Repetitive strain injury (RSI) is a term that is used to refer to various kinds of injuries to muscles, tendons or nerves. These injuries are caused by repetitive movement of a particular part of the body. RSI can also be referred to as upper limb disorder (ULD). This is because the condition often involves the upper part of the body - the forearm, elbow, wrist, hands, and neck.

The most common RSI conditions include:

* Bursitis - inflammation and swelling of the fluid-filled sac near a joint at the knee, elbow or shoulder.
* Carpal tunnel syndrome - pressure on the median nerve passing through the wrist.
* Dupuytren’s contracture - a thickening of deep tissue which passes from the palm of the hand into the fingers.
* Epicondylitis - inflammation of an area where bone and tendon join - for example, tennis elbow.
* Ganglion - a cyst in a tendon sheath, usually occurring on the wrist.
* Rotator cuff syndrome - inflammation of muscles and tendons in the shoulder.
* Tendinitis - inflammation of a tendon.
* Tenosynovitis - inflammation of the inner lining of the tendon sheath that houses the tendons that control the fingers and thumbs.
* Trigger finger - inflammation of the tendon sheaths of fingers or thumb accompanied by swelling of the tendon.
* Diffuse RSI - nerve damage.

RSI is often caused, or aggravated, by frequently repeated movements, such as a task or leisure activity - for example playing golf or tennis regularly. Symptoms usually persist over time if left untreated.

As the number of people using computers increases, the chances of developing RSI increases. The repetitive action of typing on a computer can cause painful symptoms in fingers and hands, such as a throbbing pain. RSI caused by typing on a computer is typically referred to as ‘writer’s cramp’.

RSI is also linked to many types of repetitive manual work, such as the use of vibrating equipment in factories.

If there are any symptoms, including painful, tingling or swollen hands, elbows, wrists or shoulders, it is important to get treatment quickly. The sooner treatment is started the better the chances of recovery.

Types of RSI

RSI can be categorised into two types, Type 1 RSI and Type 2 RSI:

* Type 1 RSI - this includes conditions that are due to repetitive tasks, but can also be common in people who do not carry out repetitive tasks. The main symptoms tend to be swelling and inflammation of muscles and tendons. Typical type 1 RSI conditions include carpal tunnel syndrome (pressure in the wrist), tendonitis (inflammation of a tendon), and tenosynovitis (inflammation of tendon sheath).
* Type 2 RSI - is when a person’s symptoms do not fit into one of the above listed conditions. This is usually because there is no obvious inflammation or swelling in the affected area, merely a feeling of pain. This type is often called ‘non-specific pain syndrome’.

The symptoms of repetitive strain injury (RSI) vary, but can include: * pains or tenderness in your muscles or joints,
* a throbbing sensation in the affected area,
* tingling (pins and needles) or numbness in your hand or arm, and
* loss of strength or sensation in your hand.

Initially these symptoms may only occur when you are carrying out the repetitive motion, for example during working hours. Towards the end of the day your symptoms may improve when you have finished work and are resting. This initial stage of symptoms may last for several weeks.

If left untreated, the symptoms are likely to persist, causing pain or aching much of the time. You may also have tender swelling in the affected area, which can last for several months.

Pain could also be experienced all the time, affecting your sleep. At this stage the condition may be irreversible. Therefore, recognising the early symptoms of RSI is important to ensure that any treatment is most effective.

The actual cause of repetitive strain injury (RSI) is unknown. In some cases, there is no swelling in your muscles or tendons, and yet pain can continue to cause you discomfort.

RSI is related to overuse of muscles in your hands, wrists, arms, shoulders, back, or neck. This overuse is usually a repeated action that is often carried out on a daily basis. For example, if you use a computer at work you may experience a typical RSI condition called ‘writers cramp’. The repetitive action of typing on the computer can cause painful symptoms in your hands, such as a throbbing pain.

Cold temperatures, vibrating equipment, or forceful movements are also thought to worsen the condition.

Other things that may bring on the symptoms of RSI include:

* awkward posture,
* poorly organised workstations,
* badly designed equipment, or
* lack of rest breaks.

Stress may also be a contributing factor in RSI. However, relaxation techniques may be able to help reduce stress (see treatment section).

There are no tests to confirm a diagnosis of repetitive strain injury (RSI). Pain felt in the affected area may be common, but can often be due to a variety of factors.

