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REPETITIVE STRAIN INJURY (RSI) - The Facts
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Repetitive strain injury (RSI) describes a painful condition that is associated with doing  either a particular activity repeatedly or for long periods of time. For example working with computers and typing or repetitive manual work.  Yes you can also develop it if you don't regularly carry out these sorts of tasks.

It is also known as work-related upper limb disorder (WRULD), as it generally covers a number of conditions that can affect your hands, arms and upper body.

Types of RSI

There are two types of RSI:

Type 1 RSI: RSI is classed as type 1 when a doctor can diagnose a recognised medical condition, such as carpal tunnel syndrome Symptoms usually include swelling and inflammation of the muscles or tendons.

Type 2 RSI: RSI is classed as type 2 when a doctor cannot diagnose a medical condition from the symptoms. This is usually because there are no obvious symptoms, just a feeling of pain. Type 2 RSI is also referred to as non-specific pain syndrome.

RSI conditions
There are several medical conditions and injuries that can be classed as type 1 RSI, including the following.

  • Bursitis: inflammation and swelling of the fluid-filled sac near a joint at the knee, elbow or shoulder.
  • Carpal tunnel syndrome: pressure on the median nerve passing through the wrist.
  • Dupuytren's contracture: a thickening of deep tissue in the palm of the hand and into the fingers.
  • Epicondylitis: inflammation of an area where bone and tendon join. An example of epicondylitis is tennis elbow. 
  • Rotator cuff syndrome: inflammation of muscles and tendons in the shoulder.
  • Tendonitis: inflammation of a tendon.
  • Tenosynovitis: inflammation of the inner lining of the tendon sheath that houses tendons. Tenosynovitis most commonly occurs in the hand, wrist or forearms.
  • Ganglion cyst: a sac of fluid that forms around a joint or tendon, usually on the wrist or fingers.
  • Raynaud’s phenomenon: a condition where the blood supply to extremities, such as the fingers, is interrupted.
  • Thoracic outlet syndrome: compression of the nerves or blood vessels that run between the base of the neck and the armpit. (see information and advice link PDF).
  • Writer’s cramp: part of a family of disorders known as dystonia that cause muscle spasms in the affected part of the body. Writer’s cramp occurs from overuse of the hands and arms.



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What does it feel like?
Symptoms are wide ranging but are often worse when doing the activity that caused them. These include:
  • a sharp or a dull ache
  • stiffness
  • tingling
  • numbness
  • weakness
  • cramp

There may be some swelling but it's also possible that you won't have any physical signs, even though your hand or arm feels painful.

Typical Causes of RSI
A number of factors put you at risk of developing RSI. These include:
repetitive activities
activities such as  such as lifting or carrying heavy objects
carrying out an activity for a long period of time without adequate rest periods
poor posture or activities that require you to work in awkward positions

How common is RSI?
In the UK one worker in 50 has reported an RSI condition.

Treatment of RSI
There is no single treatment for RSI. However, there are often specific treatments for recognised conditions, such as carpal tunnel syndrome.
If you have one of these conditions please click the associated link for further information and advice on treatment.

You may be advised by you GP to have Physiotherapy  or Osteopathy for treatment on the affected area and exercises to build up strength in
the affected muscles and for advice about ways to improve and strengthen your posture. 

In all cases of treatment will be undergone in the context of changing your work or leisure environment.

Although you should try to rest the affected area regularly, it's not helpful for you to rest for long periods as it can weaken your muscles. Gently massaging and flexing the affected limb stimulates circulation and can prevent your muscles from weakening.

Self-help
Regular rest to the affected are, though not for long periods as it can weaken the muscles.
Gentle massage and movement stimulates the blood flow to the affected area and helps prevent weakening
Make changes to your working environment - look at what you do and how you do it, and modify the activity causing the problem.
If possible, carry on working but reduce the amount of time you spend on the activity that causes the pain.
If you can't stop doing it completely, take regular short breaks to stretch and flex your arms and hands.
Make sure you are doing several different tasks so that you don’t  spend long periods of time doing the same thing.
Exercise such as swimming, pilates or yoga may help to ease your symptoms.
There are a number of support groups for RSI. You may find it helpful to talk to other people with RSI as they may be able to offer
advice and suggest things that could improve your symptoms.

Medicines
Paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs).
 Low doses of antidepressants are also thought to have some specific painkilling effect in chronic pain conditions such as RSI.
There are mixed responses to taking pain killers to take painkillers as they dull the pain and allow you to carry on doing the harmful
activity, aggravating your RSI.
If you do take medicines, follow the instructions on the patient information leaflet and ask your pharmacist for advice.

Prevention of RSI
If the problem is caused through work activity:
Employers have a legal duty under the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work Regulations
1999 to prevent work-related RSI and ensure that anyone who already has the condition doesn't get any worse.Your employer needs to adjust
your work area so it's suitable and comfortable for you. The risk of an accident or injury occurring should be reduced as much as possible.

Guidelines if you work at a computer:

  • your chair supports your back and you sit up straight
  • your chair is the right height for you; if not use a footrest
  • your monitor is around 60cm from your eyes
  • your screen, keyboard and mouse are directly in front of you with the mouse as close to the keyboard as possible
  • when you type, your arms aren't extended forwards, your forearms are horizontal and your fingers are at the same height as the middle row of keys
  • your legs have room to move under the desk or table
  • you only use a wrist rest when having a break from typing - don't place your wrists on it while typing.

For more information see computer posture.

Also see Carpal Tunnel Syndrome

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Content by Jane Morris - connect with me on Google+



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