| Repetitive strain injury |
| Classification and external resources |
| DiseasesDB |
11373 |
| eMedicine |
pmr/97 |
| MeSH |
D012090 |
Repetitive strain injurie (RSIs) are "injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions".[1] RSI is also known as cumulative trauma disorders, repetitive stress injuries, repetitive motion injuries or disorders, musculoskeletal disorders, and [occupational] overuse syndromes.
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Contents
- 1 Definition
- 2 Causes
- 3 Treatment
- 4 Adjunct Intervention
- 4.1 Ergonomics
- 4.2 Adaptive software
- 4.3 Adaptive hardware
- 4.3.1 Mouse
- 4.3.2 Keyboards and keyboard alternatives
- 5 See also
- 6 Footnotes
- 7 External links
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Definition
Repetitive strain injury (RSI) is a syndrome incorporating several discrete conditions associated with activity-related arm pain such as edema, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, stenosing tenosynovitis, intersection syndrome, golfer's elbow or medial epicondylitis, tennis elbow or lateral epicondylitis, radial tunnel syndrome, and focal dystonia.
RSI is also used as an umbrella term for non-specific illnesses popularly referred to as Blackberry thumb, iPod finger, gamer's thumb (a slight swelling of the thumb caused by excessive use of a gamepad), Rubik's wrist or "cuber's thumb" (tendinitis, carpal tunnel syndrome, or other ailments associated with repetitive use of a Rubik's Cube for speedcubing), Trigger finger, Stylus Finger" (swelling of the hand caused by repetitive use of mobile devices and mobile device testing.), Raver's Wrist, caused by repeated rotation of the hands for many hours (for example while holding glow sticks during a rave), and others.
Doctors have recently begun making a distinction between tendinitis and tendinosis in RSI injuries. There are significant differences in treatment between the two, for instance in the use of anti-inflammatory medicines, but they often present similar symptoms at first glance and so can easily be confused.
The following complaints are typical in patients who might receive a diagnosis of RSI:[2]
- Short bursts of excruciating pain in the arm, back, shoulders, wrists, hands, or thumbs (typically diffuse – i.e. spread over many areas).
- The pain is worse with activity.
- Weakness, lack of endurance.
Causes
Gloves to avoid
RSI during typing.
RSI is believed by many to be caused due to lifestyle without ergonomic care[citation needed], E.g. While working in front of computers, driving, traveling etc. Simple reasons, like using a blunt knife for everyday chopping of vegetables, may cause RSI.
Other typical habits that some sources believe lead to RSI:[citation needed]
- Reading or doing tasks for extended periods of time while looking down.
- Sleeping on an inadequate bed/mattress or sitting in a bad armchair and/or in an uncomfortable position.
- Carrying heavy items.
- Holding one's phone between neck and shoulder.
- Watching TV in incorrect position e.g. Too much to the left/right.
- Sleeping with head forward, while traveling.
- Prolonged use of the hands, wrists, back, neck, etc.
- Sitting in the same position for a long period of time.
Treatment
RSIs are assessed using a number of objective clinical measures. These include effort-based tests such as grip and pinch strength, diagnostic tests such as Finkelstein's test for Dequervain's tendinitis, Phalen's Contortion, Tinel's Percussion for carpal tunnel syndrome, and nerve conduction velocity tests that show nerve compression in the wrist. Various imaging techniques can also be used to show nerve compression such as x-ray for the wrist, and MRI for the thoracic outlet and cervico-brachial areas.
The most-often prescribed treatments for early-stage RSIs include drug therapies such as anti-inflammatory medications combined with passive forms of physical therapy such as rest, splinting, massage and the like. Low-grade RSIs can sometimes resolve themselves if treatments begin shortly after the onset of symptoms. However, some RSIs may require more aggressive intervention including surgery and can persist for years.
General exercise has been shown to decrease the risk of developing RSI.[3] Doctors sometimes recommend that RSI sufferers engage in specific strengthening exercises, for example to improve sitting posture, reduce excessive kyphosis, and potentially thoracic outlet syndrome.[4]
Since workstation design often contributes to RSIs, ergonomic adjustments of the workstations are often recommended.
Adjunct Intervention
Ergonomics
Modifications of posture and arm use (ergonomics) are often recommended.[5] Specially designed tools such as pliers are now widely available for production line workers to minimise the risks of repetitive strain injuries. The handles of such pliers are bent so that the workpiece is aligned with the arm, wrist and hand. The handles are also designed to maximise grip using both thermoplastics and rubber.
