Article featured on Practical Pain Management
Art therapy can be an effective and creative way to manage chronic pain. Just make sure you don’t add to your burden with repetitive strain injuries.
It’s no secret that art has profound benefits for mental health, including for people with a chronic pain condition, according to research such as this 2021 review published in Canadian Journal of Counselling and Psychotherapy. But if you’re not careful, your art practice can lead to repetitive strain injuries (RSIs) and actually add to—not subtract from—your chronic pain burden.
Art-related RSIs may start with tingling, numbness, aching or the unsettling realization that you’re dropping things. One day, you wake up, and the pain has gone from annoying to excruciating.
What Are Repetitive Strain Injuries?
According to Joseph Herrera, DO, a physiatrist and the Lucy G. Moses Professor and Systems Chair for the Department of Rehabilitation and Human Performance for the Mount Sinai Health System in New York, N.Y., visual artists, craftspeople, graphic designers, weavers and sculptors, as well as other types of artists, are highly vulnerable to RSIs—often known as overuse injuries—particularly of the shoulder, elbow and hand.
These result from at least two factors – sitting in one position for protracted periods and performing the same movement repeatedly without taking a break. Prolonged immobility injures postural muscles that are needed to keep the body in that position; repetitive movement injures structures responsible for that movement. Other contributing factors include poor posture, use of tools which require force or cause vibration (such as those used in sculpting) and poor and/or working environments that are too cold. “There’s a reason that athletes warm up before starting,” says Dr. Herrera.
Types of Repetitive Strain Injuries
RSI is an umbrella term for a range of musculoskeletal disorders caused by repeated micro-trauma of the structural tissues of the body – nerves, tendons, muscles and ligaments. Artists may be especially prone to these types of conditions, which can include but are not limited to:
- DeQuervain’s stenosing tenosynovitis
- Dupuytren’s contracture
- Ganglion cysts
- Rotator cuff injury
- Carpal tunnel syndrome
- Epicondylitis (tennis elbow or golfer’s elbow, depending on whether the pain is on the outside or the inside of the elbow)
Other conditions that can be related to or worsened by repetitive stress include osteoarthritis, rheumatoid arthritis, and thoracic outlet syndrome.
There are a number of other injuries that can plague artists and artisans.
Graphic artists and others who spend hours hunched over a computer are very likely to develop lower back and neck pain from sitting in one position or from craning the neck forward.
“Prolonged sitting or standing puts stress on the cervical or lumbar discs that are between each vertebra of the neck or lumbar spine.” says Dr. Herrera. “Because of the line of gravity and the position of the pelvis, lying down with a small pillow under your knees is actually the healthiest position for human beings.”
Renowned Mexican artist Frida Kahlo, who had multiple catastrophic injuries and numerous surgeries due to a serious bus accident, was able to paint lying down but most painters would find that extremely difficult, if not impossible.
Preventing Art Injuries
There is a great deal of overlap between prevention and treatment for overuse injuries.
Ergonomics is the applied science that focusses on designing and arranging things that will allow people to interact with them most efficiently and safely. Ergonomic chairs with lumbar supports, specially designed mice and keyboards, sitting-standing desks and numerous other items can be irreplaceable in terms of both comfort and prevention of injuries.
A 2018 University of Pittsburgh study published in the journal Occupational and Environmental Medicine found that people with chronic low back pain reduced their pain and disability by 50% using a sit-stand desk and taking movement breaks.
“Although making art is a passion-driven activity, and it’s difficult for artists to stop when they’re absorbed in what they’re doing, intermittent periods of rest are one of the best ways to prevent repetitive stress injuries,” says Dr. Herrera, who recommends a timed break within 30-40 minutes after beginning to work and at regular intervals after.
Good posture – maintaining a straight back, keeping your neck straight and your head up to prevent “tech neck,” having both feet on the floor when sitting – and proper body mechanics when lifting or moving heavy objects such as litho stones or bags of plaster or cement are important.
There are many adaptive devices which can be helpful. Pick and choose according to the type of art you make, the positions and instruments, if any, that you frequently use. There are pencil grip tools, angled drawing boards, triangular pencils, and jigs to hold vibrating tools instead of using your hands.
Stretching, with or without the use of stretching bands can also help with constricted circulation in a body part. Yoga, tai chi, and other movement activities can be useful and relaxing. However, during the acute phase of an injury, you should seek professional advice as to what kind of exercise is appropriate.
Splinting, braces, compression gloves and whole-arm immobilizers can help with both prevention and treatment of RSIs; it is crucial that these be correctly sized and appropriate to your body, any pre-existing injury or surgery and the way you work.
Treating Repetitive Stress Injuries
Early treatment of repetitive stress injuries is important not only to relieve inflammation and pain, but also to avoid making the injury worse, avoiding the need for surgery, and to lessen the risk for deformity or severe disability.
“The most important treatment is rest of the injured part,” emphasizes Dr. Herrera. “This is not a ‘no pain, no gain’ situation, and it is not the time to power through the pain. You must listen to your body.”
Over-the-counter analgesics such as acetaminophen, non-steroidal anti-inflammatory (NSAIDs) such as ibuprofen, aspirin, and naproxen work by inhibiting the production of substances which causes pain, inflammation and fever, and are useful in relieving pain.
Applications of ice can help during the acute stages of an injury or if swelling is present.
Tricyclic antidepressants and serotonin-norepinephrine reuptake Inhibitors (SNRI’s) may be used to treat pain and any accompanying depression.
Anticonvulsants such as gabapentin and pregabalin (Lyrica) are useful in treating nerve-related pain.
Muscle relaxants and antispasmodics are typically used to ease acute pain associated with muscle tension and painful spasms, such as those often experienced with lower back pain. Steroid injections (such as cortisone) may be helpful. Opioids (used with caution) and medical marijuana are other options for pain relief.
Physical therapy, massage, trigger point massage, transcutaneous electric nerve stimulators and other pain-relieving devices can be used for either acute or chronic pain.
“Take good care of your body, be aware of potential risks, and utilize rest both prophylactically and when an injury is present. That is the best way to avoid having to come see me in my office,” says Dr. Herrera.
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