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Repetitive strain injury (RSI)


Expert reviewer, Jon H Edmondson, Musculoskeletal Clinical Lead, Bupa UK
Next review due August 2022

Repetitive strain injury (RSI) is the aches and pain in your body caused by repetitive movements or poor posture while doing certain activities (including work). It’s also called occupational overuse injury and overuse syndrome. RSI mainly affects your wrists and hands.

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What is repetitive strain injury (RSI)?

You can get RSI from a wide range of occupations and activities. You may develop RSI if you use a computer regularly or if your job involves repetitive movements. RSI may also be linked with hobbies such as painting, and with sports such as tennis and golf.

If you think you have RSI, it’s important not to ignore it. Sometimes, RSI has an underlying cause such as carpal tunnel syndrome, which causes pain in your wrist and forearm but can improve with treatment.

Types of repetitive strain injury (RSI)

There are two types of RSI: Type 1 and Type 2.

  • Type 1 RSI is when RSI is caused by a health condition, such as carpal tunnel syndrome or tendonitis (inflammation of your tendons).
  • Type 2 RSI is when your RSI symptoms don’t fit in with any health condition – there’s no swelling or problems with your nerves. This is also called non-specific pain syndrome.

Causes of repetitive strain injury (RSI)

RSI has many possible causes. These include:

  • doing repetitive activities
  • doing an activity that involves lifting or carrying heavy objects
  • carrying out an activity for a long time without taking enough breaks
  • poor posture from working at a poorly designed workstation
  • doing activities that involve working in an awkward or tiring position
  • using vibrating equipment

If the type of work you do may be increasing your chances of getting RSI, you can take some steps to prevent the symptoms. Speak to your employer about this. Also see the Prevention of RSI section and the FAQ on using a computer at work.

Symptoms of repetitive strain injury (RSI)

RSI can cause a wide range of symptoms, including pain and tenderness in your muscles and joints. You might notice them more during the day, when you're doing the activity that causes them.

Other common RSI symptoms are:

  • aches
  • stiffness
  • tingling
  • numbness
  • weakness
  • cramp

You may not have any physical signs such as swelling, even though your body feels painful. The pain may get worse if you don’t get any treatment. It may get so bad that you’re not able to do your work or usual activities.

If your symptoms get better when you rest, it’s worth thinking about whether you can change your activities or adapt your work environment. Speak to your employer or occupational health advisor for advice. If your symptoms of RSI continue despite making changes to your work or activities, make an appointment with your GP.

Diagnosis of repetitive strain injury (RSI)

RSI isn’t always easy to diagnose because there’s no specific test for it. If you see your GP with symptoms of RSI, they’ll ask about your symptoms and examine you. They may also ask you about your medical history and what type of work you do. Tell your GP if you’ve noticed that certain activities could be causing your symptoms or making them worse.

If you have Type 1 RSI (see the section: Types), your GP may suggest you have some tests. These are to see if an underlying health condition could be causing your symptoms. This may include blood tests and nerve conduction studies, for example. If you have Type 2 RSI, it’s more difficult to diagnose, as there aren’t any specific tests. But your GP may still suggest you have some tests to rule out other conditions.

Self-help for repetitive strain injury (RSI)

Reducing activity

You may notice your RSI symptoms improve when you rest the affected part of your body. Try having a complete break from the activities that trigger your symptoms, and then gradually reintroduce them once your symptoms have settled down. If this isn’t practical, it may help if you limit the amount of time you spend on these activities. Keep moving the affected part of your body in a way that doesn’t cause pain to help stretch the muscles and keep them strong.

Changes at work

If your symptoms are related to your work, your first step should be to speak to your manager or supervisor. Your employer may refer you to an occupational therapist or occupational health advisor for help and advice. By looking at your working environment and how you work, you may discover which activity is causing the problem. Carry on working if you can, but try to take steps to reduce how much time you spend doing this activity.

If you can't stop or reduce the activity that’s causing the problem, take regular short breaks to stretch and move your arms and hands. You could try to divide up your time by doing different tasks so that you don't spend long periods doing the same thing.

If you use a computer, you may be able to change your mouse or keyboard to relieve pain. You can buy specially designed ones that make your movements as natural as possible. There isn’t much solid proof that they work but some people find them useful.

Cold and heat

You may find that if you apply cold packs to the affected part of your body, it helps to ease pain and reduce swelling. When your symptoms flare up, put an ice pack or ice wrapped in a towel on the area. Use the cold pack or ice for up to 20 minutes at a time. Don’t apply ice directly to your skin because ice can harm skin.

If ice doesn’t work for you, you could try heat treatment instead. Gently hold a heat pack or hot water bottle against the affected part of your body. Alternatively, try a warm bath.

