Upper limb pain in association with work is common.

The term RSI encompasses a variety of signs and symptoms in the neck, shoulders, elbows, wrists and fingers attributed to, or made worse by, repetitive movements and/or constrained postures in the workplace. Other synonyms include Repetitive Motion Injury (RMI), Cumulative Trauma Disorder (CTD), Painful Regional Occupational Disorder (PROD), Occupational Overuse Syndrome (OOS), Work-related Repetitive Movement Injury (WRRMI) and Work-related Upper Limb Disorder (WRULD).

Specific clinical conditions which could be RSI include Epicondylitis (elbows), de Quervain’s disease (thumbs), carpal tunnel syndrome (wrists), tenosynovitis and peritendonitis crepitans (shoulders and forearms).

Symptoms and signs of RSI:

Persistent pain and discomfort of muscles, tendons or soft tissues of the limbs
Swelling and tenderness of inflammation
Crepitus (creaking) of tendons
Tingling and numbness of fingers
The symptoms of RSI can be acute, recurrent or chronic

Contributory factors:

Occupational:

i. Repeated, frequent movements of the arms over a prolonged period

ii. Awkward postures and/or postures at the extreme range of shoulder, elbow or wrist joint movement

iii. Static load – using the arms to support weight for sustained periods

Non-occupational:

i. Hobbies, household chores, computer games etc.

ii. Previous injury of the same site

iii. Individual susceptibility – some people more prone to RSI
than others

iv. Psychological overlay (psycho-social stress, bullying etc.)

v. Financial compensation

Treatment of RSI:

Treatment depends on the severity, site and clinical features. Procedures which have been tried include:

i. surgery

ii. rest and immobilisation

iii. physiotherapy

iv. painkillers

v. local anaesthetic/steroid injections

vi. ultrasound

vii. friction massage

viii. acupuncture

ix. osteopathy