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Repetitive Strain Injury

Cross-posted from Aches & Joints


Repetitive Strain Injury or RSI describes a group of conditions associated with overuse of soft tissues such as muscles, tendons and nerves. RSI causing pain can affect the upper back, arms, hands, wrists, or fingers. Continuous and prolonged use of a computer keyboard, strumming a guitar, or wielding tools on an assembly line, have all been associated with RSI.



RSI is commonly misdiagnosed as carpal tunnel syndrome, frozen shoulder, tennis elbow and golfer’s elbow. Symptoms may be intermittent, and patients report some limitations in movement or loss of strength. While RSI may not be life threatening, it can cause crippling pain with an associated inability to perform skilled activity.

Considering the wide range of symptoms and activities associated with RSI, it is difficult to blame any one cause, and thus find one specific treatment. RSI has been attributed to poor posture in sedentary jobs, and repetitive actions using a limited number of muscles and tendons. Further, the difficulty with treating RSI is the lack of standardized assessment tools.

How to treat RSI?
“When a patient comes in with pain, discomfort or functional impairment consistent with RSI, we recommend evaluation by an occupational therapist, as well as a physiatrist, to understand the cause of the symptoms,” advises Dr. Jesse Jupiter, Chief of the Hand Service at Massachusetts General Hospital and Professor at Harvard Medical School, Boston, MA. “We also recommend evaluation of the work station and associated activities,” adds Dr. Jupiter.

Occupational therapists assess the workplace and work habits, and may recommend changes in the furniture and layout. Even a simple change of the computer mouse has been reported to decrease loads on neck muscles and resulting hand pain. Depending upon symptoms, a physical therapist can recommend various stretches and exercises to strengthen weak muscles, so that patients can return to performing their normal activities without pain.

“The long term prognosis for RSI is generally very good, if patients understand what causes the symptoms and ergonomic workplace modifications can be introduced. Patients also need to maintain appropriate posture, do regular exercises, and play an active role in their health decisions” reminds Dr. Jupiter.

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