What is RSI?

Repetitive Strain Injury: A Growing Problem

RSI is an acronym for "repetitive strain injury," although the name is the subject of much debate, with some in the medical profession preferring the term "cumulative trauma disorder" (CTD). It is also known as "repetitive stress injury," "repetitive motion injury" and "occupational overuse syndrome," but all these terms refer to overuse injuries (1). More recently, organizations like the Workers' Compensation Board have moved towards the all-encompassing term MSI for "musculoskeletal injury"(2).

RSI encompasses a range of conditions brought on by repetitive actions, and as such, can affect many different parts of the body. However, it primarily affects the soft tissues -- muscles, ligaments, tendons, nerves and blood vessels of the upper body: the neck, shoulders, back and upper limbs. Pain in the wrists and fingers due to carpal tunnel syndrome or neck and back pain from poor posture at a workstation can all be termed as RSIs. While carpal tunnel syndrome is the most common RSI, it is only one of many.

There are three types of disorders related to RSI. Tendon disorders include tendinitis, tenosynovitis, stenosing tenosynovitis (trigger finger), De Quervain's disease, lateral epicondylitis (tennis elbow), medial epiocondylitis (golfer's elbow) and rotator cuff tendinitis. Nerve disorders include carpal tunnel syndrome, cubital tunnel syndrome and Guyon's canal. Neurovascular disorders include thoracic outlet syndrome (TOS) and Reynaud's phenomenon (white finger).

Office workers are not the only ones who develop RSI -- anyone who performs repetitive motions, such as assembly line workers and musicians, are also at risk. RSI is an insidious condition ‚ after months or years of performing the same tasks seemingly without difficulty, it can cause problems ranging from a dull, persistent pain to severe disability. Paradoxically, there is no correlation between the number of hours worked per week and the discomfort experienced by the worker (3).

In 2000/01, 10% of Canadians aged 20 or older reported having a repetitive strain injury (RSI) in the previous 12 months that was serious enough to limit their usual activities. (4). This indicates that a substantial number of Canadians suffer from the effects of a repetitive strain injury which should be a cause for concern.

Three Stages of RSI

1. Aches and fatigue during work hours only with no change in work performance. Damage is reversible.

2. Symptoms begin early in work shift and do not resolve overnight. Ability to perform at work is diminished.

3. Symptoms persist while at rest; worker has difficulty performing light tasks (5).

Ergonomics is of most use to individuals in stage one, as early intervention can put an end to symptoms. Stages two and three require both medical intervention as well as ergonomics.

Causes

Repetitive Strain Injury is caused by repetitive, awkward motions that occur over a prolonged period. Over time, the soft tissues are strained or damaged, causing pain and/or poor circulation.

Main risk factors for computer users:

Work pace and repetition, lack of rest breaks, high typing speeds and deadlines.
Awkward postures from poor chair support and worker habits.
Typing with excessive force.
Lack of support for the upper extremities (6).

Symptoms

While not everyone experiences the same symptoms, the common indicators are pain, numbness and tingling, symptoms that often worsen at night.

Fatigue
Lack of endurance
Tingling, numbness or loss of sensation
Frequent clumsiness
Difficulty opening and closing hands
Stiffness
Difficulty using hands (i.e. to turn pages of a book, to put on jewelry or use keys)

Nobody is certain of how much RSI costs both the Canadian and US economy, but estimates are in the billions of dollars. Computer-related injuries cost employers in numerous ways, not only in lost wages and productivity, but also through medical treatment and the rehabilitation of the injured worker.