Repetitive strain injury

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Repetitive Strain Injury

Classification and external resources 11373 DiseasesDB pmr/97 eMedicine D012090 MeSH Repetitive strain injuries (RSIs) are "injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions".[1] RSI is also known as cumulative trauma disorders, repetitive stress injuries, repetitive motion injuries or disorders, musculoskeletal disorders, and [occupational] overuse syndromes.

Contents

1 Definition 2 Treatment 3 Adjunct Intervention o 3.1 Ergonomics o 3.2 Adaptive software o 3.3 Adaptive hardware 3.3.1 Mouse 3.3.2 Keyboards and keyboard alternatives 4 See also 5 Footnotes 6 External links

Definition
RSI is a repetitive strain (or stress) injury, Repetitive strain injury (RSI) is a syndrome incorporating several discrete conditions associated with activity-related arm pain such as edema, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, stenosing tenosynovitis, intersection syndrome, golfer's elbow or medial epicondylitis, tennis elbow or lateral epicondylitis, radial tunnel syndrome, and focal dystonia. RSI is also used as an umbrella term for non-specific illnesses popularly referred to as Blackberry thumb, iPod finger, gamer's thumb (a slight swelling of the thumb caused by excessive use of a gamepad), Rubik's wrist or "cuber's thumb" (tendinitis, carpal tunnel syndrome, or other ailments associated with repetitive use of a Rubik's Cube for speedcubing), Trigger finger, Stylus Finger" (swelling of the hand caused by repetitive use of

mobile devices and mobile device testing.), Raver's Wrist, caused by repeated rotation of the hands for many hours (for example while holding glow sticks during a rave), and others. Doctors have recently begun making a distinction between tendinitis and tendinosis in RSI injuries. There are significant differences in treatment between the two, for instance in the use of anti-inflammatory medicines, but they often present similar symptoms at first glance and so can easily be confused. The following complaints are typical in patients who might receive a diagnosis of RSI:[2]

Short bursts of pain in the arm, back, shoulders, wrists, hands, or thumbs (typically diffuse i.e. spread over many areas). The pain is worse with activity. Weakness, lack of endurance.

Treatment
RSIs are assessed using a number of objective clinical measures. These include effort-based tests such as grip and pinch strength, diagnostic tests such as Finkelstein's test for Dequervain's tendinitis, Phalen's Contortion, Tinel's Percussion for carpal tunnel syndrome, and nerve conduction velocity tests that show nerve compression in the wrist. Various imaging techniques can also be used to show nerve compression such as x-ray for the wrist, and MRI for the thoracic outlet and cervico-brachial areas. The most-often prescribed treatments for early-stage RSIs include drug therapies such as antiinflammatory medications combined with physical therapy such as rest, splinting, massage, stretching and strengthening[3]. Low-grade RSIs can sometimes resolve themselves if treatments begin shortly after the onset of symptoms. However, some RSIs may require more aggressive intervention including surgery and can persist for years. General exercise has been shown to decrease the risk of developing RSI.[4] Doctors sometimes recommend that RSI sufferers engage in specific strengthening exercises, for example to improve sitting posture, reduce excessive kyphosis, and potentially thoracic outlet syndrome.[5] Since workstation design often contributes to RSIs, ergonomic adjustments of the workstations are often recommended.

what is the treatment for repetitive strain injury?

See your doctor as soon as you feel that a problem may be due to RSI. It is thought that the earlier the problem is recognised and dealt with, the better the outcome. A doctor may advise various things such as:

If at all possible, stop or reduce the tasks or activities which seem to be causing the symptoms. This may be easier said than done if your job or livelihood depends on the task. If possible, discuss the problem with your employer. A change of task, or changes to your work environment, may be possible. Look into practical ways of adjusting your work set-up so as to reduce strain.

Anti-inflammatory drugs have usually been recommend although recent studies suggest that simple painkillers such as paracetamol work just as well. Other medication you may be offered includes muscle relaxant tablets and a low dose of a certain type of antidepressant (tricyclic). A referral to a physiotherapist who can give advice to help with posture and how to strengthen or relax the muscles involved. Physiotherapists can also offer other treatments such as transcutaneous electrical nerve stimulation (TENS) which uses a mild electrical current to block pain signals, ultrasound therapy and infrared wave treatment. Some people find relaxation techniques, and regular general exercise (such as swimming) to be useful in easing the symptoms. An injection of steroid, sometimes combined with a local anaesthetic, may be considered into an area which has definite inflammation, such as a tenosynovitis or carpal tunnel syndrome.

Symptoms often ease with the above measures. It is then wise to review your work or other activities to prevent further bouts of RSI. For example:

If you work with a computer: is your seat, keyboard, mouse, etc, positioned in the correct way with the least strain likely on your hands and fingers? The RSI Awareness website (see below) has practical suggestions on how to reduce strain from repetitive tasks - for example, how to set up your computer and workstation to reduce RSI. Do you work with a good posture? Do you sit correctly if you have a desk job? If you do a repetitive task at work, do you get enough breaks? Is there anything your employer could do to improve your working environment? If you are under stress at work, is there anything you or your employer could do to improve this?

Symptoms of RSI
RSI has a wide range of symptoms including pain and tenderness in your muscles and joints. You will probably notice symptoms most when you're doing the activity that caused them. Symptoms that occur in your upper body include:

a sharp or a dull ache stiffness tingling numbness weakness cramp

The pain may get worse so it's there all the time, even when you're resting. It may get so bad that you aren't able to do routine work or household activities. If you're in constant pain, you may find it difficult to sleep. It's important to see your GP as soon as you notice any pain in a particular area that lasts for more than a couple of weeks.

You may have some swelling but it's also possible you won't have any other symptoms, even though your hand or arm feels painful.