Repetitive strain injury

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Repetitive strain injury 

Repetetive strain injury 

Repetitive strain injury

Also called repetitive stress injury, is a loose group of conditions from overuse. 

It is an occupational overuse syndrome affecting muscles, tendons and nerves in the arms and upper back; hence it is also known as work related upper limb disorder or WRULD

The medically accepted reason it occurs is when muscles in these areas are kept tense for very long periods of time, due to poor posture and/or repetitive motions. 

There's also a connection between mind and the body, where pain is worsened or lessened by thought. It is most common among assembly line and computer workers. 

Good posture and ergonomic working conditions can help prevent or halt the progress of the disorder; stretches, strengthening exercises, massages and biofeedback training to reduce neck and shoulder muscle tension can help heal existing disorders. 

Specific conditions Repetitive strain injury is not a specific disease but a loose group of other, more specific conditions. Many of these disorders are interrelated, so a typical sufferer may have many of these at once. 

In this case it is often best to treat RSI as a single general disorder, targeting all major areas of the arms and upper back in the course of treatment. The most famous repetitive strain injury is carpal tunnel syndrome, which is common among assembly line workers but relatively rare among computer users: computer-related arm pain is generally caused by another specific condition. 

Some of these are: 

  • Carpal tunnel syndrome 

  • DeQuervain's syndrome 

  • Intersection syndrome 

  • Reflex sympathetic dystrophy syndrome (RSDS) 

  • Stenosing tenosynovitis 

  • Tendonitis 

  • Tenosynovitis 

  • Thoracic outlet syndrome 

  • Trigger finger/thumb Ulnar nerve entrapment 

  • Warning signs RSI conditions have many varied symptoms. 

The following may indicate the onset of an RSI. 

  • Recurring pain or soreness in neck, shoulders, upper back, wrists or hands. 

  • Tingling, numbness, coldness or loss of sensation. 

  • Loss of grip strength, lack of endurance, weakness, fatigue. 

  • Muscles in the arms and shoulders feel hard and wiry when palpated. 

  • Pain or numbness while lying in bed. 

Often early stage RSI sufferers mistakenly think they are lying on their arms in an awkward position cutting off circulation. 

Symptoms may be caused by apparently unrelated areas; for example hand numbness may be caused by a nerve being pinched near the shoulder. 

In the initial stages of RSI, an area may be in quite bad condition but not feel painful unless it is massaged, or feel weak unless a long endurance exercise is performed. Therefore all areas of the upper body are considered when evaluating an RSI condition. 

Prevention: The following applies to typing or computer use.

  • RSI is best prevented in its early stages before it becomes difficult to control. 

  • Pay attention to pain and fatigue. 

  • Stop using the computer before you begin to feel symptoms. 

  • Pay attention to posture. 

  • The head and back should form a straight line from the ears to the pelvis. 

  • The shoulders and head should not be hunched forward. 

  • Take regular breaks. 

  • One option is to install reminder software. 

  • Avoid resting the wrists on anything when typing. 

  • Hold them straight, rather than bent up, down, or to the side. 

Keep in good shape, with regular aerobic exercise, adequate sleep, drinking enough water, and not smoking. 

This will help improve strength and blood flow in the affected muscles. 

Learn a systematic muscle-relaxation technique such as diaphragmatic breathing, qigong, or progressive muscle relaxation to help keep neck and shoulder muscles relaxed. 


If RSI symptoms have already appeared, there are various further methods of treatment that can be applied in addition to the above preventative techniques. 

The sufferer should gather as much information as possible on their disorder. RSI healing generally cannot be achieved solely by medical professionals and requires active participation by the patient over a period of several months. 

The more the patient understands, the more likely it is that treatment will be effective. 

Consider reading books on this type of strain as well as asking several experts for advice.

Occupational therapists, physical therapists, physiatrists, surgeons, and alternative medicine practitioners may all be involved in the diagnosis and treatment plan. 

It is likely the partial or complete cessation of hand activity might be necessary for some period of time in order for healing to begin. 

Adaptive technology ranging from special keyboards and mouse replacements to speech recognition software might be necessary. 

The medical professional may prescribe orthopedic hand braces, but the patient should not self-prescribe, or further injury or strain might result. 


The medical professional might prescribe Non-steroidal anti-inflammatory medications such as ibuprofen to reduce swelling, or anti-convulsant medications such as gabapentin to reduce neuropathic pain. 

Soft Tissue Therapy works by decompressing the area around the repetitive stress injury thus enhancing circulation and promoting healing. 

Biofeedback can be used to reduce stress-related muscle tension and strain in the muscles of the neck and shoulders. 

Massage treatment (for acute pain and nerve trigger points). This is best administered by a trained therapist but self-massage is also sometimes helpful. 

Stretches (for less acute pain and general maintenance). 

Many doctors will prescribe occupational therapy or physical therapy to rebuild strength and flexibility. 

Some sufferers find great relief in specific movement therapies such as T'ai Chi Ch'üan, yoga, or the Alexander Technique. Strengthening exercises (to improve posture and reduce fatigue in the long term). These should be prescribed by a medical professional, as overuse of the strained muscles and tendons can worsen symptoms. 

Surgery. This should only be used as a last resort; it is not always effective, and the above methods have been known to heal even some very serious RSI conditions provided they are properly applied.

The author of this Repetitive strain injury web page is Anthony George

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