Repetitive strain injury (RSI) is a common complaint that we see at Specialist Pain Physio Clinics as it is often reported as persisting or recurring. There is a spectrum from those suffering mild symptoms to those who have had to stop working due to pain and other signs and symptoms of RSI. The term describes what has happened in essence but we know more about how and why this problem occurs and continues therefore allowing for more effective treatment and management. The overall aim is to reduce symptoms and restore function, usually including a return to work.
- Pain: e.g./ sharp, dull, achy, spontaneous, shooting, throbbing
- Altered sensation: pins & needles, numbness, crawling
- Altered perception of the limb, including size
- Temperature change
- Altered movement including being unable to grip, type, write, hold or perform fine motor skills (buttons, picking up small objects)
- Altered joint position sense (unaware of where a body part is in space and where it is going, hence a loss of accuracy)
For normal tissue health the brain relies upon a regular flow of information about current status. There is a huge network of nerves performing this task. This information includes ‘online’ data about movement. However, with smaller movements such as typing, the brain does not register the movement as accurately. Essentially a mismatch can develop between what is expected and the information coming in. We know that this kind of sensorimotor mismatch can lead to the development of sensitivity. Subsequent to this sensitivity build up, the same nerve network can release chemicals into the tissues and provoke a host of symptoms. This is called neurogenic inflammation.
It is feasible that ‘overuse’ can lead to a breakdown of tissue via an imbalance that develops when the natural breakdown-rebuild process tips in the favour of the former. If an inflammatory process starts, the chemicals released cause sensitivity to develop. This can evolve into a greater problem over time if the tissues do not have the opportunity to heal adequately.
An inflammatory process that develops in the neck can cause a nerve to become sensitised with subsequent pain being felt in the tissues that the nerve supplies, in the hand for example. This is referred pain and can cause altered use of the limb that in itself leads to further problems of disuse and pain.
There are a range of conditions that can come under the repetitive strain banner:
- Cubital tunnel syndrome
- Carpal tunnel syndrome
- DeQuervain’s syndrome
- Diffuse RSI
- Dupuytren’s contracture
- Dystonia (writers cramp)
- Gamekeeper’s thumb
- Raynauds disease
- Thoracic outlet syndrome
At Specialist Pain Physio we will ascertain the cause through the assessment along with the type(s) of pain so that we can provide the right treatment programme and advice. We work with you to restore function and relieve the symptoms.
Return to work
We provide return to work strategies that includes visiting your workplace and talking to your employer or occupational health department.