Repetitive Strain Injury – Definition, Causes Symptoms and Treatments

Repetitive Strain Injury (RSI), also called Repetitive Stress Injury, is a general term that is used to describe the prolonged pain experienced in shoulders or hands or neck or arms. It is used to refer to the types of soft tissue injuries like the nerve spasms, trigger finger and carpal tunnel syndrome.

It can also refer to other disorders such as the carpal tunnel syndrome, upper limb disorder, work-related upper limb disorders, musculoskeletal disorders, computer vision syndrome and cumulative trauma disorders

RSI can be used to refer to any syndrome associated with particular repetitive activity. They are generally caused by the work-associated activities such as using keyboards and mouse. The term includes a group of disorders that most commonly develop in workers using excessive and repetitive motions of the head and neck extremity, resulting from incorrect posture, stress and bad ergonomics.

Symptoms

Repetitive Stress Injury generally causes numbness, tingling, weakness, stiffing, and swelling and even nerve damage. The chief complaint is the constant pain in the upper limbs, neck, shoulder and back.

The work patterns of computer professionals carries a lot of orthopedic disorders. For the people who work on computer for more than few hours a day, who use musical instruments and who work in production lines are at high risk of developing RSI.  For those people, the following preventative measures can be helpful:

Prevention

Position: The recommended position to sit in front of a computer is semi-reclined with the forearms resting in a cradle or on an extension of the keyboard support. There should be ample support for the back. The hands should be free and point in the direction of the forearms. The feet should rest on the ground or feet support. All of these can be assisted greatly by utilizing an ergonomic chair.  The distance of the monitor should be 18 inches or more and at a slightly lower level than the eye level.

Hydration: Drink adequate fluids to keep the tendons and soft- tissues soft.

Shortcuts: Using keyboard shortcuts and less of mouse is the most effective preventive method. Touch the keyboard softly and do not pound at it. The wrist should rest on the table or wrist rest.

Telephone use: Don’t cradle the telephone between the face and shoulder while working, as this can lead to neck strain.

Exercise: Get regular cardiovascular exercise as well as upper-body strength training and stretching.  Staying active and strong can help avoid the onset of RSI.

Pace yourself: Take a 5-to-10 minute break at least every 30 minutes and limit your overall time at the computer.

Know your Body: If you feel strain or stress, make sure to rest.  Listen to your body.

In addition, companies and organizations can enact policies which can help prevent the onset of RSI for its employees.  These include:

1. You need to educate your employees on the importance of adopting a proper posture which is one of the main causes of Repetitive Stress Injury.
2. Ensure that all your employees are using quality ergonomic furniture that will save loss of working hours by guaranteeing full comfort of the employees.
3. Give periodic reminders through lectures and audio-visual presentations by medical professionals on the importance of taking good care of health while using computers and Repetitive Stress Injury.

Exercises:

There are some RSI exercises that you can do at your desk during rest periods that will help you with repetitive stress injury. They can also help prevent it if you don’t have it yet. You don’t have to do them all and it doesn’t matter what order you perform them in.

Stretching

Each of the RSI exercises will result in some sought of stretching, you should hold each stretch for about 15 to 30 seconds and repeat it for three times. These are just guidelines and you should do only what is comfortable for you.

Make sure that you only feel a gentle stretch and that there is no pain when you are doing these RSI exercises. You should reduce the number of repetitions or shorten the amount of time that you hold each stretch if you feel some pain. Stop doing that particular RSI exercise if the pain continues.

Some RSI Exercises That Can Help You to Avoid RSI

• Hold both your hands out in front of you and stretching them for a few seconds. Splay your fingers until you feel a gentle stretch.
• Hold both hands in front of you and curling your fingers and thumbs under at your first knuckle.
• Keep your arms straight out in front of you and drop your right hand down with it bent at the wrist. Put your left hand on the knuckles of your right hand and press toward you until you feel the gentle stretch in the top of your wrist. Swap your hands and repeat it on the other hand.
• While your arms are still out in front of you, lace your fingers together and turn your hands downward and over so that your palms are facing away from you. Press outward until your arms are completely straight and you feel the gentle stretch.
• Place your arms straight out in front of you, then raise your right hand so that your palm faces away from your body. Place your left palm onto the fingers of your right hand and press the fingers toward you until you feel the gentle stretch. Repeat the same steps only using the other hand.
• Next you can hold your right hand out in front of you with your palm facing up. Massage your right hand with your left hand from the inside out and in between your fingers. Do this on both hands.

Treatment

You can’t achieve healing from an RSI solely by seeing your doctor. You will need to be an active participant during the course of your treatment and afterwards.

Occupational therapists, physical therapists, physiatrists, surgeons, and alternative medicine practitioners are the people that may be involved in the diagnosis and treatment of RSI.

Simple Repetitive Strain Injury Treatment Measures

One simple measure, which is more common sense than anything is painkillers and anti inflammatory pills, these are available over the counter at any good pharmacy.

When taking painkillers and anti inflammatory pills it is important that you rest the affected area, just because the pain is not there it doesn’t mean the condition has instantly been resolved.

Another simple measure is speaking to your employer, you may find they have guidelines to work towards that may mean you can get some support in alleviating your condition. This means your work place may be assessed and improvements implemented.

You can get a simple support bandage from your local pharmacy to help add strength to the affected area, if it is your wrist or arm. You may need to purchase a special keyboard and/or mouse or get speech recognition software in order to prevent further irritation to your injury.

