Repetitive strain injuries (RSI) are a group of disorders that most commonly develop in workers whose work involves excessive and repetitive motions of the neck and upper extremity. There are quite a few occupations that comprise such activities. It is also quite common in people involved in sports activities.
It all starts with taking a careful history, performing a proper physical examination and specific diagnostic maneuvers to detect these musculoskeletal injuries.
RSI may be present in a range of ways – cervical syndrome, tension neck syndrome, thoracic outlet syndrome, and frozen shoulder syndrome. Injuries involving the elbow, wrist and hand joints include epicondylitis, carpal tunnel syndrome and ulnar nerve entrapment.
RSI is especially common in all kinds of workplaces. The disorders of the forearm flexor tendons are most common among workers at assembly lines and trainees, whereas the cervical rotation and side-flexion are most affected in office workers. RSI may also occur as a result of sports and recreational activities. These injuries result from repetitive and forceful motions, awkward postures, and other sports/work-related conditions and ergonomic hazards.
Occupationally induced RSIs are costly, creating a strong incentive for physicians to become familiar with the symptoms, signs, and risk factors so that they can be diagnosed early and properly treated.
Hand/forearm-related RSI are common in office settings – such as carpal tunnel syndrome, cubital tunnel syndrome, Guyon canal syndrome, lateral epicondylitis, and tendonitis of the wrist or hand. The diagnosis is clinical but MRI and ultrasonography can be used for the diagnosis, but the role of such imaging in the diagnosis of upper limb disorders remains unclear. Once diagnosed, exercise can be beneficial for non-specific upper limb disorders. Other options, such as the immobilizing hand braces and open carpal tunnel surgery release are beneficial for carpal tunnel syndrome. Nonsurgical management, such as topical and oral non-steroidal anti-inflammatory drugs, and corticosteroid injections are helpful for lateral epicondylitis. Exercise is probably beneficial for neck pain, as are corticosteroid injections and exercise for shoulder pain.
In general, mainstay of treatment is mainly conservative and consists of rest, application of ice or heat and anti-inflammatory drugs. It typically takes a few or months to completely resolve.
It is very important to make necessary modifications in the workplace in order to prevent many of these injuries. Assessing the exposure of workers to known risk factors is essential The ergonomics of the workplace should properly be studied and accounted for in order to prevent workplace-related RSI. Training staff and performing necessary workplace changes would allow the staff to more effectively use their workplace through increased office ergonomics knowledge and skills. Once such training and interventions are in place, it leads to an increase in workers’ office ergonomics knowledge and awareness, and that results in a significant decrease in work-related musculoskeletal disorders.
RSI that is sports-related, can also be prevented by getting professional training to ensure the technique is right and the chance of injury is minimized.