The upper limb is the formal word used to describe your arm which extends from the shoulder region till the hand including forearm. Upper limb is very much essential for doing simple tasks daily. It is subjected to wear and tear as one grows older. Repetitive strain injury (RSI) can be described as (mild to chronic) pain in the muscles, tendons and nerves of the upper limb by doing repetitive movements. Overuse and persistent repetitive motions are the main cause for RSI.
People working in awkward posture and doing tasks persistently like typing on the computer or working in assembly line are vulnerable for developing RSI. This is also known as work related upper limb pain or disorder. The pain can be felt in any part of the arm like elbow, forearm, hands, neck and even shoulders. Initially mild pain is felt on the muscles and tendons of upper limb and the pain subsides if you stop working. Treatment options include RICE and taking rest at intervals at workplace.
Symptoms Of Repetitive Strain Injury :
The signs of RSI are not the same for all individuals and the degree of pain may also vary. One can feel the pain in the upper limb area and that part becomes stiff and tender. It can also produce tingling sensation due to nerve damage. Muscle cramps can be present in the area of damage. All the above symptoms are in early stage of RSI and the pain would improve once you stop doing particular task or repetitive movement.
Pain can be mild or medium or severe and for some people it becomes chronic. While you are resting there may not be any pain first but the symptoms may become worse causing persistent pain later. The affected part of the upper limb may develop swelling due to pain. If no treatment is given in this stage, the condition of RSI can become permanent and irreversible.
RSI can be divided into 2 main categories namely Type 1 and Type 2.
- Type 1 RSI is marked with well defined symptoms like tendonitis, Tenosynovitis (swelling of tendon sheath) and Carpel tunnel syndrome (compression of nerve with sharp pain).
- Type 2 RSI has no well defined signs and one cannot measure the symptoms like swelling or nerve damage. Hence it is also known as diffused RSI.
Causes :
Overuse and making repetitive movement of tendons and muscles of the upper limb is the main cause of RSI. We all make several motions using the upper limb in our daily tasks which may not cause any pain. But RSI is concerned with making repeated movements at workplace daily without any break. Any part of the upper limb including shoulder, elbows, forearms, hands, wrists and neck can be affected due to RSI.
People doing intense work for prolonged time without any rest and those involved in repetitive actions are at high risk of getting RSI. People who sit in poor posture while working in the computer or laptop are also at risk. Typists, computer operators, musicians, sports persons, line men and workers in the supermarket are at risk for developing RSI. The symptoms may become worse during cold months. It is essential that you are sitting in the right posture at office and assembly line workers should take break at regular intervals to prevent RSI. It is still unclear why only certain people develop RSI and others are not. For some people there will not be any visible signs but still they can get RSI. Stress also plays an important role in causing RSI.
Diagnosis :
No concrete tests are available for detecting RSI, Based on the symptoms the doctor will recommend medications and physiotherapy.
Treatment :
Before starting any treatment, your doctor will ask you series of questions related to your daily tasks at workplace. He would take a decision based on the repetitive activities that you carry out at workplace. Most of the symptoms would reduce if you are working in proper posture and by taking break at regular intervals. You can make changes in your lifestyle and modify your activities at workplace. By doing stretching exercises in short breaks your symptoms would improve drastically. You can talk with your employer or HRM department to make modifications in your work. Do regular aerobics at home before starting for work. This would help in strengthening your muscles and tendons reducing the symptoms.
Self help measures and change in daily activities will for sure make changes in managing pain. For people who work on computer check your seat, sitting position and other keyboard pads etc which can be the cause for creating strain. Your doctor would evaluate the medical condition before giving any drugs. Combined approach of medications and physiotherapy is very effective in treating RSI. Infrared beam of light is passed directly into the affected area or ultrasound therapy can be used for getting quicker results. For some people, electric current is used to block the nerve signals of pain using TENS (Transcutaneous electrical nerve stimulation) method.
Anti-inflammatory medications like aspirin and muscle relaxants (prescribed by your doctor) and topical creams are effective in reducing pain. Some people will be given antidepressants if RSI pain is interfering with their quality of sleep. You can use hot or cold packs alternatively on the affected part of the body to reduce inflammation. If required, your doctor would recommend you to wear splint or elastic support for at least 3 weeks or until the swelling subsides.
In severe cases, steroid injections will be given directly on the affected part of upper limb to give quick relief from symptoms. Surgery is the last option for treating RSI for which Carpel tunnel syndrome or damaged nerves is the root cause. Regular massage and osteopathy is helpful in preventing further damage to the tendons. Alternative therapies like acupuncture, yoga and meditation can be useful in relieving the symptoms and in improving the quality of life.
Outlook :
By making small changes most of the people would see improvement in symptoms. Taking medications and doing regular exercises will help in speeding up the recovery. Prognosis is good in most cases in 4-6 months. In rare cases pain will be persistent and chronic even with combined approach of therapies. For such cases change of job would be the right option.
Tips for Prevention :
You need to realize that you are causing strain by doing certain activities repeatedly. By avoiding them you can prevent RSI. Once you identify what exactly causes problem you can modify such tasks to prevent further damage. RSI symptoms will not appear suddenly and it proceeds gradually. After seeing the initial symptoms you can make suitable alterations in work, lifestyle, and hobbies. Employers are bound to answer work related RSI and hence they should come forward in giving good atmosphere for employees.