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Repetitive Strain Injury

Work related upper limb disorder

Repetitive strain injury (sometimes referred to as work related upper limb disorder) is an over use condition that affects the muscles and tendons in the arms. Sufferers develop arm pains that are described as an ache or a cramping sensation, sometimes with numbness or tingling. Symptoms seem to be related to work, usually where fine repetitive movements of the fingers, hands or wrists occur.

RSI is usually brought on by small, rapid, tense movements such as typing at a keyboard. When typing, tendons in the wrist slide to and fro inside their sheaths and if the wrist is held in an awkward position, cocked up, down or to one side, it can lead to inflammation of tissues around the sheaths (peritendinitis and tenovaginitis), painful cramping in wrist, fingers or hands (writer's cramp) or inflammation of tissues surrounding a joint (eg tennis elbow). Carpal tunnel syndrome in which a nerve becomes trapped by tissue swelling in the wrist can also be made worse by certain work conditions.

Work Related Problems

People with work related upper limb problems often develop pain that is difficult to pin down, there is no obvious sign of tissue injury or damage, which is why the term RSI, implying strain and injury is now considered a poor description. Some rheumatologists believe symptoms are due to a muscular condition, while others believe symptoms are associated with pressure on a nerve. Unfortunately, recovery is often slow.

Rest is very important especially in the early stages. Physiotherapy can also help to build up strength of affected muscles, reduce pain using heat and ultrasound treatments and help to maintain limb mobility. Working splints may help, but are not always practical.

Useful Tips

Prevention is terribly important, you can minimise the risk of upper limb pains by sitting with your body in the correct alignment and taking regular breaks. Other helpful tips include:

• Take regular breaks from tasks requiring repetitive movements, try not to sit still for more than 20 minutes.
• Stretch arms back, upwards and forwards while sitting, and circle elbows to your sides.
• Every hour walk around, swing your arms, touch your toes, jog on the spot etc to boost your circulation.
• Make sure you sit correctly with back straight, do not sit cross legged. You may find a seat wedge which tilts you forwards slightly is most comfortable
• When using a keyboard, your shoulders should be relaxed, your upper arm vertical, forearm horizontal and your wrist in a neutral, balanced position, not cocked upwards
• Your lower back should be supported at belt level.
• Use ergonomically designed chair, VDU stand and wrist rest.
• Keep feet flat on the floor or use a foot rest.
• Use a document holder to minimise neck movements.
• Ergonomically designed keyboards with specially shaped key pads and integral wrist rest are available.
• Avoid excessive stress at work and try to minimise noise disturbance and interruptions when you are working

The Japanese recommend that typists make no more than 40,000 key strokes per 8 hour day, yet bonus schemes in some UK companies depend on producing more than 10,000 keystrokes per hour. If you believe your work conditions are adversely affecting your health, contact the Health and Safety Executive who will arrange an inspection and keep your involvement anonymous so that your job is not at risk. Apply one or more electromagnetic patches over tender areas on the arm or wrists. Easy to apply magnetic wrist bands are also available.