Repetitive Strain Injuries

Repetitive strain injuries (RSIs) result from overuse or misuse of soft tissues including muscles, tendons, or nerves. Tendons are the cord-like structures that attach muscles to bones. RSIs can affect almost any part of the body. However, RSIs are most common in the arms (thumbs, wrists, elbows, shoulders) and legs (ankles, knees). Common medical conditions that are often caused by repetitive strain include carpal tunnel syndrome, tennis or golfer's elbow, bursitis, and tendonitis. If RSIs are treated early, and the repeated activity is reduced or removed, the severity and length of your problems can usually be reduced. RSIs are also called cumulative trauma disorders (CTD).

CAUSES

Many RSIs occur due to repeating the same activity at work over weeks or months without sufficient rest, such as prolonged typing. RSIs also commonly occur when a hobby or sport is done repeatedly without sufficient rest. RSIs can also occur due to repeated strain or stress on a body part in someone who has one or more risk factors for RSIs.

RISK FACTORS

Workplace risk factors

  • Frequent computer use, especially if your workstation is not adjusted for your body type.

  • Infrequent rest breaks.

  • Working in a high-pressure environment.

  • Working at a fast pace.

  • Repeating the same motion, such as frequent typing.

  • Working in an awkward position or holding the same position for a long time.

  • Forceful movements such as lifting, pulling, or pushing.

  • Vibration caused by using power tools.

  • Working in cold temperatures.

  • Job stress.

Personal risk factors

  • Poor posture.

  • Being loose-jointed.

  • Not exercising regularly.

  • Being overweight.

  • Arthritis, diabetes, thyroid problems, or other long-term (chronic) medical conditions.

  • Vitamin deficiencies.

  • Keeping your fingernails long.

  • An unhealthy, stressful, or inactive lifestyle.

  • Not sleeping well.

SYMPTOMS

Symptoms often begin at work but become more noticeable after the repeated stress has ended. For example, you may develop fatigue or soreness in your  wrist while typing at work, and at night you may develop numbness and tingling in your fingers. Common symptoms include:

  • Burning, shooting, or aching pain, especially in the fingers, palms, wrists, forearms, or shoulders.

  • Tenderness.

  • Swelling.

  • Tingling, numbness, or loss of feeling.

  • Pain with certain activities, such as turning a doorknob or reaching above your head.

  • Weakness, heaviness, or loss of coordination in your hand.

  • Muscle spasms or tightness.

In some cases, symptoms can become so intense that it is difficult to perform everyday tasks. Symptoms that do not improve with rest may indicate a more serious condition.

DIAGNOSIS

Your caregiver may determine the type of RSI you have based on your medical evaluation and a description of your activities.

TREATMENT

Treatment depends on the severity and type of RSI you have. Your caregiver may recommend rest for the affected body part, medicines, and physical or occupational therapy to reduce pain, swelling, and soreness. Discuss the activities you do repeatedly with your caregiver. Your caregiver can help you decide whether you need to change your activities. An RSI may take months or years to heal, especially if the affected body part gets insufficient rest. In some cases, such as severe carpal tunnel syndrome, surgery may be recommended.

PREVENTION

  • Talk with your supervisor to make sure you have the proper equipment for your work station.

  • Maintain good posture at your desk or work station with:

  • Feet flat on the floor.

  • Knees directly over the feet, bent at a right angle.

  • Lower back supported by your chair or a cushion in the curve of your lower back.

  • Shoulders and arms relaxed and at your sides.

  • Neck relaxed and not bent forwards or backwards.

  • Your desk and computer workstation properly adjusted to your body type.

  • Your chair adjusted so there is no excess pressure on the back of your thighs.

  • The keyboard resting above your thighs. You should be able to reach the keys with your elbows at your side, bent at a right angle. Your arms should be supported on forearm rests, with your forearms parallel to the ground.

  • The computer mouse within easy reach.

  • The monitor directly in front of you, so that your eyes are aligned with the top of the screen. The screen should be about 15 to 25 inches from your eyes.

  • While typing, keep your wrist straight, in a neutral position. Move your entire arm when you move your mouse or when typing hard-to-reach keys.

  • Only use your computer as much as you need to for work. Do not use it during breaks.

  • Take breaks often from any repeated activity. Alternate with another task which requires you to use different muscles, or rest at least once every hour.

  • Change positions regularly. If you spend a lot of time sitting, get up, walk around, and stretch.

  • Do not hold pens or pencils tightly when writing.

  • Exercise regularly.

  • Maintain a normal weight.

  • Eat a diet with plenty of vegetables, whole grains, and fruit.

  • Get sufficient, restful sleep.

HOME CARE INSTRUCTIONS

  • If your caregiver prescribed medicine to help reduce swelling, take it as directed.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Reduce, and if needed, stop the activities that are causing your problems until you have no further symptoms. If your symptoms are work-related, you may need to talk to your supervisor about changing your activities.

  • When symptoms develop, put ice or a cold pack on the aching area.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15-20 minutes.

  • If you were given a splint to keep your wrist from bending, wear it as instructed. It is important to wear the splint at night. Use the splint for as long as your caregiver recommends.

SEEK MEDICAL CARE IF:

  • You develop new problems.

  • Your problems do not get better with medicine.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.