What causes repetitive strain injury?
The main cause is frequent and repetitive movements of a part of the body - for example, typing, using a computer mouse a lot, etc. Other factors may contribute, such as poor posture whilst doing the movement, using excessive force whilst doing the movement and not having enough breaks from the task.
However, the precise reason why repetitive strain injury (RSI) develops is not clear. In many cases there is no swelling or inflammation and there are no other obvious problems which develop in the muscles or tendons, and yet symptoms develop. Also, it is not clear why some people develop RSI and not others who do the same repetitive tasks.
Research suggests that psychosocial workplace factors (which usually means stress at work) can also contribute to RSI. It may be that stress increases muscle tension and/or affects how the body feels pain in general.
How is repetitive strain injury diagnosed?
There is no test that a doctor can do to diagnose repetitive strain injury (RSI). This is where difficulties may arise. Pains in the areas affected by RSI are common and can be due to various causes.
If you develop a well-defined condition, such as carpal tunnel syndrome, frozen shoulder, tendinopathy, etc, it may or may not be related to repetitive tasks. Biomechanics may help to sort this out. Biomechanics use the science of mechanics to study the way various parts of the body move. In certain sports, for example, biomechanics have discovered that people sometimes overstretch their muscles when doing various movements, such as kicking a football. Some wheelchair users have been found to jerk their shoulders when manually propelling their chairs, leading to persistent pain in the joint. This sort of information can help to plan treatment strategies.
Blood tests are sometimes done to rule out inflammatory joint disease. X-rays, scans or nerve conduction tests may be needed if surgical treatment of a Type 1 condition is being considered. Otherwise, the diagnosis is usually made on the basis that the condition developed only following a repetitive task and is relieved or partially relieved by rest from that task.
Further reading and references
Ageing and work-related musculoskeletal disorders. A review of the recent literature; Health and Safety Executive, 2010
Waersted M, Hanvold TN, Veiersted KB; Computer work and musculoskeletal disorders of the neck and upper extremity: a BMC Musculoskelet Disord. 2010 Apr 2911:79.
Wan B, Shan G; Biomechanical modeling as a practical tool for predicting injury risk related to repetitive muscle lengthening during learning and training of human complex motor skills. Springerplus. 2016 Apr 125:441. doi: 10.1186/s40064-016-2067-y. eCollection 2016.
Verhagen AP, Bierma-Zeinstra SM, Burdorf A, et al; Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults. Cochrane Database Syst Rev. 2013 Dec 12(12):CD008742. doi: 10.1002/14651858.CD008742.pub2.
Bruls VE, Jansen NW, de Bie RA, et al; Towards a preventive strategy for complaints of arm, neck and/or shoulder (CANS): the role of help seeking behaviour. BMC Public Health. 2016 Nov 2816(1):1199.
Varatharajan S, Cote P, Shearer HM, et al; Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. J Occup Rehabil. 2014 Dec24(4):692-708. doi: 10.1007/s10926-014-9501-1.
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