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Repetitive Strain Injury (RSI)
Has been around since people first began repeating motions and carrying out manual labour. The first description of repetitive strain injury (RSI) came from an Italian physician, Bernardino Ramazzini, in 1700. He described more than 20 categories of RSI that he observed in the industrial workers of Italy.
Today, the main causes of RSI are manual labour, office work, and the use of modern technological devices, and of course sporting activities.
What is an RSI?
RSI refers to a wide variety of problems. An RSI can affect almost any moveable part of the body. RSIs are associated with repetitive tasks, forceful exertions, vibrations, mechanical compression and sustained or awkward motions.
Symptoms
RSI has a wide range of possible symptoms that may include:
Tenderness or pain in the affected muscle or joint
Throbbing or pulsating sensation in the affected area
Tingling, especially the hand or arm
Loss of sensation
Loss of strength
Loss of movement
Inflammation symptoms within the affected region
Other symptoms depend on which part of the body is affected.
Causes
The causes of RSIs vary widely.
Here are some activities and equipment that can increase the risk:
Repeating the same movements over and over again (i.e. DIY, Sports training, work activities)
Overuse of a particular muscle or group of muscles
Vibrating equipment
Working in cold temperatures
Poor posture or a non-ergonomically designed workspace
Forceful activities
Holding the same posture for prolonged periods
Direct pressure to particular areas
Carrying heavy loads
Increased psychological stress has been shown to worsen RSI
Diagnosis
A doctor, Physiotherapist, Osteopath will normally be able to diagnose an RSI through a physical examination and by asking questions about the sort of repetitious tasks the patient does regularly, what causes the discomfort, and when it tends to happen.
There are two broad types of RSI:
Type 1 RSI is a musculoskeletal disorder. Symptoms usually include swelling and inflammation of specific muscles or tendons.
Type 2 RSI has a range of causes. It is often related to nerve damage resulting from work activities.
Treatment
The causes and symptoms of RSIs are varied, so treatment also varies.
Types of treatment that are commonly used include:
Medication: Anti-inflammatory painkillers (such as aspirin or ibuprofen), muscle relaxants, and antidepressants may help. Sleeping tablets may be suitable if sleeping is affected.
Extracorporeal Shockwave Therapy (ESWT): Sound waves utilised to break down distorted tendon tissue and promote growth. Usually applied by a Physiotherapist.
Heat or cold: Applying heat packs or ice packs. Avoid excessive heat or applying ice directly to the skin, as these can burn.
Splints: Some people use an elastic support or splint.
Physical therapy: This Includes exercises, manual therapy, bracing or splinting, and advice on adapting activities to cope with tasks or reduce the risk of worsening the injury.
Steroid injections: These are only advised if there is inflammation associated with a specific medical condition, as they can have adverse effects.
Surgery: As a last resort, surgery can correct problems with specific tendons and nerves.
Prevention
It can be difficult to prevent an RSI from developing or worsening if the cause is related to work or other necessary activities. The main way to reduce the risk is to stop or reduce the intensity of the activity. If the activity cannot be stopped, tips for reducing the risk include:
Taking breaks: Taking regular breaks from a repetitive task can help. An alarm can act as a reminder to take short breaks.
Stand up: Standing up and stretching frequently can reduce the risk. Extend the back, arms, and fingers.
Eye break: Rest the eye muscles by looking up and staring for a moment at objects in the distance.
General health: Eat healthfully and get regular exercise to keep your body resilient, and avoid smoking, as this reduces blood flow.
Guidelines for computer and desk workers
The most common cause of an RSI nowadays is using a computer or sitting at a desk.
The following guidelines may help prevent the most common complaints:
Ergonomics: Ensure that the desk, chair, and screen are aligned in an ergonomic fashion. Employers will have access to official guidelines.
Posture: To avoid slouching, keep the ears and back in a straight line with the pelvis.
Wrists: Avoid bending the wrists, and keep the arms, wrists, and fingers aligned when typing.
Typing: Avoid hitting the keys too hard while typing. Touch typing can help, as each finger will take its fair share of pressure, and there is no need to keep looking down at the keyboard. Voice-activated software can also minimise typing.
Shortcuts: Keyboard shortcuts can reduce typing and mouse movements.
Mouse: Do not grip too tightly and slow your speed to reduce muscle tension in the hand.
Temperature: Ensure you are working in an appropriate temperature.
Telephone: For those who need to type while using a telephone, wearing a headset is better than clamping the receiver between the head and the shoulder.
Examples of RSIs
Here are a few of the many conditions that are linked to RSI, although these conditions may also stem from other causes:
Intervertebral Disc Protrusions: This is a form of RSI. Persistent positioning & loading of the spinal discs gradually causes them to decentralise and dehydrate, thereby, placing close by nerve roots at risk of irritation or compression.
Bursitis: The fluid-filled sac near a knee, elbow, or shoulder joint becomes inflamed and swollen.
Tendonitis: A tendon becomes inflamed.
Tendinosis: Cellular degeneration of collagen results within the tendons, due to overuse. This is different from tendinitis.
Carpal tunnel syndrome: Painful compression of a nerve as it passes across the front of the wrist.
Raynaud’s disease: Blood vessels in the extremities constrict when cold or stressed. It can be triggered by work involving vibration, such as using a jackhammer.
Cubital tunnel syndrome: This can result from repeated or prolonged pressure on the nerve in the “funny bone” area, or from stretching this nerve for long periods of time.
De Quervain syndrome: This painful condition affects the tendons on the thumb side of the wrist, and it is often associated with overuse of the wrist.
Thoracic outlet syndrome: Blood vessels or nerves become trapped between the collar bone and first rib. It mostly affects people whose job involves heavy usage of the upper extremities against resistance.
Intersection syndrome: A painful inflammation of specific muscles in the forearm, caused by repeated flexion and extension of the wrist. It often affects weightlifters, rowers, racket sport players, horseback riders, and skiers.
Dupuytren’s contracture: A thickening of deep tissue in the palm of the hand and fingers can lead to permanently bent fingers. Using vibrating tools increases the risk.
Some types of Rotator cuff & Sub-acromial Impingement Syndromes: Damage to any of the tendons that hold the shoulder joint in place. It is common in work that involves prolonged overhead activity.
Medial epicondylitis, or golfer’s elbow: This affects the inside of the lower arm, near the elbow. Frequently playing certain sports or repetitive twisting motions can lead to this condition.
Lateral epicondylitis, or tennis elbow: This affects the outer part of the elbow.
Stenosing tenosynovitis, or trigger finger: A finger becomes stuck in the bent position and, when straightened, it does so with a snap. This is also known as “texting tendonitis.” It may result from repeated, strong gripping.