Repetitive strain injury

The term "repetitive strain injury" is most commonly used to refer to patients in
whom there is no discrete, objective, pathophysiology that corresponds with the pain
complaints. It may also be used as an umbrella term incorporating other discrete
diagnoses that have (intuitively but often without proof) been associated with
activity-related arm pain such as carpal tunnel syndrome, cubital tunnel syndrome,
thoracic outlet syndrome, DeQuervain's syndrome, stenosing tenosynovitis/trigger
finger/thumb, intersection syndrome, Golfer's elbow (medial epicondylosis), Tennis
elbow (lateral epicondylosis), and focal dystonia.

Finally RSI is also used as an alternative or an umbrella term for other non-specific
illnesses or general terms defined in part by unverifiable pathology such as reflex
sympathetic dystrophy syndrome (RSDS), Blackberry thumb, disputed thoracic outlet
syndrome, radial tunnel syndrome, "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), "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).

Although tendinitis and tenosynovitis are discrete pathophysiological processes, one

must be careful because they are also terms that doctors often use to refer to non-
specific or medically unexplained pain, which they theorize may be caused by the
aforementioned processes.

Treatment

On their own, most RSIs will resolve spontaneously provided the area is first given
enough rest when the RSI first begins. However, without such care, some RSIs have
been known to persist for years, or have needed to be cured with operations.

The most often prescribed treatments for repetitive strain injuries are rest, exercise,
braces and massage. A variety of medical products also are available to augment
these therapies. Since the computer workstation is frequently blamed for RSIs,
particularly of the hand and wrist, ergonomic adjustments of the workstation are
often recommended.

Ergonomics

Ergonomics: the science of designing the job, equipment, and workplace

Recommended posture and arm use (ergonomics
ergonomics)
There are several kinds of software designed to help in Repetitive Strain Injury.
Among them, there are speech recognition software, and break timers. Break timers
software reminds the user to pause frequently and perform exercises while working
behind a computer. There is also automated mouse-clicking software that has been
developed, which can automate repetitive tasks in games and applications.

Adaptive hardware

Adaptive technology ranging from special keyboards, mouse replacements to pen

tablet interfaces might help improve comfort.

Mouse

Switching to a much more ergonomic mouse, such as a roller mouse, vertical mouse
or joystick, or switching from using a mouse to using a stylus pen with graphic tablet
may provide relief, but in chronic RSI they may only result in moving the problem to
a different area. Using a graphic tablet for general pointing, clicking, and dragging
(i.e. not drawing) may take some time to get used to as well. Switching to a
trackpad, which requires no gripping or tensing of the muscles in the arms may help
as well. Inertial mice(which do not require a surface to operate) might offer an
alternative where the user's arm is in a less stressful thumbs up position rather than
rotated to thumb inward when holding a normal mouse. Also, since they do not need
a surface to operate ("air mice" function by small, forceless, wrist rotations), the
wrist and arm can be supported by the desktop.

Medical Products

A number of medical treatments, including non-narcotic pain medications, braces,

and therapy. Although some professionals consider these to be palliative, their
widespread use and effectiveness is undeniable.

Pain medications, particularly non-steroidal anti inflammatory drugs (NSAIDs), are

most often used to eliminate pain. The major problem with such drug use with RSI's
is that the pain can be masked, and therefore the patient returns to the activities
which strained the tissues in the first place before the tissues have had time to heal.
So a balance must be struck where pain is reduced, yet not so much that the tissues
will be reinjured with continued over-use.

Medical devices are available which help the strained tissues to heal faster. Several
types of devices are available, and are classified as either passive or active devices.
Passive devices generally immobilize the limb allowing the body to heal itself, while
active devices enhance the body's healing capacity. The Carpal Therapist is an active
device designed to provide deep tissue massage and myofascial manipulation. It is
an automated (electromechanical) therapeutic massager for injured soft tissues. The
Flextend product is a passive device designed to provide some resistance to wrist
movement. This encourages strengthening of the injured soft tissues.

Braces, particularly wrist braces, are by far the most often used products for RSIs.
They stabilize the hand and allow healing to occur without further stressing the joint.
Braces are available in two basic varieties; soft (i.e., nylon fabric) and hard shell.
 Exercise

Exercise decreases the risk of developing RSI.

• Doctors[sometimes recommend that RSI sufferers engage in specific

strengthening exercises, for example to improve posture.
• In light of the fact that a lifestyle that involves sitting at a computer for
extended periods of time increases the probability that an individual will
develop excessive kyphosis, theoretically the same exercises that are
prescribed for thoracic outlet syndrome or kyphotic postural correction would
benefit an RSI sufferer.[10]

Resume Normal Activities Despite the Pain?

Some researchers believe that, for the most difficult chronic RSI cases, the pain itself
becomes less of a problem than the disruption to the patient's life caused by

• avoidance of pain-causing activities

• massive investment of time into increasingly futile attempts at treatment