RSI

Repetitive strain injury (RSI) is a term used to describe a pain syndrome most commonly affecting the arms, wrists, neck and hands caused by carrying out repetitive tasks and activities such as typing on a keyboard or lifting and carrying. RSI is also sometimes referred to as overuse injury and work-related upper limb disorder.

Causes

Nobody knows why some people develop RSI whilst others (who carry out the same repetitive task) do not.

Factors that appear to increase your risk of developing it include: long periods spent doing the same activity without taking breaks; regular lifting and carrying; poor posture; using equipment that vibrates; and working in a cold environment.

One school of thought says psychosocial workplace factors – notably stress at work – are a contributory factor. Stress is known to increase muscle tension.

Symptoms

These can range from mild to severe but tend to involve pain and tenderness in your muscles and joints.

Symptoms include: throbbing; numbness; cramping; tingling; muscle weakness and tightness; and cramps. They tend to be more painful when you are carrying out the activity that is the trigger, but the pain can persist when you are resting. Often there are no visible signs like swelling or inflammation.

For this reason, symptoms tend to be divided into two categories: type 1 RSI which involve recognised medical conditions including tendonitis (tendon inflammation) and carpal tunnel syndrome (nerve compression in the wrist); and type 2 RSI where symptoms do not fit into a known syndrome or show visible symptoms.

Diagnosis

There is no single or specific test for RSI, and your doctor will start by taking a detailed history to identify what is causing your discomfort and pain. You might be diagnosed with a recognised problem such as tendinopathy (tendon inflammation). If symptoms do not fit into any immediately obvious condition with symptoms such as swelling, you are likely to be diagnosed with type 2 RSI.

In some cases, a blood test might be done to check for evidence of inflammatory joint disease. In the case of a type 1 RSI condition, x-rays and scans might be ordered to assess if surgery is needed.

Who gets RSI?

Potentially anybody who is performing repetitive tasks and activities. These days this includes lots of people who use keyboards, but it also includes nurses and shop workers. Figures from the Health and Safety Executive reveal there were 526,000 cases of work-related musculoskeletal disorders in 2013/14. Statistics also suggest women suffer more than men and older workers more than younger ones.

However, younger people now also appear to be at risk because of their heavy use of new technology. A study at Boston University found 50 per cent of students reported neck, shoulder and back pain related to laptop computer usage. The charity RSI Action says there are now cases of seven year olds with serious RSI conditions.

Treatments

Many people get better within three to six months by using self-help treatments. Standard advice is to stop, or reduce, how much time you spend on the task that appears to be causing your symptoms. This isn't always possible if this is your livelihood, so experts suggest at least adjusting your work set-up to reduce strain, whilst improving posture and taking regular breaks.

Over-the-counter painkillers such as ibuprofen or paracetamol can also help, and a hot or cold compress pack may ease symptoms. Regular hand and arm exercises help strengthen your muscles. Try 'the prayer stretch': put your hands together as if in prayer and gently push one hand against the other to one side. Hold this position for up to 30 seconds and repeat on the opposite side. Aim to do this every time you take a break.

Relaxation techniques, swimming and walking may also be beneficial. If self-help treatments don't work, you may be referred to a physiotherapist who can help you improve strength in the affected muscles with specific exercises. They can also offer transcutaneous nerve stimulation (TENS) – which uses mild electric impulses to numb pain – and ultrasound therapy. For type 1 RSI conditions, where there is evidence of inflammation, a steroid injection may be recommended.

Research suggests diet can also play a part in reducing inflammatory symptoms of RSI and other joint conditions. Omega 3 fatty acids from oily fish, nuts and seeds, and in supplement form, can reduce inflammation and appear to increase joint mobility in conditions like rheumatoid arthritis (RA).<>Another source of omega 3 fatty acids is the New Zealand green lipped mussel. <> Research suggests that, together with conventional treatment, green-lipped mussel extract provides clinical benefit to people with mild to moderate osteoarthritis. Studies have also shown curcumin, a compound in the spice turmeric, reduces pain, inflammation and stiffness related to osteoarthritis (OA) .

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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