Can a workplace epidemic be cured? With the personal-computing boom of the 1990s came thousands of "repetitive stress injuries" or "repetitive...

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NEW YORK — Can a workplace epidemic be cured?

With the personal-computing boom of the 1990s came thousands of “repetitive stress injuries” or “repetitive strain injuries.” RSI became the hip medical acronym of the keyboard era, with subset carpal-tunnel syndrome the diagnosis of the day.

“At its height of diagnosis, anybody showing up at a doctor’s office with wrist pain or hand pain was being diagnosed with carpal tunnel,” said Carol Harnett, vice president of insurer Hartford Financial Services Group’s group-benefits division.

Since then, carpal-tunnel cases have plummeted, declining 21 percent in 2006 alone, according to the Bureau of Labor Statistics. Among workers in professional and business services, the number of carpal-tunnel-syndrome cases fell by half between 2005 and 2006.

What changed?

First, it may not have been the white-collar epidemic it appeared to be.

Mayo Clinic study

A 2001 study by the Mayo Clinic found heavy computer users (up to seven hours a day) had the same rate of carpal tunnel as the general population. Harvard University headlined a 2005 news release “Computer use deleted as carpal tunnel syndrome cause.”

“Clearly, if keyboarding activities were a significant risk for carpal tunnel, we should have seen, over the last ten to 15 years, an explosion of cases,” said Dr. Kurt Hegmann, director of the Rocky Mountain Center for Occupational & Environmental Health.

Blue-collar workers, especially those doing assembly-line work such as sewing, cleaning and meat or poultry packing, have a far greater incidence of carpal tunnel than white-collar workers, according to Bureau of Labor Statistics data.

Artificially high number?

That doesn’t mean white-collar workers don’t get carpal tunnel and related disorders. But it may mean such disorders were overdiagnosed, resulting in an artificially high number of cases by the late 1990s. Most doctors have dropped the term “RSI,” calling them “musculoskeletal disorders.”

Now, some experts think some of those patients had “referred pain” from trouble elsewhere, such as the neck.

Other theories claim attention to ergonomics has prevented injuries or that they have become underreported.

Clay Scott, now an assistant professor of electrical engineering and computer science at the University of Michigan, developed severe wrist pain during college at Harvard University.

His recovery started with physical therapy. It took three or four years for him to recover, he said.

“I was hurting myself for about two years before figuring it out and realizing I needed to change my work habits.”

Some businesses have been focusing on prevention, part of a growing effort by employers to keep their workers healthy.

Blue Cross Blue Shield of Kansas started a program in 1991, when costs of the injuries to its employees passed $500,000.

It bought ergonomic chairs and desks, introduced ergonomic assessments for new employees during their first two weeks of work and hired two full-time registered nurses to work with employees.

Since the program started, the company’s workers’ compensation costs have fallen by 62 percent, said Terri Janda, a nurse who leads the Blue Cross program.

Said Barbara Silverstein, research director at the Washington state Department of Labor and Industries, “People have gotten the message about how to design work, so people aren’t as at risk as in the past.”

California is the only state with an ergonomic standard, according to Federal Occupational Safety and Health Administration.

But Hegmann sounds a note of caution.

As carpal tunnel is strongly linked with aging, obesity and diabetes, “It means we should have more cases than we have,” Hegmann said.

Some of the reduction in cases, he said, “may be due to the realization that it’s a common situation; there’s no rush to do anything about it.”