Published by Bupa's Health Information Team, August 2011.

This factsheet is for people who have repetitive strain injury (RSI), also known as upper limb disorders, or who would like information about it.

RSI is a general term that refers to pain in any part of the upper body caused by overuse or poor posture. RSI commonly affects the arms, elbows, wrists, hands, fingers, neck, shoulders or upper back.
 

About RSI
Symptoms of RSI
Causes of RSI
Diagnosis of RSI
Treatment of RSI
Prevention of RSI
Video
 

About RSI

RSI describes a painful condition generally associated with doing a particular activity repeatedly or for long periods of time. It often occurs as a result of working with computers and typing or repetitive manual work, but you can also develop it if you don't regularly carry out these sorts of tasks.

The term RSI covers a number of muscle-related injuries that can affect your hands, arms and upper body. RSI can be categorised as type 1 and type 2. Type 1 RSI means the disorder is a recognised medical condition, such as:

  • tendonitis – inflammation of a tendon (the tissue that joins muscles to bones)
  • carpal tunnel syndrome (pain or weakness in the forearm or hand)
  • tennis elbow
  • rotator cuff syndrome (shoulder pain)
  • Dupuytren's contracture (a condition that causes the fingers to bend towards the palm of your hand)
  • writer's cramp (cramp of the hand)

With type 2 RSI, either your symptoms don't fit with those of a recognised medical condition and a doctor can't find any inflammation or swelling, or the pain doesn't stay in one area. This is also known as non-specific or diffuse pain.

There are different stages of RSI and the earlier it's treated the greater your chance of making a full recovery. The longer you leave your symptoms untreated, the harder it is to treat RSI. It can develop into a chronic pain condition. When describing a condition, the term 'chronic' refers to how long a person has it, not to how serious a condition is.
 

Symptoms of RSI

RSI has a wide range of symptoms including pain and tenderness in your muscles and joints. You will probably notice symptoms most when you're doing the activity that caused them.

Symptoms that occur in your upper body include:

  • a sharp or a dull ache
  • stiffness
  • tinglin
  • numbness
  • weakness
  • cramp

The pain may get worse so it's there all the time, even when you're resting. It may get so bad that you aren't able to do routine work or household activities. If you're in constant pain, you may find it difficult to sleep.
It's important to see your doctor as soon as you notice any pain in a particular area that lasts for more than a couple of weeks.

You may have some swelling but it's also possible you won't have any other symptoms, even though your hand or arm feels painful.

  Causes of RSI

There are a number of things that can increase your risk of developing RSI. These include:

  • repetitive activities
  • doing an activity that involves force, such as lifting or carrying heavy objects
  • carrying out an activity for a long period of time without adequate rest periods
  • poor posture or activities that require you to work in awkward or tiring positions
  • using vibrating equipment
  • working in a cold environment

It's important that your working environment (for example, your desk layout or assembly line set-up) is designed so you can work with your body upright and without having to twist or stretch. See our video for more information about organising your workstation. Working with your arm raised above your head or sitting in a fixed position for long periods of time may increase your risk of developing RSI.

A wide variety of jobs may lead to RSI, such as data entry or typing, working on an assembly line or on a supermarket checkout. Therefore, it's important for you to take steps to prevent getting RSI. Speak to your employer about this.
Some people find their pain is linked to stress, which may be work-related.
 

Diagnosis of RSI

Your doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history. If you have type 1 RSI symptoms, your doctor will be able to identify specific recognised conditions, such as carpal tunnel syndrome, when you describe your symptoms and by examining you.

If you have type 2 RSI symptoms, diagnosis is more difficult. Your doctor may refer you for an X-ray to rule out any other conditions that could be causing your pain, such as osteoarthritis. If a recognised condition can't be confirmed, you may be diagnosed with type 2 RSI.

Please note that availability and use of specific tests may vary from country to country.
 

Treatment of RSI

There is no single treatment for RSI. However, there are often specific treatments for recognised RSI type 1 conditions. If you're diagnosed with a particular condition, follow the recommended treatment. This may involve self-help treatments, physical therapy (physiotherapy), steroid joint injections into the affected joint, or possibly surgery.

Doctors are less clear about how to treat type 2 RSI and there is little scientific evidence about which treatments are effective.

You may be referred to a physical therapist (physiotherapist) – a health professional who specialises in maintaining and improving movement and mobility – to teach you exercises to help build up strength in the affected muscles and for advice about ways to improve and strengthen your posture.

