Repetitive strain injury

Repetitive strain injury, also called repetitive stress injury or typing injury, is an occupational overuse syndrome affecting muscles, tendons and nerves in the arms and upper back. It occurs when muscles in these areas are kept tense for very long periods of time, due to poor posture and/or repetitive motions.

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 and massages can help heal existing disorders.

Contents

1 Specific conditions 2 Warning signs 3 Prevention 4 Treatment 5 References 6 External links

Specific conditions

Repetitive strain injury is not a specific disease but a loose group of other, more specific conditions. Some of these are:

• Tendonitis
• Stenosing tenosynovitis
• Tenosynovitis
• Carpal tunnel syndrome
• DeQuervain's syndrome
• Thoracic outlet syndrome
• Trigger finger/thumb
• Intersection syndrome
• Reflex sympathetic dystrophy syndrome (RSDS)

Note that 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.

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.

Note that symptoms may be caused by apparently unrelated areas --- for example hand numbness may be caused by a nerve being pinched near the shoulder. Note also that in the initial stages of RSI, an area may be in quite bad condition but not feel painful unless it is massaged, or weak unless a long endurance exercise is performed. Therefore it is important to consider all areas of the upper body 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 if 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 and do regular aerobic exercise. This will help improve strength and bloodflow in the affected muscles.

Note that there are various other recommendations (for example, drink a lot of water), but the above are the main approaches recommended by almost all experts.

Treatment

If RSI symptoms have already appeared, there are further methods of treatment which should be used 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 (see references) as well as asking several experts for advice.
• Massage treatment (for acute pain and nerve trigger points). This is best admistered by a trained therapist but self-massage is also sometimes helpful.
• Stretches (for less acute pain and general maintainance).
• Strengthening exercises (to improve posture and reduce fatigue in the long term).
• Surgery. This should only be used as a last resort; it is not always effective, and the above methods have been known heal even some very serious RSI conditions provided they are properly applied.

See the references section for specific massages, stretches and exercises.

References

• Repetitive Strain Injury: A Computer User's Guide; Emil Pascarelli and Deborah Quilter (ISBN 0471595330)
• It's Not Carpal Tunnel Syndrome! RSI Theory and Therapy for Computer Professionals; Suparna Damany, Jack Bellis (ISBN 0965510999)
• Conquering Carpal Tunnel Syndrome & Other Repetitive Strain Injuries, A Self-Care Program; Sharon J. Butler (ISBN 1572240393)
• The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition; Clair Davies, Amber Davies (ISBN 1572243759)

External links

• Sorehand (http://www.ucsf.edu/sorehand/) - Popular discussion group for RSI sufferers, with book recommendations and advice.
• MIT Medical Department: REPETITIVE STRAIN INJURIES: What You Absolutely Need to Know (http://web.mit.edu/atic/www/disabilities/rsi/RSIBrochure2004.pdf) (PDF)
• The Typing Injury FAQ (http://www.tifaq.com/)

• Open-source break-reminder software (http://workrave.sf.net)
• Open-source software for defining custom keyboard and mouse macros (Windows) (http://www.autohotkey.com/)

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