Speech recognition software is a great alternative for those who suffer due to computer work, speech recognition software works by the software writing what you say for you.

Your medical professional might possibly prescribe that you wear an orthopedic hand brace. You don’t want to wear one of these if your doctor doesn’t prescribe it because it could lead to further injury.

Medical Treatments for RSI

Your doctor may prescribe physical therapy, a physical therapists role is to develop and maximize the movement of the body, and this can also include the provision of aids to alleviate symptoms.

Another prescribed therapy your doctor may request is occupational therapy, it may sound like occupational therapy and physical therapy are very similar but there are differences.

Occupational therapy helps develop and maintain the skills required to carry out all the general functions needed to live a comfortable life.

Occupational therapy includes assessing what a persons requirements are and supporting them with offering recommendations on adapting to their living or working space and offering simple exercises to regain movement.

Alternative Treatment Methods

Deep body massages have been reported to work wonders for those suffering with repetitive strain injury as it works deep into the body’s soft tissues like the muscles and tendons where the pain comes from.

Soft tissue therapy is a type of therapy that works by decompressing the area surrounding the RSI. This will increase your circulation and aid in healing. They may also try biofeedback. This is generally used to reduce tension in the muscles in your shoulders and neck.

Some people have reported that slow martial arts like Tai Chi can have a dramatic affect on their condition because they work on specific movements and improve strength and flexibility.

As a last resort, your medical doctor might recommend that you have surgery. You should keep in mind that it doesn’t always work and you will be left without the use of your hand and arm for a long time. The above treatment methods have been proven to help heal even the worst RSI disorders when they are done correctly.

Types of Injuries

Carpal Tunnel Syndrome

A case of carpal tunnel syndrome develops when the median nerve which is located inside of the wrist becomes compressed.

When this occurs, the afflicted individual will experience feelings of numbness and tingling within their wrist, sometimes causing them to awaken in the middle of the night due to the pain. The range of motion of the wrist may also be affected in the afflicted person.

See our Carpal Tunnel Syndrome page for much more information regarding this ailment.

DeQuervain’s Syndrome

Also known as washerwoman’s sprain, this injury affects the thumb.  There are two tendons within the body that work to control the movement of the thumb, and when the sheaths that hold these tendons become inflamed, pain and swelling may occur within the thumb. DeQuervain’s syndrome suffering people also often experience a lack of ability to grip with the affected thumb.

Tendonitis

Tendonitis occurs when a tendon within the body becomes inflamed. Some of the most commonly affected areas by tendonitis include

• Elbow
• Wrists
• Arms
• Shoulders
• Legs
• Knees
• Ankles
• Hips

Many of these forms of tendonitis develop due to participation in sports; for example, many rock climbers develop a case of tendonitis within their fingers, and many basketball players develop tendonitis in the knees due to the amount of jumping that they perform.

Tenosynovitis

Tenosynovitis is similar to tendonitis in a number of ways. As opposed to an inflammation of the tendon as in tendonitis, those with tenosynovitis develop an inflammation of the sheath that surrounds the tendon.

More often than not, cases of tenosynovitis develop within the fingers, and the syndrome is also known as ‘trigger finger’. Those with a case of tenosynovitis may experience limited range of motion within the fingers, and may feel a cracking occurring when they try to straighten the affected fingers.

Intersection Syndrome

Intersection syndrome is confused with DeQuervain’s syndrome. It’s a painful repetitive strain injury type that occurs when muscles within the forearm overlap with wrist tendons.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is similar to carpal tunnel syndrome. Those with a case of cubital tunnel syndrome experience compression of the ulnar nerve which is located within the elbow.

Cubital tunnel syndrome cases may result in a limited range of motion of the elbow, as well as a feeling of burning and numbness present within the elbow.

Trigger Finger

Trigger finger is similar to DeQuervain’s syndrome. In a case of trigger finger, the sheath surrounding the tendons of the thumb becomes swollen or a type of nodule becomes present on the tendon.

These two types of afflictions can cause the tendon of the thumb to be unable to move through the sheath, causing cracking sounds when motion occurs and often causing pain when bending the digit.

Thoracic Outlet Syndrome

Pain in the nerves and blood vessel around the brachial plexus and axilla (between the base of the neck and the armpit) is caused by compression of blood vessels.

The subclavian artery and vein are the two blood vessels that most commonly get compressed to cause this condition, although the vertebral artery and the nerves that make up the brachial plexus can also become compressed.

Compression is caused by the body’s position due to repetitive movements. The condition is called thoracic outlet syndrome because it is found in the thoracic region of the body.

There are things that you can do in order to decrease the likelihood that you will be personally affected by one of these cases of injury:

You need to make sure that you don’t overuse these delicate areas, so be sure to take breaks when in the middle of repetitive motions. If you begin to feel pain or fatigue in any body part that you are using to perform a task, take it as a warning sign and step back from the activity.

Also, make sure that you are using good posture, as it can be a great preventative measure.

More often than not, the inflammation and the swelling of the affected area can be reduced using non-steroidal anti inflammatory drugs. In all cases, resting the affected area of the body is of the utmost importance, with most doctors recommending at least 2 weeks of rest.

Surgery may be necessary to correct the problem in the event of an advanced case of RSI. Luckily, most surgeries are outpatient surgeries which require little down-time.