Repetitive strain injury / tendonitis in forearms, is nursing the right path?

HelloWish, ADN, BSN · May 3, 2017

I think any nursing will require repetitive use of the arms, especially with computer charting. However, this is also true of all jobs in general not just nursing. I can't think of any job that wouldn't require repetitive use of the arms.

I see you have done many therapies, however I didn't see physical therapy. Have you seen an orthopedist?

allnurses Guide · May 3, 2017

Hello,
I'm a first year nursing student but have been battling RSI / "tendonitis" in both my forearms for close to 6 months now. I get tingling in all my fingers, pain and twitching in the forearm flexors and extensors... after 2 months, I started getting pain and twitching in my upper forearms as well. Sometimes I'm just sitting doing nothing and will get random pain, but it's usually brought on by repetitive use of my arms.
Clinicals won't be for another year and I'm doing my best to not use my arms... no computer / video games, limit typing as much as possible, switch hands to write, no lifting weights at the gym, no lifting anything heavy in general... I'm not working, just in school.
I've tried self massage, stretching, topical Voltaren, splinting at night, nerve conduction / EMG test is normal, seen by a rheumatologist, acupuncture, physio, chiro (ART / shockwave)... IMS is next.
All I've got to show for is a big hole in my wallet. It's incredibly frustrating and some days I lose hope...
Assuming I heal, I'm worried that some nursing specialties will aggravate my condition. Maybe psych nursing is a better idea? Looking for some input.
Thank you.

It sounds a lot like some kind of nerve entrapment. Most common is Carpel Tunnel but since it's your forearm it may be an entrapment of the Ulnar nerve. Have they done a nerve conduction study? I have an ulnar nerve entrapment in my rt arm it is annoying as all heck. My only treatment option is surgery and I don't heal well after going under the knife so I am hemming and hawing over it.

Hppy

llg, PhD, RN · May 3, 2017

There is not much we can tell you here. You have a health problem -- one that could very well have an effect on your career possibilities. You need a good diagnosis so that you can get good information about your prognosis. We can't give that to you one way or the other. What does you physician say?

I have similar problems with my hands and am thankful that I am close to retirement.

KatieMI, BSN, MSN, RN · May 3, 2017

So, it is RSI, "tendonitis" or what? The mentioned two conditions are quite a bit different animals, leaving alone a whole line of others diseases with very sililar presentation.

I would get an opinion of reputable specialist(s) about your prospects working a job where repetitive movements, heavy workloads, high level of stress and exposure to harmful substances of all kinds are pretty much not avoidable. Make sure the doctor understands other potential limitations of nursing as a professional field. For example, if you might require treament with medications which are known to cause sedation as a side effect or with controlled substances, that might make your job search very difficult.

After you get this (and probably second and third, if necessary) opinion, get every doctor's notes and request a meeting with your program's Dean. Explain your limitations, if any, and see what the program can do for you. Nursing programs can and do accomodate students with physical limitations to certain extent, with BSN programs typically being better at that as well as for arranging "specialty" rotations and making students hireable for specialty positions/transferable to higher education right out of school. I and several my classmates were thus "accomodated", although it was not a simple thing to arrange and we all heard some dirty talks behind our backs.

In any case, do not delay acting. You have to make your plans and limitations, if any, known while you taking general ed and theory courses which are transferable in case you will have to change your specialty, and before you start clinicals.

Good luck!

repetitivestrain · May 4, 2017

I think any nursing will require repetitive use of the arms, especially with computer charting. However, this is also true of all jobs in general not just nursing. I can't think of any job that wouldn't require repetitive use of the arms.
I see you have done many therapies, however I didn't see physical therapy. Have you seen an orthopedist?

No, an orthopedist is one of the only specialists I haven't seen. I'll ask my GP for a referral.

