Four things I’ve learnt from working with chronic pain

The last day of February every year is International RSI Awareness day. And this year, for me, marks 20 years since I was first diagnosed with RSI. So, it seemed like a good point at which to look back on how chronic pain has affected the way I live and work over the past two decades.

To quickly recap, I started suffering the classic symptoms of RSI, shooting pains in my right hand and wrist, not long after I’d switched from a career as a classroom EFL teacher to one working all day every day at a computer in ELT publishing. Over the period that followed, I learnt a lot about repetitive strain injury and how it’s caused by sitting in a tense awkward position, often with a poor desk setup, doing small repeated movements, especially with a mouse. 

I also discovered that my pain issues stretched far beyond my right hand and that initial crisis was a trigger for a whole load of underlying musculoskeletal problems. As well as the sensitisation of the nerves running through my right hand, arm, shoulder and neck, I discovered that an old shoulder injury turned out to be a permanently dislocated collarbone which was making my whole right side wonky and unstable. Then, added into the mix was a degree of hypermobility, a condition that means that my skeleton and the tendons attached to it are particularly loose and stretchy, meaning that my frame can’t take the strain of holding my body in one position for very long. All of which has led to a messy chronic pain condition that’s had a huge impact on my life and work. It’s a topic I could write about endlessly, but here are the top four things I’ve learnt.

#1 Pacing myself

I soon discovered that I couldn’t manage a regular full-time job. I have good patches and bad patches, I’m better at working in short bursts with breaks in between and I have to fit my work around what I can physically manage. So, being freelance gives me more freedom to manage how and when I work. For any freelancer though, trying to achieve a schedule that gives you a steady flow of work is an incredible challenge. Work comes in fits and starts, projects get delayed, they run over, and sometimes get cancelled altogether. Most freelancers end up agreeing to more than they’d like just so that if one thing’s delayed or cancelled, they have something else to cover the time. And then when it all comes at once, they put in extra hours, work evenings and weekends, and just juggle their time to fit it all in. For me, however, that’s not an option. I simply can’t afford to get into a position where I’m working extra hours because my body will break down and everything will grind to a halt. That means I have to be conservative about the amount of work I take on, only agreeing to as much as I can reasonably cope with; 15-20 billed-for hours a week is ideal, 25 for the odd week at a push. That leaves me really vulnerable to those delays and cancellations though. If I’ve only got one project in my diary and that suddenly disappears at short notice, then I simply have no money coming in. I’ve got used to having a significantly lower income than my peers, but at times, with bills to pay and nothing in the bank, it’s definitely a source of stress and frustration.

#2 Avoiding the fiddly bits

Contrary to many people’s impression of RSI, for me at least, straightforward typing isn’t particularly problematic. That’s especially true with ELT materials where you’re very rarely typing long stretches of text, it’s mostly short sentences with thinking time in-between and doesn’t put that much strain on my hands. What gets me is all the fiddly stuff navigating around documents and formatting text either using a mouse or repeated keystrokes (such as lots of paging up and down). Although I use a graphics tablet instead of a mouse because I find it more comfortable, there are still certain things that are really problematic. My biggest bugbear is anything that involves highlighting specific sections of text, in order to cut and paste, or change the format. Trying to highlight exactly the right words and characters involves a degree of tension and control in your hand and wrist no matter what device you’re using and it’s that focused tension that really causes me the most pain, especially if it’s repeated over and over again.

I’m perfectly happy just typing text into a straightforward Word document and even using a template with Word styles isn’t a problem once you get into the swing of it. The projects I hate are the ones, often for digital materials, that require you to fill in lots of different fields with codes for exercise types, that involve copying and pasting the same instructions numerous times, repeating the same text for answer keys and audio scripts and artwork directions. I’ve worked on a couple of projects where getting the initial content down “on paper” took up a fraction of the time compared with filling in field after field of text in what amounted to no more than data input. Those are the jobs that I now avoid.

#3 Not standing around

Perhaps the number one most frustrating aspect of my health though is something that affects me both socially and professionally. For me, standing around for any length of time gets really uncomfortable. It can be a tricky one for people who know me to get their head around because in many ways I’m quite fit. I walk a lot – I’m currently walking around 20 miles a week as part of a walking challenge – and I don’t look like a hobbly old lady. But for me, there’s a huge difference between walking along at pace and standing around or even mooching about slowly – it puts my body under a whole load of different strains. On a bad pain day, just standing about for a few minutes can leave me unable to think about anything other than sitting down in a comfortable chair. Add to that standing around holding a drink (really painful for my arm and shoulder) or standing around with a bag on my shoulder (so uncomfortable I now avoid it at all costs) and the prospect of any kind of social or networking event that isn’t going to involve comfortable chairs fills me with dread.

It’s a real killer, because I really enjoy being sociable and chatting to people, whether they’re friends or colleagues. But unless I’m going into a situation that I’ll be able to control, such as meeting in a café where I know we’ll sit down, I find myself avoiding situations where I might end up  uncomfortable, distracted and wishing I could leave. That gets amplified at events which I’ve had to travel to (another potential source of discomfort) and at which I’m going to have to spend extended lengths of time without any respite.  It makes me feel like an unsociable grouch which I’m really not … honest!

#4 Perspective

If all that’s sounding a bit negative, there is one major positive to having a chronic health condition and that’s the perspective it gives you on life. For me, work-life balance isn’t a luxury add-on, it’s absolutely essential. If I’m overdoing it, my body will tell me so in no uncertain terms and I have no choice but to listen. I’ve learnt not to let my working life get out of perspective. That’s not to say I don’t ever get annoyed and frustrated by stuff, but I’m pretty good at stepping away from my desk, taking a break, going out for a walk, then coming back and dealing with the problem before it gets out of hand. Over the years, I’ve got better at standing my ground, speaking up when expectations are unrealistic and if necessary, just walking away. I love my work and I want to do a professional job, but you know, sometimes there are just more important things.

... like a cup of coffee in the sunshine ...