What are Repetitive Strain Injuries (RSIs)

Repetitive strain injuries result from the overuse or misuse of muscles, nerves, or cords of tissue that attach muscles to bones (tendons). RSIs can affect almost any part of the body. However, RSIs are most common in:

• The arms, including the thumbs, wrists, elbows, and shoulders.
• The legs, including the ankles and knees.

Repetitive strain often causes certain common medical conditions, such as carpal tunnel syndrome, tennis elbow, and golfer’s elbow. The severity and duration of symptoms caused by an RSI can usually be reduced by treating the condition early and by stopping or modifying activities that cause symptoms.

What are the causes?

RSIs are caused by repeating the same activity for long periods of time without enough rest. Repetitive strain often results from activities done:

• At work, such as typing for long periods of time.
• During a hobby or sport.

What increases the risk?

Certain workplace and personal factors may make you more likely to develop an RSI.

Workplace Risk Factors

• Frequent computer use.
• Infrequent rest breaks.
• Repetitive motions.
• Working in an awkward position or holding the same position for a long time.
• Forceful movements, such as lifting, pulling, or pushing.
• Vibration caused by using power tools.
• Working in cold temperatures.

Personal Risk Factors

• Poor posture.
• Not exercising regularly.
• Being overweight.
• Arthritis, diabetes, thyroid problems, or other long-term (chronic) medical conditions.
• Vitamin deficiencies.

What are the signs or symptoms?

Symptoms often begin while you are using your affected body part and become more noticeable after the repeated stress has ended. Common symptoms include:

• Burning, shooting, or aching pain.
• Tenderness.
• Swelling.
• Tingling or numbness.
• Fatigue.
• Weakness, heaviness, or loss of coordination in the affected body area.
• Muscle stiffness.
• Sudden, involuntary muscle tightening (spasms).

In some cases, symptoms can become severe enough to cause difficulty with everyday tasks.

How is this diagnosed?

An RSI may be diagnosed with a physical exam and an evaluation of your everyday activities. Your health care provider may ask questions about your job and your physical activity level. You may have tests, including:

• X-rays.
• Electromyogram (EMG). This test measures electrical signals that your nerves send to your muscles.

How is this treated?

Treatment depends on the severity and type of RSI you have. Treatment may include:

• Resting the affected body part. This may include modifying or stopping certain activities that cause symptoms.
• Medicines to help relieve pain.
• Wearing a splint on the affected body part.
• Wearing a wrap that applies pressure (compression wrap) to the affected body part.
• Physical therapy.
• Occupational therapy.
• Surgery. This may be done for severe RSIs.

RSIs may take weeks or months to heal, depending on your condition.

Follow these instructions at home:

Managing pain, stiffness, and swelling

• Wear compression wraps only as told by your health care provider.
• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If directed, apply heat to the affected area as often as told by your health care provider. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
• If your arm or leg is affected, move your fingers or toes often to avoid stiffness and to lessen swelling.
• If possible, raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
• Rest your affected body part as told by your health care provider.

If you have a splint:

• Wear the splint as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the splint if your fingers or toes tingle, become numb, or turn cold and blue.
• Keep the splint clean and dry.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Stop or modify activities that cause your symptoms or make them worse, as told by your health care provider.
• Do exercises as instructed.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• If your condition is work-related, talk to your employer about changes that can be made.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Maintain good posture. Good posture means that:

• Your spine is in its natural S-curve position (neutral position).
  • Your feet are flat on the floor.
  • Your knees are directly over your feet, bent at a right angle.
  • Your arms are relaxed and at your sides. Your neck is relaxed and not bent forward or backward.
• If possible, adjust your work station so that you can maintain good posture.
  • Sit in a chair that supports the natural curve of your lower back.
  • Slide your chair under your desk so that you are close enough to reach your keyboard and computer mouse with your elbows at your side, bent at a right angle, and your forearms parallel to the ground.
  • Have your computer monitor directly in front of you so that your eyes are level with the top of the screen. The screen should be about 15–25 inches (38.1–63.5 cm) from your eyes.
• Take breaks often from any repeated activity. Alternate with another task that requires you to use different muscles.
• Change positions regularly. If you spend a lot of time sitting, get up and move around frequently.
• Exercise regularly, as told by your health care provider.
• Maintain a healthy weight.

Contact a health care provider if:

• You develop new symptoms.
• Your symptoms get worse or do not improve with medicine.