Other jobs I can think of with minimal hand use... security, retail, bus / taxi driver, tutor, grade school teacher, tour guide, start my own business (but what?) ... not exactly what I had planned for my life but I may have no choice. I think Youtube is trying to tell me something when I see Breaking Bad under 'recommended videos for you'

It sounds a lot like some kind of nerve entrapment. Most common is Carpel Tunnel but since it's your forearm it may be an entrapment of the Ulnar nerve. Have they done a nerve conduction study? I have an ulnar nerve entrapment in my rt arm it is annoying as all heck. My only treatment option is surgery and I don't heal well after going under the knife so I am hemming and hawing over it.
Hppy

Yes, the nerve conduction test was normal

There is not much we can tell you here. You have a health problem -- one that could very well have an effect on your career possibilities. You need a good diagnosis so that you can get good information about your prognosis. We can't give that to you one way or the other. What does you physician say?
I have similar problems with my hands and am thankful that I am close to retirement.

My GP has been very supportive + has provided referrals. She said it's good I'm at least trying the school route for now, and not to lose hope (it's difficult not to). I'll have to try to figure out what's happening with my health in the meantime. Wait lists for A&P courses are very long here and I am lucky to have got in for this semester.

She did mention she had a patient who developed a repetitive strain injury.... from nursing.... and that person had to retrain and do a less hands-on form of nursing (she wasn't sure what) -- it took them 1 year to heal up. Most cases go away in 3-4 months so it's very curious that I am still struggling with this at 26 years old no less, despite actively getting treatment for it.

Congrats on being close to retirement!

So, it is RSI, "tendonitis" or what? The mentioned two conditions are quite a bit different animals, leaving alone a whole line of others diseases with very sililar presentation.
I would get an opinion of reputable specialist(s) about your prospects working a job where repetitive movements, heavy workloads, high level of stress and exposure to harmful substances of all kinds are pretty much not avoidable. Make sure the doctor understands other potential limitations of nursing as a professional field. For example, if you might require treament with medications which are known to cause sedation as a side effect or with controlled substances, that might make your job search very difficult.
After you get this (and probably second and third, if necessary) opinion, get every doctor's notes and request a meeting with your program's Dean. Explain your limitations, if any, and see what the program can do for you. Nursing programs can and do accomodate students with physical limitations to certain extent, with BSN programs typically being better at that as well as for arranging "specialty" rotations and making students hireable for specialty positions/transferable to higher education right out of school. I and several my classmates were thus "accomodated", although it was not a simple thing to arrange and we all heard some dirty talks behind our backs.
In any case, do not delay acting. You have to make your plans and limitations, if any, known while you taking general ed and theory courses which are transferable in case you will have to change your specialty, and before you start clinicals.
Good luck!

The official diagnosis from my GP is tendonitis, but I've learned that there is no fully agreed upon treatment plan, it's more of a "let's try this and see if it works." Some believe in a corticosteroid shot, others strongly advise against this.

That is a very good point about medication and side effects, I had not thought of that. I'll have to set up a meeting with the Dean as well.

-----

It would have been easier if I broke both of my arms... all of this happened within 1 week of very heavy computer game usage + 2 days of lifting weights at the gym (I was on vacation before this).

The only other thing I can think of is I tried acupuncture for my back during that 1 week time period, and perhaps the needles were not sterile, which triggered some sort of autoimmune reaction in my body (sounds ridiculous).

I suppose this could all be in my head too... as impossible as it may seem, one must consider all possibilities. Dr Sarno's "The Mind Body Prescription" goes into tension myositis syndrome (TMS) in repetitive detail... basically pain is due to unconscious mental stress, anxiety, and anger. I am very self-critical and have a hard time letting go of dumb things I have done; if I am sitting at home reflecting on my past, I will get very angry at myself. Sadly I am also a perfectionist and a hypochondriac, working through the exercises mentioned in "The Anxiety & Phobia Workbook" by Dr. Bourne... mindfulness, meditation, avoiding negative self-talk, etc etc. The longer this goes on, the worse my mental health gets... lately I've been thinking of inhaling an inert gas, but that would crush my family and friends...

Thank you so much to everyone who has posted, I really appreciate it.