Self-help

Although you should try to rest the affected area regularly, it's not helpful for you to rest for long periods as this can weaken your muscles. Gently massaging and moving the affected limb stimulates circulation and can prevent your muscles from weakening.

Look at your working environment and how you work to try to find out what activity if causing the problem. Carry on working if you can, but try to take steps to reduce how much time you spend doing this activity or change how you do it. If you can't stop doing it completely, take regular, short breaks to stretch and move your arms and hands.

Divide up your time by doing different tasks so that you don't spend long periods of time doing the same thing.

You may find it helpful to learn to touch type if you use a keyboard regularly. This will enable you to keep looking straight ahead and not down or to the side.

Exercise such as swimming, Pilates or yoga may help to ease your symptoms.

You may find it helpful to talk to other people with RSI as they may be able to offer advice and suggest things that could improve your symptoms.
 

Medicines

Medicines generally aren't helpful in treating RSI, although your doctor may recommend over-the-counter painkillers or non-steroidal anti-inflammatory medicines. These could be gels or creams that you rub into the painful area, or tablets that you swallow.

Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

However, it may not be a good idea to take painkillers regularly. This is because they dull the pain and allow you to carry on doing the harmful activity, aggravating your RSI.

If you're having trouble sleeping, you may be prescribed sleeping tablets. This will only be for a few days because there is a risk of you becoming dependent on them.

 

Complementary therapy

Although there is no evidence to suggest that complementary therapies can successfully treat RSI, some people say that techniques such as massage and osteopathy ease their symptoms and help them to relax.

Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.
 

Prevention of RSI

Your work area should be suitable and comfortable for you. The risk of an accident or injury occurring should be reduced as much as possible.

If you use a computer, make sure:

  • your chair supports your back and you sit up straight
  • your chair is the right height for you; if not use a footrest
  • your monitor is around 60cm from your eyes
  • your screen, keyboard and mouse are directly in front of you, with the mouse as close to the keyboard as possible
  • when you type, your arms aren’t extended forwards, your forearms are horizontal and your fingers are at the same height as the middle row of keys
  • your legs have room to move under the desk or table
  • you only use a wrist rest when having a break from typing. Don't place your wrists on it while typing.

 
If you have been off work because of RSI, when you return try not to do the activity that causes your pain. You may need to modify your job when your pain is severe. Take regular breaks and alternate tasks to prevent long periods of repeating the same movement.
 

Video

See our videos related to repetitive strain injury (RSI):

Organising your work station

Posture

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
 
Is there a difference between RSI and an upper limb disorder?
I think I have RSI. What help can I expect from my employer?
Are there early symptoms of RSI that I should look out for?
My son spends hours on his games console and texting. Is he at risk of developing RSI?
 
 

Is there a difference between RSI and an upper limb disorder?

 

Answer

The two terms broadly refer to problems affecting the upper back, neck, shoulders, arms, elbows, wrists, hands and fingers. Repetitive strain injury (RSI) and upper limb disorders (ULDs) cover around 20 conditions.

 
Explanation

The terminology can be confusing. Different organisations and publications often use different terms for the same conditions, for example, the Health and Safety Executive uses RSI to refer to pain in the arm caused by working on computers. But RSI and ULDs can be used to describe the same group of medical conditions. You may also see the same conditions referred to as work-related upper limb disorders (WRULDs), overuse injuries or musculoskeletal disorders.
 
These conditions are grouped together as they affect your upper limbs. Examples include tennis elbow (epicondylitis), carpal tunnel syndrome, tendonitis and frozen shoulder (adhesive capsulitis).
 
H3 Further information
Health and Safety Executive
0845 345 0055
www.hse.gov.uk
 

Sources

 

I think I have RSI. What help can I expect from my employer?

Answer

Report any possible RSI symptoms to your employer as soon as possible, as carrying on can make things worse. By law your employer must offer you help.

Explanation

Your employer has a legal duty under the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work Regulations 1999 to prevent work-related RSI, and to stop RSI from worsening. You need to talk to your manager, human resources department or the occupational health department. It may make it easier for your employer to help you if your GP can give you a specific diagnosis, but often this won’t be possible.  
 
