7/30/2019 Repetitive strain injury (RSI): Diagnosis, symptoms, and treatment

Repetitive strain injury (RSI)

explained
By Tim Newman | Last updated Fri 19 January 2018

Reviewed by Gregory Minnis, DPT

What is an RSI? Symptoms Causes Diagnosis Treatment Prevention Examples

Repetitive strain injury has been around since people first

began repeating motions and carrying out manual labor.
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 labor, office work, and the use of modern
technological devices. Examples include Blackberry thumb, iPod finger, PlayStation thumb,
Rubik's wrist or cuber's thumb, stylus finger, raver's wrist, and Emacs pinky.

The range of RSIs is wide, but this article will focus mainly on those caused by working
environments, sports, and the use of modern devices.

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Fast facts on RSI

Here are some key points about RSI. More detail is in the main article.

• There are many different kinds of RSI, and different ways of treating and preventing
them.

• Modern technological devices have caused an upswing in RSIs.

• Repetitive motions in one part of the body can affect the muscles in another part.

• Psychological stress and monotony can worsen the symptoms.

• Improved workplace practices can help prevent it.

What is an RSI?
RSI refers to a wide variety of problems. An
RSI can affect almost any movable part of the
human body.

RSIs are associated with repetitive tasks,

forceful exertions, vibrations, mechanical
compression, and sustained or awkward
positions.

Other names include repetitive motion

injuries, repetitive motion disorder (RMD), Wrist pain can result from using a laptop for long periods of time.

cumulative trauma disorder (CTD),

occupational overuse syndrome, overuse syndrome, and regional musculoskeletal disorder.

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7/30/2019 Repetitive strain injury (RSI): Diagnosis, symptoms, and treatment

Symptoms
RSI has many possible causes, and a wide range of possible symptoms.

Here are some of the more general symptoms:

• tenderness or pain in the affected muscle or joint

• a throbbing or pulsating sensation in the affected area

• tingling, especially the hand or arm

• loss of sensation

• loss of strength

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:

• 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

• fatigue

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7/30/2019 Repetitive strain injury (RSI): Diagnosis, symptoms, and treatment

• increased psychological stress has been shown to to worsen RSI

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Diagnosis
A doctor 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.

A Type 2 RSI will have no additional symptoms, just a general feeling of pain or discomfort. It
is sometimes known as non-specific pain syndrome.

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7/30/2019 Repetitive strain injury (RSI): Diagnosis, symptoms, and treatment

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.

• 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.

Repeated actions such as lifting boxes or painting a ceiling can lead

to pain in parts of the body that are used excessively.
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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 minimize 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

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7/30/2019 Repetitive strain injury (RSI): Diagnosis, symptoms, and treatment

Here are a few of the many conditions that are linked to RSI, although these conditions may
also stem from other causes:

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.

Rotator cuff syndrome: 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.

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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.

Radial tunnel syndrome: There is a dull ache at the top of the forearm. Overuse of the arm to
push or pull, or overuse of the hand and wrist can irritate the nerve and cause pain.

Writer's cramp: Muscle spasm occur in the hands and arms, due to overuse.

RSIs have been with us for centuries and they are unlikely to go away. However, learning
more about what causes them and how to treat them can help us reduce the inconvenience
and discomfort they can bring.

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Additional information

Article last updated by Tim Newman on Fri 19 January 2018.

Visit our Pain / Anesthetics category page for the latest news on this subject, or sign up to our newsletter to
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All references are available in the References tab.

References

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