Repetitive strain injury (RSI)
- Dr Sundeept Bhalara, Consultant Rheumatologist and Physician
Repetitive strain injury (RSI) is when you get aches and pains in your body from doing repetitive movements. RSI mainly affects your arms, shoulders, wrists and hands. It’s also called overuse syndrome or upper limb disorder.
About repetitive strain injury (RSI)
The term ‘RSI’ is used to describe a range of different problems that affect your muscles, tendons, joints and nerves in your upper body. Repeated strain on these tissues can start to damage them. Over time, this can lead to symptoms such as pain and loss of strength.
Most repetitive strain injuries get better on their own within three to six months. There are lots of things you can do yourself to ease your symptoms and help your recovery. But sometimes you need to seek help from a health professional.
Causes of repetitive strain injury (RSI)
There are lots of different causes of repetitive strain injury (RSI). These include frequently:
- doing an activity that involves repeated movements with your arm or hand – for example, using a computer, working in an assembly line, playing tennis or golf
- doing an activity that involves lifting or carrying heavy objects
- doing an activity for a long time without taking enough breaks
- working at a poorly designed workstation leading to poor posture
- doing activities that involve working in an awkward or uncomfortable position
- using vibrating equipment such as power tools
Other things can increase your risk of developing an RSI too. For example, if you have a high workload and tight deadlines, this can make you feel stressed. Your risk can also be increased if you’ve had a previous injury, you haven’t trained properly for a particular sport or your equipment isn’t appropriate.
Sometimes, a particular condition – for example, carpal tunnel syndrome or tendonitis – can be caused by a repetitive activity so these are considered RSI conditions.
Symptoms of repetitive strain injury (RSI)
Repetitive strain injury (RSI) can cause a wide range of symptoms including pain and tenderness in your muscles and joints, especially when you do certain activities. It tends to mostly affect your upper limbs, including your arms, shoulders, wrists and hands.
Other common RSI symptoms include:
- aches
- tenderness
- stiffness
- tingling
- numbness
- weakness
- cramp
- burning
- reduced movement in your joints
You may or may not have any physical signs such as swelling, even though it’s painful. Eventually, your symptoms may prevent you doing your work or normal activities at all. But if you make some changes early on, you can help to prevent your RSI from getting worse.
Self-help for repetitive strain injury (RSI)
You don’t always need to seek help from a health professional for repetitive strain injury (RSI). There are lots of things you can do yourself that may help to manage your symptoms.
- Try to have a complete break from activities that trigger your symptoms. You can gradually start to do them again once your symptoms have settled down.
- Cold and heat therapies may help to ease your symptoms. Put an ice pack or ice wrapped in a towel on the affected area to help reduce pain and swelling. You can leave it on for up to 20 minutes at a time. Heat can help to ease muscle pain and stiffness. You could gently hold a heat pack or hot water bottle against the area or have a warm bath.
- Use over-the-counter painkillers, such as ibuprofen and paracetamol to ease your symptoms. But don’t take them regularly without a GP’s advice.
- Raise your injured area up on a pillow until any swelling goes down.
Changes at work
If your symptoms are related to the type of work you do, speak to your manager for support. Employers have a legal duty to prevent RSI at work, and to stop an existing RSI from getting any worse. Your employer may refer you to an occupational therapist or occupational health advisor for help and advice. They’ll look at your working environment and how you work to help find which activity causes your RSI, and ways to control it.
You may need to stop doing the activity that causes your symptoms for a while – or at least reduce the time spent doing it. Your employer may find you different tasks to do while you recover. In the longer term, your employer may suggest some changes to stop your RSI or to try and prevent it in the first place. These may include the following.
- If you work at a desk, making some changes to your workstation or work environment to improve your posture. This might include adjusting your desk height or providing a suitable chair. It might also mean trying a different keyboard or mouse that gives you better support.
- Making sure you use suitable equipment or work tools in order to do your job safely.
- Taking enough breaks or dividing your time between different tasks so you’re not doing one task for too long. You should also have the opportunity to move and stretch.
If you are self-employed, you’ll need to check your own working environment.