RSI is often diagnosed based on the fact that symptoms develop following a repetitive task, and tend to fade, or be partially relieved, once the task is stopped. For example, if you have recently done a lot of DIY around your house, once the task has been competed, the pain may disappear.

Your GP can diagnosis certain RSI conditions such as carpal tunnel syndrome (pressure in the wrist) by examining your affected arm or wrist. X-rays may be used, but this is rare.

Reporting early symptoms is essential to avoid repetitive strain injury (RSI) conditions becoming disabling - that is, reducing your mobility and independence. See you GP if you experience any aches or pain in a particular area over a prolonged period of time (if it continues for more than a couple of weeks).

It is likely that your GP will initially advise that, if possible, you stop doing the task or activity that appears to be causing your symptoms. In some cases, this might not be possible if it is an activity you carry out on a daily basis for work. In this case, you may need to tell your employee about your RSI so that improvements can be made to relieve your symptoms.

Treatment for RSI usually aims to help with your pain, and to enable your strength and mobility to return. Your GP may recommend that you take a course of anti-inflammatory painkillers, such as aspirin or ibuprofen, to help relieve any pain. Children under the age of 16 should not take aspirin. You may also need to use heat or cold packs, elastic supports, and firm splints. All of these are available over-the-counter (OTC) from your local pharmacy, but they only offer temporary pain relief.

Steroid injections are usually only considered if you have defined inflammation in an affected area. For example if you have pressure on the nerves of your wrist (carpel tunnel syndrome), or inflammation on your tendon sheath (tenosynovitis).

Your GP may also suggest you take a short course of sleeping tablets if your sleep is disturbed due to your RSI-related pain.

Complementary therapies

Because there is no cure for RSI, chronic sufferers may find complementary therapies also help to relieve symptoms. For example, if your symptoms are severe, your GP can refer you to a physiotherapist, who can help you with your posture and teach you how to strengthen the muscles that are causing you particular discomfort. Your physiotherapist may also decide to perform a therapy called electrotherapy, which uses small electrical impulses placed on particular points of your body to help reduce your pain.

Other complementary therapies that may prove helpful include:

* Messages - to help relax your upper body muscles and tissues.

* Osteopathy - a treatment that focuses on your skeleton and muscles.

* Chiropractic - a method using your body structure, particularly your spine, to ease symptoms.

* Kinesiology - oriental medicines are used to help restore your body’s energy flow and balance.

* Alexander technique - is a method that works to change your movement habits in your everyday activities, helping to make you aware of balance, posture and co-ordination.

* Feldenkrais method - is similar to the Alexander technique but focuses less on specific body positions.

* Pilates - is more strenuous than the Alexander technique and the Feldenkrais method, as it involves exercise to both strengthen and improve your flexibility.

* Acupuncture - is a traditional Chinese treatment method that is often used to relieve pain and restore balance to your life force.

* Shiatsu - is a traditional Japanese technique often described as ‘finger pressure’ therapy, which is a form of massage that applies pressure to energy lines using fingers, thumbs, and elbows.

* Reflexology - is a foot message of Chinese origin that has been said to improve blood circulation and help to relax you.

Fitness techniques

You may find that there are a number of fitness techniques you can include in your lifestyle to help ease your RSI pain. These include:

* walking,
* swimming,
* yoga - the practice of poses, stretches and flexibility,
* tai chi - a mind and body discipline of choreographed movements to restore your body’s harmony, and
* relaxation techniques, such as meditation.

Symptoms for repetitive strain injury (RSI) can ease over time. To prevent the development of RSI, or relieve your symptoms, you need to review particular aspects of your lifestyle. For example, if you take part in regular sporting activities remember to warm up before you start, and cool down afterwards.

Aspects of your working environment are likely to have the most impact on your RSI. For example:

* If you work at a computer all day, make sure your seat, keyboard, mouse, and screen are positioned so that they cause you the least amount of strain to your fingers, hands, wrists, neck and back.

* Sit at your desk with a good posture. Adjust your chair so that your forearms are horizontal with the desk, and that your eyes are the same height as the top of your computer screen.

* If you do a repetitive task at work try to take plenty of regular breaks. It is better to take more frequent smaller breaks than just one long break at lunch.

* Speak to your employer if there is anything relating to your working environment that you feel could be improved. It is in their interest to ensure they do everything possible to help prevent or ease your RSI. You may also find it beneficial to speak to your employer’s occupational health advisers for further assistance and advice.

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