Painkillers

Over-the-counter painkillers, such as non-steroidal anti-inflammatory medicines (NSAIDs) and paracetamol may help to ease your symptoms. You can buy these painkillers from pharmacies and supermarkets, but don’t take them regularly without your GP’s advice. Taking painkillers regularly may stop the pain, but you may carry on doing the activity that’s causing your symptoms without realising it. This could make your condition worse in the long term.

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Treatment of repetitive strain injury (RSI)

Physiotherapy

If self-help measures and any changes you make at work don’t help to improve your symptoms, you may need to see a physiotherapist. They’ll show you how to rest your body to ease your pain. They’ll also help you to stretch and strengthen any affected muscles with safe gentle exercise, and to sit or work with good posture.

Steroid injections

If other treatments haven’t worked or you have inflammation in a specific tendon, your GP may suggest you have a corticosteroid injection.

Surgery for RSI

If your GP suspects your symptoms are caused by a specific health condition such as carpal tunnel syndrome, they may refer you to a surgeon who specialises in this area.

Prevention of repetitive strain injury (RSI)

To prevent RSI, try to limit your repetitive actions, especially if they involve using heavy equipment or vibration. You’ll also need to improve your working posture and environment and take regular breaks.

Employers have a legal duty to prevent work-related RSI or stop existing RSI from getting worse. This is under the Health and Safety at Work etc. Act 1974 and the Management of Health and Safety at Work Regulations 1999. If you use a computer at work, you’re protected by the Health and Safety (Display Screen Equipment) Regulations 1992. If you don’t take some action, your RSI may get so bad that you can no longer do your job properly.

Most injuries are caused by poor posture, working in an unusual or uncomfortable way or working with heavy equipment. Your employer should carry out a risk assessment by watching how you work and look for possible problems. They may then need to:

  • change your work style and work environment as much as practically possible
  • provide the right equipment so you can do your job safely
  • encourage you to take regular breaks and leave work on time

Frequently asked questions

  • You may notice some early symptoms of repetitive strain injury (RSI) when you’re doing a particular activity. For example, you may get tingling, aching or numbness in a particular part of your body. If you work with a computer, you may notice your wrists and shoulders ache at the end of the day. But your exact symptoms will vary, depending on what’s causing your RSI. If you ignore any pain and carry on as usual, it can make things worse. As soon as you notice any symptoms, talk to your employer.

  • If you think your work is causing repetitive strain injury (RSI) or making it worse, speak to your employer straight away. By law, your employer must provide whatever help you need.

    Your work area should be suitable and comfortable for you. If you use a computer, make sure:

    • you adjust the height of your chair and computer screen so your eyes are the same height as the top of your monitor
    • your chair is the right height for you; if not, you may find a footrest reduces pressure on the backs of your legs
    • your monitor is angled to reduce glare or reflections
    • your keyboard and mouse are easy and comfortable to reach
    • you’ve enough room on your desk for all your documents – use a document holder if you need to
    • you’re not stretching your arms when you type; your forearms should be horizontal
    • your legs have room to move around under your desk

    You may find it helpful if you take a break from time to time. It’s best to have short breaks more often than longer ones less often. Stretch and change position and look up and away from the screen. Change your activity before you get tired, rather than waiting until you feel uncomfortable. It’s also important to keep active at work.

  • If your child makes repetitive hand or arm movements, they may be more likely to develop repetitive strain injury (RSI) in the future. Using games consoles often involves repetitive movements.

    There are several things your child can do to reduce their risk of getting RSI.

    • Take regular breaks and move around for a few minutes every half hour.
    • Sit in an adjustable chair that supports their back and tell them not to hunch over the games console.
    • They shouldn’t keep their hands and arms rigid when they’re using the controller.
    • Give their hand and thumb a quick massage regularly, and tell them to flex their fingers, and stretch their arms out to the side, then above their head.

    If your child already has symptoms of RSI, such as tingling and soreness, don't ignore this. Make sure they take regular breaks from gaming and follow this advice. If you’re still concerned, take them to see their GP.


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Related information

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    • Personal communication, Jon Edmondson, Musculoskeletal Clinical Lead, Bupa UK, 1 August 2019
    • Working with display screen equipment (DSE). Health and Safety Executive. www.hse.gov.uk, accessed 16 July 2019
    • Jalink MB, Heineman E, Pierie JPEN, et al. Nintendo related injuries and other problems: review. BMJ 2014(349):7267. doi:10.1136/bmj.g7267
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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, August 2019
    Expert reviewer, Jon H Edmondson, Musculoskeletal Clinical Lead, Bupa UK
    Next review due August 2022



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