Ergonomics: the science of designing the job, equipment, and workplace
Adaptive software
Main article: List of repetitive strain injury software
There are several kinds of software designed to help in repetitive strain injury. Among them, there are speech recognition software, and break timers. Break timers software reminds the user to pause frequently and perform exercises while working behind a computer. There is also automated mouse-clicking software that has been developed, which can automate repetitive tasks in games and applications.
Adaptive hardware
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This section needs additional citations for verification. (January 2012) |
Adaptive technology ranging from special keyboards, mouse replacements to pen tablet interfaces might help improve comfort.
Mouse
Switching to a much more ergonomic mouse, such as a roller mouse, vertical mouse or joystick, or switching from using a mouse to a stylus pen with graphic tablet may provide relief, but in chronic RSI they may result only in moving the problem to another area. Using a graphic tablet for general pointing, clicking, and dragging (i.e. not drawing) may take some time to get used to as well. Switching to a trackpad or pointing stick, which requires no gripping or tensing of the muscles in the arms may help as well. Inertial mice (which do not require a surface to operate) might offer an alternative where the user's arm is in a less stressful thumbs up position rather than rotated to thumb inward when holding a normal mouse. Also, since they do not need a surface to operate ("air mice" function by small, forceless, wrist rotations), the wrist and arm can be supported by the desktop.
Ergonomic accessories for the mouse can also make a difference. An accessory developed recently includes finger pads to create a softer surface for clicking as well as for helping the joints bend more when clicking. Additionally the accessory developed by the gel pads on mouse manufacturer includes a palm pad on the mouse to help the hand achieve a more grasping position further increasing overall ergonomics.
Keyboards and keyboard alternatives
Exotic keyboards by manufacturers such as Datahand, OrbiTouch, Maltron and Kinesis are available. Also one can use digital pens to avoid the strain coming from typing itself[dubious – discuss]. Other solutions move the mode of input from one's hands entirely. These include the use of voice recognition software or pedals designed for ergonomics and gaming to supplant normal keyboard input.
DataHand Professional II Keyboard, right side
See also
- List of Repetitive Strain Injury software
- Tendinitis
- Tendinosis
- Carpal tunnel syndrome
- ^ Public Employees Occupational Safety and Health Program of the New Jersey Department of Health and Senior Services
- ^ Ring D, Kadzielski J, Malhotra L, Lee SG, Jupiter JB (February 2005). "Psychological factors associated with idiopathic arm pain". J Bone Joint Surg Am 87 (2): 374–80. doi:10.2106/JBJS.D.01907. PMID 15687162. http://www.ejbjs.org/cgi/pmidlookup?view=long&pmid=15687162.
- ^ Ratzlaff, C. R.; J. H. Gillies, M. W. Koehoorn (April 2007). "Work-Related Repetitive Strain Injury and Leisure-Time Physical Activity". Arthritis & Rheumatism (Arthritis Care & Research) 57 (3): 495–500. doi:10.1002/art.22610. PMID 17394178.
- ^ Carolyn Kisner & Lyn Allen Colby, Therapeutic Exercise: Foundations and Techniques, at 473 (5th Ed. 2007).
- ^ Berkeley Lab. Integrated Safety Management: Ergonomics. Website. Retrieved 9 July 2008.
External links
- Repetitive Strain Injuries at the Open Directory Project
- Musculoskeletal disorders from the European Agency for Safety and Health at Work (EU-OSHA)
- Workrave application for prevention of RSI
- Amadio PC (January 2001). "Repetitive stress injury". J Bone Joint Surg Am 83-A (1): 136–7; author reply 138–41. PMID 11205849. http://www.ejbjs.org/cgi/pmidlookup?view=long&pmid=11205849.
- Harvard RSI Action
- Prevention and Management of Repetitive Strain Injury
- Epidemiological and ergonomic study of occupational factors associated with syndromes of upper limb disorders in keyboard operators by M Hanson and others. Institute of Occupational Medicine Research Report TM/99/04
- Development of an aid to identifying task elements, which may predispose individuals to work related upper limb disorders by RA Graveling and others. Institute of Occupational Medicine Research Report TM/90/08
- Clinical epidemiological study of relations between upper limb soft tissue disorders and repetitive movements at work by CJ English and others. Institute of Occupational Medicine Research Report TM/88/19
