Repetitive Strain Injury (RSI)

Common symptoms of RSI include:

• Pain
• Swelling
• Tingling
• Pins and needles
• Numbness
• Stiffness
• Muscle cramps
• Weakness
• Sensitivity to cold or heat
• Reduced movement in the joints

Repetitive strain injuries are caused by continuous, repeated movements of a part of your body. They are commonly work related but may also be caused by the overuse of technology or repeated actions performed during certain sports.

Common causes of RSI include:

• Repetitive movements at work like typing, working on an assembly line, hairdressing, or painting
• Regular use of vibrating power tools
• Sports that involve repetitive movements, for example tennis or golf
• Poor posture when standing or sitting for long periods
• Regularly lifting or carrying heavy objects
• Regularly working in an unnatural or uncomfortable position
• Working for long periods without taking a break
• Working in cold temperatures
• Excessive use of technology such as video games and mobile phones
• Emotional and psychological stress

Types of repetitive strain injury

Some common types of repetitive strain injury include:

• Carpal tunnel syndrome
• Bursitis
• Rotator cuff tendonitis
• Tennis elbow
• De Quervain's syndrome
• Stenosing tenosynovitis (trigger finger)

Risk factors for repetitive strain injury

The various risk factors for RSI can be broadly categorised as occupational, non-occupational, and psychosocial.

Occupational risk factors

Doing certain jobs can increase your risk of developing an RSI. Jobs that involve continuous repeated movements, poor posture or staying in an uncomfortable position for prolonged periods of time can cause cumulative damage to the muscles, tendons or nerves.

Jobs that commonly lead to an RSI include typing, painting, and working on a supermarket checkout or factory conveyor belt.

Psychosocial factors

Studies have found that psychosocial factors including workplace environments with poor physical conditions, high workload and negative relationships with co-workers appear to increase the risk of RSI.

Non-occupational factors

Other risk factors include:

• Age - the risk of developing RSI increases as you age
• Sex - RSI is more common in women than in men
• Smoking
• Obesity
• Alcohol consumption
• Diabetes

Home treatments

Some things you can do at home to help ease symptoms of RSI include:

• Take over-the-counter painkillers like paracetamol and ibuprofen, or apply painkilling gels to the affected area
• Apply heat or ice packs wrapped in a cloth to the affected area for around twenty minutes every two to three hours
• Rest the affected body part for a few days before gradually increasing your activity. Not using the affected body part for too long can cause stiffness and weakness, so keep as active as possible
• Immobilise the affected body part in a splint or elastic support bandage
• If your RSI is work-related, talk to your employer about making changes to your work environment

Physiotherapy

Physiotherapy is normally the best way to treat a repetitive strain injury that hasn't responded to home treatments.

Once your consultant has made a diagnosis of RSI and established the underlying cause, you may be referred to our expert team of physiotherapists for treatment.

Physiotherapy for RSI may include:

• Advising on changes to your work environment like raising your chair, desk, or screen height to improve your posture
• Encouraging regular breaks during work hours
• Exercises to improve strength and flexibility, increase blood flow and improve posture
• Massage to the affected area
• Pain management techniques such as ultrasound and the use of transcutaneous electrical nerve stimulation (TENS) machines

Steroid injections

If pain is severe and other treatments haven't worked, your consultant may recommend steroid injections. Steroid injections work by reducing inflammation in your joints, relieving pain, and making movement easier.

Steroids can provide effective short-term pain relief but should not be used for long periods of time as they can cause unpleasant side effects.

Surgery

Surgery may be an option for certain types of RSI such as carpal tunnel syndrome, tennis elbow and cubital tunnel syndrome where non-surgical treatments have been ineffective.

Most RSIs are work-related and it's important to get the support of your employer to take steps to prevent them. In the UK, your employer has a legal duty to provide safe working conditions and protect employees from injury including repetitive strain injury².

Some things you can do at work to prevent RSI include:

• Make sure your desk, chair and screen are ergonomically designed to ensure the best posture when working. Your lower back should be supported, your thighs parallel to the floor and your feet flat on the floor
• Keep your wrists, arms and fingers aligned when typing and avoid bending your wrists
• Use a wrist rest when typing
• Avoid hitting keys too hard when typing. Touch typing, speech-to-text functions and using keyboard shortcuts can help
• If your job involves spending a lot of time on the phone, use a headset to avoid straining your neck, shoulders, and arms
• Make sure your work environment is at a comfortable temperature
• Try to maintain a good posture when sitting or standing
• Take regular breaks
• Stand up and stretch frequently
• Wiggle your fingers and flex your wrists regularly
• Rest your eye muscles by looking away from your computer screen every so often and focusing on an object in the distance
• Optimise your general health by eating a healthy, balanced diet, taking regular exercise, not smoking, and taking steps to reduce stress

Your consultant will ask you some questions about your symptoms, medical history, and the type of work you do. Tell your consultant if your symptoms are triggered or made worse by certain activities.

They will perform a physical examination to check your range of movement, muscle strength, and reflexes and look for signs of inflammation or tenderness.

Most repetitive strain injuries can be diagnosed based on your symptoms and physical examination. In some cases, your consultant may arrange for tests such as an X-ray, ultrasound, MRI, or nerve conduction studies to establish the cause of your RSI.

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible during your time with us, so please ask your consultant any questions you may have.

At the end of your appointment, your consultant will discuss possible treatment options with you and decide on the best option based on your diagnosis.

Is repetitive strain injury permanent?

RSI normally develops gradually, and symptoms may be ignored leading to worsening of the condition and permanent damage. If caught early, RSI usually resolves with treatment. If you have symptoms of RSI make an appointment with a specialist as soon as possible to ensure early diagnosis and treatment.

Does repetitive strain injury go away on its own?

RSI doesn't normally go away on its own while you continue the movements that caused it to develop in the first place. In many cases, if you stop or modify the movements that caused the RSI, the condition will improve. In more severe cases, medications, physiotherapy or surgery may be necessary.

Can repetitive strain injury cause arthritis?

RSI is damage to the soft tissue such as the muscles, tendons, and nerves, while arthritis is inflammation of the joints. While RSI itself does not cause arthritis, the things that trigger RSI such as repetitive movement, strain and wear and tear on the body can also cause arthritis.

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If you would like to see a consultant or learn more about treatment for repetitive strain injury, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in February 2023. Next review due February 2026.

1. Repetitive strain injury (RSI) , NHS
2. Repetitive strain injury (RSI) explained, Medical News Today
3. Everything You Should Know About Repetitive Strain Injury (RSI) , Healthline
4. Repetitive strain injury, British Medical Journal
5. RSI in the Workplace inc Work Related Upper Limb Disorder and Computing, AbilityNet