What is Repetitive Strain Injury (RSI)?

• Introduction
• Who is at Risk?
• RSI Treatment
• Stress
• Young People
• How to control and prevent the risk of RSI

Introduction

RSI is an umbrella term covering a range of muscular and nerve problems in the body. RSI is the more commonly known term for a set of disorders called Work Related Upper Limb Disorders or WRULDS. It is a serious disease that must be stopped at an early stage or permanent disability could be caused. RSI doesn't only occur in the hands and arms, but can also occur in the knees and feet. As the focus of this website is on computer use, we will focus mainly on upper limb disorders.

There are many different names for these injuries, including:

• Tenosynovitis
• Carpel tunnel syndrome
• Tendinitis
• Dupuytren’s contracture
• Epicondylitis or ‘tennis elbow’
• Bursitis
• ‘Housemaid’s knee’ or ‘beat conditions’
• Overuse injury

examples of upper limb disorders

more examples of upper limb disorders

Currently, only Tenosynovitis is the only form of keyboard related RSI that qualifies as a prescribed industrial disease. You need to be 14% disabled to qualify for disablement benefit. Even if your RSI is so severe that you can not brush your teeth, you will not qualify.

Who is at Risk?

Anyone whose work involves some of the following risk factors:

• awkward posture,
• awkward grip,
• badly designed equipment, tools or workstations,
• repeated movements,
• overwork,
• applying physical force,
• fast-pace work,
• vibration,
• inadequate rest breaks,
• lack of training, and/or
• no variety of tasks.

Anyone who overuses their muscles in their arms and hands repeatedly may develop RSI. Workers on factory assembly lines, musicians, dressmakers, and cleaners; the list of people who often suffer is long. It is only since office work and computers have become such a prominent part of everyday life that these have fallen under the spotlight.

The change in our home life and activities also contributes to the problem. Computers are ever present, and young children and teenagers are at risk of developing RSI because of the use of computer games, whether they be hand-held or played on the TV or computer.

Stress is an important factor to consider when carrying out a DSE assessment.  Tense muscles do not function correctly, which means that someone under stress is also much more likely to suffer muscle damage and subsequent RSI.

RSI is a progressive condition that can be divided into three broad stages, although the symptoms of sufferers do not always neatly fit into these categories.

Stage 1 (mild) – Pain, aching and tiredness of the wrists, arms, shoulders, neck or legs during work, which improves over night.  This stage may last weeks or months and is reversible.

Stage 2 (moderate) – Recurrent pain, aching and tiredness occur earlier in the working day, persist at night and may disturb sleep.  This stage may last several months

Stage 3 (severe) – Pain, aching, weakness and fatigue are experienced even when a person is resting completely.  Sleep is often disturbed and the sufferer may be unable to carry out light tasks at home or work.  This stage may last for months or years.  Sometimes it is irreversible and the person never gets back full use of the affected part of the body.

This demonstrates the need to recognise the symptoms of RSI early so that remedial action can be taken and the condition at the mild stage can be reversed.

RSI Treatment

One of biggest problems facing RSI sufferers is finding a doctor who will diagnose and treat them sympathetically and effectively. Clinical signs of RSI are not obvious during the early stages of the condition and few GP's have much training in occupational medicine.

Heat or cold packs; the natural anti-inflammatory arnica, which comes as a capsule or cream form; painkillers such as paracetamol, and anti-inflammatory medicines such as ibuprofen, can all relieve pain and discomfort. Elastic wrist support bandages and special exercises can help too.

When the situation has become very bad, stronger medicines may be needed from the doctor, who may also recommend acupuncture or firm wrist splints to help relieve the pain.

Physiotherapy, osteopathy, or the Alexander technique, are good for pain relief, and also encourage good posture. However there has been no real assessment of the effectiveness of these "alternative therapies".

Surgery does not have a good record of success. Using ergonomic hardware such as a Maltron keyboard can not cure RSI. Wrists wrests and gel wrist supports should not be used as they can restrict blood flow into your hands.

The best overall treatment for RSI is to stop the activity that is causing the pain and resting the limb. See also the tips on the easyDSE forum .

Stress

Although the role of stress is not fully understood it plays and important role in the development of RSI.  It is clear that workers under stress are more tense and excessive tension in the muscles is an important risk factor for developing RSI.

Causes of stress:

• bullying or harassment, by anyone, not necessarily a person's manager
• feeling powerless and uninvolved in determining one's own responsibilities
• continuous unreasonable performance demands
• lack of effective communication and conflict resolution
• lack of job security
• long working hours
• excessive time away from home and family
• office politics and conflict among staff
• a feeling that one's reward is not commensurate with one's responsibility

Signs of Stress:

• sleep difficulties
• loss of appetite
• poor concentration or poor memory retention
• performance dip
• uncharacteristic errors or missed deadlines
• anger or tantrums
• violent or anti-social behaviour
• emotional outbursts
• alcohol or drug abuse
• nervous habits

Young People

Young workers are facing a repetitive strain injury epidemic, according to the TUC. Using official data, the TUC claims that a whole generation of workers could become victims, devastating the British economy and leaving millions in pain. Jacqueline Paige reports.

The Health and Safety Executive (HSE) figures reveal that young workers are more at risk than any other age group on not one, or even two, but on every single one of the four main risk factors associated with RSI: repetition and speed, awkward posture, lack of control over the work process, and the use of force (see right). Nearly 4 million young people between the ages of 16 and 24 are in work.

"These statistics point to the future of British industry being bleak because if a high percentage of our young workers already suffer from RSI, then businesses of the future will have a limited workforce to choose from," said Roger Lyons, general secretary of the union MSF. [Hazards 73, 16 February 2001]

How to prevent or control the risk of RSI?

• Improve work organisation
• Improving task and equipment design
• Taking account of the individual
• Improving the work environment
• Monitoring health
• Drink lots of water and eat a healthy balanced diet

Control measures prove extremely cost effective in terms of not only improved employee health and quality of life, but also in improved productivity and customer satisfaction. 

An unpublished study commissioned by the Health and Safety Executive concluded that a 12-15 minute break every hour leads to maximum productivity. A 12 minute break every hour is better than a 20 minute break every two hours. We at easyDSE strongly recommend a break reminder software called Workpace.

Employers should not be asking, “can we afford to do it?” but instead should be asking - “can we afford not to do it?”