouts of carpal tunnel over the years, all of which were helped far more by frequent visits to the chiropractor than to a hand therapy clinic. I can't recommend anyone specific, as the provider I saw for RSI no longer practices. I'm also a fan of acupuncture.

Some self-care tips: ice regularly (consider keeping an ice pack in your office refrigerator, if that's possible). Consider mousing with your left hand for a while. Take Advil regularly.

And yes, you should certainly file a worker's comp claim if you believe this is a work-related injury.
posted by stonefruit at 9:44 AM on August 25, 2007