Diagnosis of repetitive strain injury (RSI)
If your symptoms don’t go away with the measures in our self-help section above, you may need to ask a health professional for help. A GP or physiotherapist will usually be able to tell that your symptoms are due to repetitive strain injury (RSI) from talking to you about your symptoms. Physiotherapists are often the best health professionals to help with RSI problems. In some areas, you may be able to book an appointment with an NHS physiotherapist without seeing a doctor first. But in others, a GP will need to refer you.14 Or you can choose to pay for private physiotherapy.
If you see a physiotherapist or GP with symptoms of RSI, they’ll ask about your symptoms and examine you. They’ll also want to know about your medical history and what type of work you do. Tell them if you’ve noticed that certain activities seem to cause your symptoms or make them worse. Sometimes, they may suggest you have some tests to rule out other conditions. These may include nerve conduction studies and scans of the affected area.
Treatment of repetitive strain injury (RSI)
Physiotherapy
A physiotherapist can help to restore movement and function in the part of your body that’s affected. It’s usually best to keep moving as much as you can. A physiotherapist can help you to do this in a way that causes the least amount of pain. They’ll also help you to stretch and strengthen any affected muscles to improve your posture.
Physiotherapists may also be able to offer certain therapies to manage your pain, including:
- TENS (transcutaneous electrical nerve stimulation) machines
- ultrasound therapy
Steroid injections
Sometimes, if your pain is severe and other measures haven’t helped, your GP may offer you a steroid injection for repetitive strain injury (RSI). Steroids can reduce inflammation in your tendons and joints and help to ease your pain. These are usually injected around tendons, and can help you to keep moving.
Surgery for RSI
Surgery isn’t usually needed for RSI but it can be an option if you have a health condition such as carpal tunnel syndrome. If your GP suspects your symptoms are caused by something like this, they may refer you to a surgeon who specialises in this area to investigate further.
Physiotherapy services
Our evidence-based physiotherapy services are designed to address a wide range of musculoskeletal conditions, promote recovery, and enhance overall quality of life. Our physiotherapists are specialised in treating orthopaedic, rheumatological, musculoskeletal conditions and sports-related injury by using tools including education and advice, pain management strategies, exercise therapy and manual therapy techniques.
To book or to make an enquiry, call us on 0345 850 8399
Repetitive strain injury (RSI) causes pain and tenderness in your muscles and joints. It mainly affects your upper limbs – including your shoulders, arms, wrists, hands, and fingers. You might get other symptoms including stiffness, tingling, and numbness.
Find out more about how RSI might affect you in our section on symptoms of RSI.
A doctor or physiotherapist can usually tell if you have repetitive strain injury (RSI) based on your symptoms and information about your work and activities. They may only need to do tests to rule out other conditions. You can often manage symptoms of RSI yourself and don’t always need to see a doctor or physiotherapist.
For more information, see our section on diagnosis of RSI.
The most important thing you can do is to stop or reduce the activity that’s causing your symptoms. You may need to make some changes at work to prevent it flaring up again. You can take over-the-counter painkillers and use heat and cold packs to manage your pain. If you need to, you can see a physiotherapist or GP for further treatment.
To find out more, see our sections on self-help and treatment for RSI.
Repetitive strain injury (RSI) doesn’t usually cause permanent damage and most injuries get better after three to six months. But your symptoms may come back if you don’t change how you work or whatever else has caused them. Your employer may refer you to an occupational therapist or occupational health advisor for help and advice.
For more information, see our section on treatment of RSI.
Repetitive strain injury (RSI) is a broader term than tendonitis.
RSI results from doing repetitive movements. It includes:
- more widespread muscle pain (for example in your forearm)
- weakness or lack of coordination in a muscle
- joint pain
- nerve swelling and entrapment
- tendonitis.
Tendonitis is a smaller area of swelling (inflammation) in a specific tendon only. It can make joints painful and stiff, and can affect how well you move.
Carpal tunnel syndrome
Carpal tunnel syndrome is a condition where a nerve in your wrist is under pressure (compressed).
Physiotherapy
Rotator cuff injury
A rotator cuff injury is when you have inflammation or a tear in the muscles and tendons (connecting tissue) in your shoulder.
Tennis elbow
Tennis elbow is a common condition that causes pain around the outside of your elbow.
Trigger finger
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- Rachael Mayfield-Blake, Freelance Health Editor
