Repetitive Strain Injury (RSI)

What is RSI?

Repetitive strain injury, commonly abbreviated as RSI, is a general term used to describe damage and pain caused by repetitive movement and overuse of the muscles, nerves and tendons in the upper body. 

The condition usually results from improper technique or posture while doing everyday tasks like working on a computer, lifting heavy loads etc. Excessive use of computers and smartphones with improper ergonomics commonly cause injuries in wrists and finger joints. RSIs can also happen in sports with repeated motions, such as swinging a tennis racquet or shooting a basketball. These repeated motions can make athletes susceptible to numerous injuries such as carpal tunnel syndrome, tendonitis, tennis elbow, golfer’s elbow, bursitis and many more. 

Although these injuries are not life-threatening, they can be quite painful and can cause a hindrance in carrying out even the simplest of daily tasks.

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Types of RSI

Repetitive stress injuries include many different muscular conditions that are associated with repeated motions or tasks. Some of the common conditions include:

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Causes and Risk Factors

RSI can be caused by: 

  • Repeated actions or tasks
  • Awkward positions
  • Forceful exertion
  • Contact stress (such as resting your wrist on the end of the desk)
  • Incorrect posture
  • Vibration (such as using power tools)
  • Muscle fatigue
  • Lack of recovery time

Certain work environments or sports can increase the risk for repetitive stress injuries. These include computer work, playing musical instruments, sports like tennis and golf, assembly line work and carpentry.

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Symptoms

Repetitive stress injuries usually occur in parts of the body that are involved in repeated motions throughout the day. It usually happens in the hands, wrists, elbows, and shoulders. However, it can also affect other areas, including your neck, back, knees, and ankles.

Symptoms of RSI can range from mild to severe and usually develop gradually. They often include:

  • Pain, aching or tenderness
  • Tingling
  • Numbness
  • Swelling or throbbing
  • Sensitivity to cold and heat
  • Stiffness
  • Weakness and cramps
  • Clicking or popping when you move

Initially these symptoms might appear only when you’re carrying out a particular repetitive activity. But if the condition is left untreated, the symptoms of RSI might eventually become constant and cause longer periods of pain.

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Diagnosis

If you are experiencing any of the above symptoms, and if the pain or loss of function are limiting your activities, seek medical help immediately.

Your doctor will examine the area where you have pain and ask about your symptoms and medical history. They'll ask you about your personal history, your daily work environment, and recreational activities.

They may also order imaging tests to help provide a diagnosis. These tests can be used to diagnose repetitive stress injuries or to rule out other conditions. Imaging tests may include

  • Ultrasound: Used to evaluate your nerves, tissues, and surrounding structures
  • X-ray: Provides images of the bones to rule out other conditions, like fractures
  • Magnetic resonance imaging (MRI): Provides a detailed look at the body's soft tissues and abnormalities that may be affecting the nerves

Nerve conduction studies and an electromyogram (EMG) may also be ordered to test for muscle and nerve damage.

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Treatment

To treat a repetitive stress injury, it's important to limit or avoid the actions that are causing your symptoms. 

Self-Care at Home

  • Home care for a painful or swollen joint should include elevation and not moving it until your doctor can be contacted. You can also use ice for relief of pain and swelling.
  • Most doctors recommend icing 2-3 times a day for 20-30 minutes each time.
  • Wrap ice or a bag of frozen vegetables in a towel and place it on the affected area.
  • If your shoulder is involved, you should not keep it immobile for more than 24-48 hours because your shoulder may become frozen and have decreased range of motion.
  • Use a splint (such as on your wrist for carpal tunnel syndrome) to help stabilize the area and relieve pressure

Medical Treatment

  • Most cases of RSI are best treated with immobilization and ice during the early phase and moist heat during the long-term phase. 
  • Bands placed around the elbow may be used for tennis elbow and golfer's elbow.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin, naproxen, or ibuprofen) may be prescribed to reduce the inflammation.
  • If your condition is not helped by NSAIDs, the doctor may choose to inject steroids into the surrounding area of inflammation. 
  • You should begin graduated range-of-motion exercise once your symptoms begin to improve.

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Prevention

  • Do adequate warm-up and cool-down maneuvers (crucial to proper tendon and bursae health).
  • Avoid activity that makes your injury flare-up. This will speed the healing of the RSI affected parts of your body.
  • When working at a computer, make sure your seat, computer, and monitor are lined up correctly. For example, you should have your back supported, head and neck upright, feet on the floor, and your wrists in a neutral position. 
  • If reaching overhead in your work has caused a repetitive motion injury, your occupational therapist may be able to redesign your job so you won't have to reach overhead.
  • Practice range-of-motion exercises, especially with tendinitis. These are important to ensure minimal decrease in function.
  • Use splints or bands to decrease the strain on a tendon that occurs with sporting activities, such as tennis and golf. These devices may be bought over-the-counter or obtained from your doctor.

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Next Blog: Assistive tech solutions for RSI computer usage- review of other products and services

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