Repetitive Strain Injury (RSI)

 

What is it?

Repetitive Strain Injury or RSI is a condition which affects the soft tissues of the body. A variety of symptoms can develop in response to the body performing repetitive movements. These types of movements can be part of an occupation or even everyday tasks in the home. Common symptoms include muscle and tendon aches and pains, altered sensations such as pins and needles or numbness and sometimes a feeling of weakness. In the early stages the symptoms may take some time to develop but as the problem becomes more longstanding the symptoms can come on earlier and stay for longer.
 

In the case of the wrist and hand the symptoms can be made up of many combinations of signs which mimic other well known conditions. In many instances pain can be present without the usual signs of inflammation and swelling and the symptoms may not necessarily be consistent. This is why making the correct diagnosis and finding the correct treatment can often take some time. For many individuals their pain is related closely to the activities which they perform frequently on a regular basis. Typists and musicians for example have to perform many hundreds of fast repetitive movements over and over again.

 

Causes

The exact cause of RSI is not clear, it is not known for example why some individuals get RSI whilst others who are performing the same tasks are symptom free.
 

Medical professionals generally categorise RSI type problems into two groups. Type I RSI includes those symptoms which are similar to other well known inflammatory or nerve compression type problems and such as carpal tunnel syndrome or tenosynovitis. Type II RSI includes those symptoms that do not fit clearly into type I such as diffuse aches, intermittent and inconsistent symptoms in the absence of inflammatory and neurological signs.
 

It is thought that, as with many conditions, it is a combination of factors which can lead to its development. Certainly overuse or doing too much of a particular task can place excessive strain on the soft tissues. It is well known that there is a postural element to the problem and as such their is much focus on postural reeducation and work space ergonomics in its management.
 

There is some evidence to suggest that work relates stress can play a large part in the development of the symptoms, perhaps this stress leads to increased tone and strain in the muscles around the shoulders and upper back which may exacerbate the wrist and hand symptoms.

 

Treatment
 

Following a thorough examination and assessment of the presenting problem, advice and treatment may include the following:

• Electrotherapy i.e. Ultrasound, Interferential and Laser to reduce inflammation and pain

• Acupuncture to restore normal muscle tone and reduce pain

• Soft tissue manipulation to restore normal muscle tone, length and function

• Addressing any associated muscle imbalances or vertebral (spinal) restriction in the neck / upper back area

• Use of taping / strapping or splints to offload painful areas

• Postural reeducation and work station ergonomic advice and education

• Provision of individually tailored exercise programme including activity modification management to minimize recurrence