Repetitive strain injury
Repetitive strain injury, also called repetitive stress injury or typing injury, is an occupational overuse syndromeaffecting muscles, tendonsand nervesin 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 lineand computerworkers. Good postureand ergonomicworking conditions can help prevent or halt the progress of the disorder; stretches, strengthening exercises, massages and biofeedback training to reduce neck and shoulder muscle tension can help heal existing disorders.
- 1 Specific conditions
- 2 Warning signs
- 3 Prevention
- 4 Treatment
- 5 References
- 6 External links
Repetitive strain injury is not a specific disease but a loose group of other, more specific conditions. Some of these are:
- Ulnar nerve entrapment
- Stenosing 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.
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 feel 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.
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 BEFORE 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, with regular aerobic exercise, adequate sleep, drinking enough water, and not smoking. This will help improve strength and bloodflow in the affected muscles.
- Learn a systematic muscle-relaxation technique such as diaphragmatic breathing, qigong, or progressive muscle relaxation to help keep neck and shoulder muscles relaxed.
If RSI symptoms have already appeared, there are further methods of treatment which could 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. Occupational therapists, physical therapists, physiatrists, surgeons, and alternative medicinepractioners may all be involved in the diagnosis and treatment plan.
- It is likely the partial or complete cessation of hand activity might be necessary for some period of time in order for healing to begin. Adaptive technologyranging from special keyboards and mouse replacements to speech recognitionsoftware might be necessary.
- The medical professional may prescribe orthopedic hand braces, but the patient should not self-prescribe, or further injury might result.
- Medications: The medical professional might prescribe Non-steroidal anti-inflammatorymedications such as ibuprofento reduce swelling, or anti-convulsantmedications such as gabapentinto reduce neuropathic pain.
- Soft Tissue Therapyis proving to be an effective way for many sufferers of repetitive stress injuries to relieve their chronic symptoms and return to full activity at work, home and play. It works by decompressing the area around the repetitive stress injury thus enhancing full circulation and allowing the body's powerful healing processes to proceed unimpeded at the cellular level.
- Biofeedbackcan be used to reduce stress-related muscle tension in the muscles of the neck and shoulders.
- Massagetreatment (for acute pain and nerve trigger points). This is best administered by a trained therapist but self-massage is also sometimes helpful.
- Stretches (for less acute pain and general maintenance). Many doctors will prescrive occupational therapyor physical therapyto rebuild strength and flexibility. Some sufferers find great relief in specific movement therapies such as tai chi chuan, yoga, or the Alexander Technique.
- Strengthening exercises (to improve posture and reduce fatigue in the long term). These should be prescribed by a medical professional, as overuse of the strained muscles and tendons can worsen symptoms.
- Surgery. This should only be used as a last resort; it is not always effective, and the above methods have been known to heal even some very serious RSI conditions provided they are properly applied.
See the references section for specific massages, stretches and exercises.
- 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)
- Electromyographic Applications in Pain, Physical Medicine and Rehabilitation: Repetitive Strain Injury Computer User Injury With Biofeedback: Assessment and Training Protocol; Erik Peper, Vietta S Wilson et al. The Biofeedback Foundation of Europe, 1997
- Computer Related Repetitive Strain Injury- Brief explanation and list of resources.
- Repetitive Strain Injury-UK Mailing List
- RSI-Relief- Repetitive Strain Injury Prevention, Support, & Recovery
- Sorehand- Popular discussion group for RSI sufferers, with book recommendations and advice.
- MIT Medical Department: REPETITIVE STRAIN INJURIES: What You Absolutely Need to Know(PDF)
- Repetitive Strain Injury for Computer Users
- Best practice posture and keyboarding technique to reduce risk of RSI
- Anti-RSI excercises and posture for RSI prevention– Based on Mensendieck
- How I Beat RSI- A personal RSI recovery storyde:RSI-Syndrom
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Categories: Overuse injuries| Occupational diseases| Traumatology
This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Repetitive+strain+injury Wikipedia article Repetitive strain injury.