Repetitive Strain Injury (RSI) is also known as repetitive stress injury (RSI) or ‘work related upper limb disorder’ (WRULD). Stress and strain in this case refer to the forces (stresses) that cause a physical change (strain) in the body's tissues. It is a common condition effecting people who use keyboards or implements for work or pleasure. It is increasingly common with the exponential use of computers for work and pleasure. Poor posture, ergonomic positioning or keyboard use are commonly implicated. Builders, butchers, musicians, assembly line workers and even surgeons can suffer from RSI.
RSI is an ‘umbrella’ term for a range of musculoskeletal conditions that mainly effect the forearm, wrist and hand but may also effect the shoulder, upper back and neck. Classically the patient will complain of pain around the wrist or lower forearm that may radiate upper or down the limb. The discomfort is recurring and often linked to manual activities which may have been the original precipitating factor. The pain is often relieved by rest or avoiding certain activities, stretch, gentle exercises for RSI (see Desk Therapy home page for more information) or applying cold or hot compresses. There is often a loss of grip strength as the body tries to enforce rest or the sufferer may complain that the arm feels weak or fatigues easily. There may also be associated pain and discomfort in the neck and upper back or across one or both shoulders. May sufferers experience numbness or pins and needles in the hands. Sometimes this pain is worse at night when they have stopped the activity. This is due to the inflammatory process causing congestion at night.
There are many separate, inter related orthopaedics conditions that make up RSI. These include:
This selection of conditions can mislead the sufferer and clinician. Two or more of the conditions may coexist amplifying the symptoms and causing problems in different areas. It is also clear that psychological or emotional issues are important. Workers are much more likely to develop RSI if they are under pressure, working longer hours are unable to move from their desks, have little time for stretches or gentle exercises or have low job satisfaction or depression. Anxiety or stress can cause muscular tension in the upper back or neck. This leads to poor posture and inefficient movement compromising other areas especially the hands, wrists and elbows. Good ergonomic set up of a work station combined with regular exercises for neck and back pain have been shown to be very effective.
The early stages of Repetitive Stress Injury may respond to a combination of approaches including the application of ice or heat, anti inflammatory medications, rest, specific gentle stretches for RSI and relaxation techniques.
It is essential to for the sufferer to look at their work station and the ergonomic set up – this may best be inspected by a professional ergonomist or occupation health specialist. Treatment from from a manual therapist (osteopaths, physiotherapists, chiropractors or massagers) may be helpful. They may also prescribe the appropriate exercises for RSI and stretches for the neck, upper back, forearms or wrists. TENS machines have been shown to be helpful. Visualisation or biofeedback techniques can be helpful in relieving the muscular tension of the upper back or neck.
Braces for the hand, wrist or forearm may be used to immobilise the limb or redirect certain stresses to other areas.
Speech recognition software can give the users some rest from the keyboard and Desk Therapy exercise programmes may help to re educate the users into taking short breaks and will demonstrate appropriate stretches.
Surgery should only be considered as a last resort as it is often uneffective and may lead to other problems.
Desk Therapy exercise software can help. Please visit our Home Page to see how Desk Therapy can create an exercise programme designed especially for you.