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What is Repetitive strain injury (RSI)?

By Dr Ananya Mandal, MD

Repetitive strain injury (RSI) is a common disorder of the upper limbs that occurs mainly due to bad posture at work. There is commonly pain in the nerves, tendons and muscles that occurs due to overuse or repetitive movement.

Repetitive strain injury is also known as Cumulative Trauma Disorder (CTD).

Causes of RSI

RSI is said to occur when overuse results in microscopic trauma in the muscles and tendons.

Other factors that affect the areas include:

  • fatigue of the ligaments, tendons and soft tissues due to over use
  • lack of blood supply to the nerves leading to ischemia and muscle damage
  • several psychosocial and work related conditions. (1-6)

Symptoms of RSI

RSI commonly affects the wrist, elbow, forearm, hands and even the neck and shoulders.

The pain may also result from swelling and underlying inflammation and muscle stiffness.

Common symptoms of the condition include pain, swelling, stiffness, numbness or tingling, limited joint movement and worsening of symptoms with time.

Types of RSI

RSI is usually of two types: type 1 RSI and type 2 RSI.

Type 1 RSI is said to occur when the symptoms all point towards the diagnosis of a recognised medical condition. There is typical stiffness, swelling and inflammation of the affected muscles and tendons.

Type 1 RSI includes conditions like bursitis that occurs when there is an inflammation and swelling of the fluid-filled sac near the joint (usually the shoulder, elbow and knee) and tendonitis that occurs when there is an inflamed tendon.

Another condition is the Carpal tunnel syndrome where swelling and inflammation in the wrist muscles leading to compression of an important nerve called the median nerve.

Other conditions include Dupuytren’s contracture, Epicondylitis or ‘tennis elbow’, ‘Housemaid’s knee’ or ‘beat conditions’ etc.

In Type 2 RSI a medical condition is not apparent. This is mainly because there are no obvious symptoms, apart from pain. This is termed “non-specific pain syndrome”.

RSI and posture

RSI is commonly caused due to bad posture at work or over long periods of time.

RSI is commonly seen in people who work with computers or carry out repetitive manual work.

Frequency of RSI

In the United Kingdom one worker in every 50 has been diagnosed with a RSI or related condition. However, the exact incidence is not known as the symptoms vary between individuals and many cases go unreported.

Several long-term, work-related studies have estimated that RSI of the upper limbs are seen at the rate of at 4.5-12.7% per year. According to the Health and Safety Executive (HSE) RSI affects up to 500,000 workers each year - with 81,000 new cases in 2007/08 alone.

Who is at high risk of RSI?

RSI occurs in people who do a particular activity for a long time without rest, perform a heavy activity, maintain a poor posture for long periods of time, work in cold climates, with vibrating equipment and suffer from work related stress.

Occupations at particular risk include:

  • heavy computer workers
  • typists
  • ultrasonographers
  • tailors
  • surgeons
  • dentists
  • nurses
  • cooks
  • cleaners
  • road maintenance staff
  • carpenters
  • drivers
  • equestrian athletes
  • swimmers
  • martial artists
  • musicians etc.

Treatment of RSI

The treatment of RSI focuses on prevention of the condition as early as possible. This is done by identification and stopping the task or activity that is causing the symptoms.

Pain and swelling may be relieved by anti-inflammatory drugs like Aspirin or Ibuprofen.

Sometimes support in form of a sling, elastic band or hot and cold packs are useful.

More severe cases may require steroid injections to reduce inflammation. Recovery requires help of a physiotherapist for advice on posture.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Oct 8, 2014

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