Different types of repetitive strain injury
With so many people spending large amounts of time typing on computer keyboards and smartphones, there has been a conspicuous rise in cases of repetitive strain injury (RSI) affecting the hands, arms, shoulders and back. Working all day at a computer puts a weight load on the smaller muscles of the hand and arm and also affects the movement of the nerves. Over time, this can lead to permanent problems, even disability. This condition is sometimes referred to as work-related upper limb disorder.
Sustained force in the same area is the trigger, and it can be exacerbated by poor working conditions, bad posture, and working for too long without a break. Those at risk are in jobs that regularly use a computer (this includes use of a computer for playing video games) and those performing any task that is repeated and mechanical. Factory workers, gardeners, farmers and construction industry workers are therefore as susceptible as typists and students.
Warning signs are varied and commonly start in the wrists. They include numbness or tingling, stiffness, cramp, throbbing or weakness. Diffuse RSI is another form where there is pain, but no accompanying inflammation or swelling. Fingers, forearms and thumbs are most likely to be strained, after wrists, and those who do a lot of kneeling, or operate a foot pedal, may get repetitive strain injury in their feet or knees. Undergoing the action that causes the problem is usually the first indicator of the problem, and without any treatment, this can become constant. Cold temperatures, stress and vibrating equipment are additional contributory risk factors.
Damage occurs initially to muscles and tendons that develop microscopic tears. Tendons then lose lubrication and start to chafe. This leads to inflammation which then pinches the nerves. In extreme cases, RSI becomes a cumulative trauma disorder, which can be debilitating. The activity causing the pain has to be abandoned altogether.
Whilst we tend to associate the issue with modern use of keyboards, these work-related conditions have been recognized for many years under different names. They typically involve damage from repetitive actions to muscles, nerves and tendons. Housemaid’s knee, potter’s wrist, writer’s cramp and weaver’s bottom are all examples of work-related injuries from earlier eras. In fact, repetitive strain injury was first identified in 1700 in Italy.
Remedial actions in the early stages involve incorporating some simple stretches into the daily routine. Anyone sitting at a computer all day should stretch out the fingers on each hand, one by one, then fold them back in again. This can be repeated at regular intervals and helps to loosen the tightness. Getting up from the desk is important, even just for a short walk around the office. Modification of the work space can sometimes reduce the symptoms, for example, raising the height of the keyboard, or switching to an ergonomic chair.
Persistent symptoms, with little or no relief from workplace modifications, may require use of anti-inflammatory painkillers or pain receptor blocking medication, elastic supports or hot and cold packs. Sufferers from RSI often find relief through yoga, massage, osteopathy and chiropractic adjustment. Prevention of RSI is the ideal, but if this is not possible, early detection and treatment should help.