Repetitive strain injury is among the most common work-related ailments. We look at the causes and treatment options.
Experiencing pain, tingling, throbbing or cramps after carrying out a particular task? It could be repetitive strain injury (RSI), a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movements, poor posture or overuse.
Repetitive strain injury can strike at any time. You can get it at work, as a result of typing on a computer or working on an assembly line. The condition can also present through leisure activities such as painting or playing computer games, or while playing sports such as tennis or golf.
GP Dr Roger Henderson looks at common causes, treatment and prevention tips for repetitive strain injury:
What is RSI?
RSI, also known as overuse syndrome or upper limb syndrome, describes the damage to muscles, tendons, and nerves caused by repeated physical actions.
It’s among the most common work-related ailments, affecting millions of workers. It has been estimated that around 200,000 employees take time off work each year in Britain because of repetitive strain injury – though a similar number suffer in silence.
Common repetitive strain injuries include:
- Carpal tunnel syndrome
- Rotator cuff tendonitis
- Tennis elbow
Certain tasks increase the incidence of repetitive strain injury, including repetitive activities, poor posture, high-intensity activities without rest, and tasks involving working in an awkward or uncomfortable position. Stress is also thought to play a part, as well as using vibrating equipment in the workplace.
RSI can affect any part of the body, though most commonly the neck, shoulders, back, arms, wrists and hands. Symptoms can range in severity, from a dull, gentle ache to a sharp pain that limits your ability to use the affected body part to perform everyday actions.
RSI symptoms typically include the following:
- Sharp pain
- Aching or burning
- Loss of sensation
- Shooting pain
- Difficulty using affected area
Repetitive strain injuries usually affect working age people. Symptoms may present very gradually at first, and left unchecked over time, become more frequent and intense. With appropriate treatment most repetitive strain injuries will recover over the course of several months, though this depends largely on their severity.
As with many soft tissue problems affecting the musculoskeletal system, repetitive strain injury is triggered by misuse or overuse of one part of the body. Contributing factors include:
- An ergonomically unsound workstation.
- Prolonged periods of work without adequate breaks.
- Sustained overuse from too much repetitive movement.
- Poor posture, or sitting in a cramped position.
- Excessive workload for extended periods of time.
- Lack of control in the prioritisation of tasks or the intensity of work.
- A cold working environment.
If you suspect you have repetitive strain injury, you should make an appointment with a healthcare professional. Your doctor will perform a physical exam and check your medical history. If they suspect your symptoms could be caused by another condition, such as arthritis or inflammatory joint disease, they may send you for further testing, such as an X-ray or blood test.
RSI treatment options
At-home treatment advice for repetitive strain injuries is generally the same regardless of the location of the injury. Early treatment is essential as chronic repetitive strain injury often becomes unmanageable. Where this happens and medical treatment is required, the options are tailored to the individual. Treatment options include:
If you’ve noticed that certain activities appear to be causing your symptoms or making them worse, take a break from those activities and gradually re-introduce them as your symptoms improve.
- Approach your employer
Where the condition is work-related, speak to your employer or occupational health representative. It may be possible to modify your working environment or rearrange your tasks – even small changes can help.
- Try cold or heat
Applying heat packs or ice packs to the affected area can help to relieve symptoms of repetitive strain injury. Use an ice pack for up to 20 minutes at a time, or fill a hot water bottle and rest it on the affected area.
- Buy painkillers
Over-the-counter painkillers like paracetamol can help to alleviate the pain and discomfort associated with repetitive strain injury. Non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen and aspirin may also reduce swelling. Speak to your doctor before taking them on a long-term basis.
- Try a brace
Strapping a brace or splint to the affected body part can reduce pressure and promote faster healing. Wrapping the area or wearing an elastic support may prove useful in protecting the muscles and tendons.
- Physical therapy
If home remedies haven’t proven effective, you may need to see a physiotherapist. They will help you strengthen and improve mobility in affected muscles with specific exercises, advise you how to move safely to prevent further damage, and share advice for resting and healing the area.
- Steroid injections
Your doctor may administer corticosteroid injections, which work by directly reducing inflammation at the site of the injury. They are only recommended when the inflammation is associated with a specific medical condition, as they can damage tissue when used over the long-term.
If your GP suspects your symptoms are caused by a specific condition – such as carpal tunnel syndrome or tennis elbow – they may refer you to a surgeon. Surgery is a last resort, and should only be considered when repetitive strain injuries do not respond to non-surgical treatment or cause severe pain and disruption.
RSI prevention tips
To minimise your chances of repetitive strain injury or ease existing symptoms, try the following:
✔️ Mix up your day
Split work up and do different tasks now and again, rather than concentrating on one job for two or three days at a time.
✔️ Take a break
Take regular breaks from whatever tool you are using, say, every hour or so, and stand up and stretch, straighten your arms and flex your fingers and wrists.
✔️ Take screen breaks
Look at distant objects through a window (a real life one, that is!) if you tend to spend hours in front of a screen.
✔️ Try touch typing
Learn to touch type if you work on a keyboard. This uses all your fingers and thumbs and enables you to look upwards instead of down and to the side.
✔️ Take an ergonomic desk assessment
Position your equipment and furniture properly as per the following four steps. Correct office ergonomics are designed to avoid postural strain and muscle tension.
- Adjust the height of a chair relative to the desk, and make sure your lumbar spine is supported.
- Sit close enough to the desk, so you can rest your hands on the keyboard.
- Shoulders should be relaxed, with upper arms hanging vertically downwards with forearms held at 90 degrees when typing.
- When working with a computer, use keyboards and mouse mats that have cushioned wrist protectors that help reduce strain on the wrists and fingers.