Ask your employer to carry out a proper risk assessment in consultation with you. This means they need to:
 

  • observe you doing your job, whether it’s sitting at a computer, on a factory production line or at a supermarket checkout
  • look at your posture, how you use any equipment and the amount of work you do
  • ask about your problems in detail

 
You may need to take time off work, but once you begin to feel better it can help to get back into work, gradually building up your hours. Always take medical advice about what is best for you. Following your assessment, your employer should give you specific advice. This may involve changing your duties or the way you work.
 

Further information

Health and Safety Executive
0845 345 0055
www.hse.gov.uk
 
RSI Action
www.rsiaction.org.uk
 

Sources

  • What people with RSI need from employers. RSI Action. www.rsiaction.org.uk, accessed 23 April 2009
  • Aching arms (or RSI) in small businesses. Health and Safety Executive. www.hse.gov.uk, accessed 16 July 2009

Are there early symptoms of RSI that I should look out for?

 Answer

Yes, but many people don't realise that they have RSI until their symptoms have worsened. Early symptoms can include mild tingling, aching or twinges in your fingers, hands or arms, usually towards the end of a long day at work.

 
Explanation

It can be difficult to know what is happening to you when you first have symptoms of RSI. It's really important to take action. Ignoring any pain you have and carrying on as normal can make things worse. As soon as you notice any possible RSI symptoms talk to your employer and your GP. The symptoms of RSI can progress to cause disabling pain. Your exact symptoms will vary depending on the specific RSI condition you have.
 

Further information

RSI Action
www.rsiaction.org.uk

 
Health and Safety Executive

0845 345 0055
www.hse.gov.uk

 
Sources

  • What people with RSI need from employers. RSI Action. www.rsiaction.org.uk, accessed 23 April 2009

  • Repetitive strain injury – what is it? RSI Action. www.rsiaction.org.uk, accessed 23 April 2009

  • Aching arms (or RSI) in small businesses. Health and Safety Executive. www.hse.gov.uk, accessed 16 July 2009

My son spends hours on his games console and texting. Is he at risk of developing RSI?

 Answer

Potentially, but there are things you can advise him to do to lessen his risk.

Explanation

Any movement of your hand or arm that is repeated over a long period of time can put you at risk of developing RSI. Using games consoles and texting on mobile phones all involve repetitive movements, so it's important to follow advice about preventing RSI. This includes:
 

  • taking regular breaks every half an hour to give your muscles and tendons a rest – flex your fingers and stretch out your arms, and try to keep your back straight

  • trying not to hunch over the console with your head tilted back to look at the screen

  • not keeping your hands and arms rigid when your fingers and thumbs move at speed

  • being aware of how you hold your mobile phone, for example, holding it in one hand and using a claw position with your thumb moving over the keys quickly can strain your arm tendons

  • giving your hand and thumb a quick massage when texting, and rotating your hand at your wrist one way and then the other

 
 
If your child already has symptoms of RSI, such as tingling and soreness, don't ignore them. Make an appointment with your GP. Keep notes on times when they have the pain or other symptoms, and on how long they spend on the games console, computer or mobile phone.
 

Further information

RSI Action
www.rsiaction.org.uk                        
 
Royal Society for the Prevention of Accidents (RoSPA)
0121 248 2000
www.rospa.com
 
AbilityNet
0800 269 545
www.abilitynet.org.uk
 

Sources

 

Related topics

Repetitive strain injury (RSI)
Back pain
Carpal tunnel syndrome
Rotator cuff injury
Tennis elbow
 
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
 
Publication date: September 2009.
 
Repetitive strain injury (RSI) factsheet

Related topics

Acupuncture
Back pain
Carpal tunnel syndrome
Osteopathy
Rotator cuff injury
Tennis elbow
 

Further information

Health and Safety Executive
0845 345 0055
www.hse.gov.uk
 
RSI Awareness
www.rsi.org.uk
 
RSI Action
www.rsiaction.org.uk

AbilityNet
0800 269545
www.abilitynet.org.uk
 

Sources

  • Aching arms (or RSI) in small businesses. Health and Safety Executive. www.hse.gov.uk, accessed 16 May 2011
  • Conditions and RSI. RSI Awareness. www.rsi.org.uk, accessed 16 May 2011
  • RSI - What is it? RSI Action. www.rsiaction.org.uk, accessed 16 May 2011
  • Repetitive strain injury. WorkSMART. www.worksmart.org.uk, accessed 8 August 2011
  • Reducing the risk of upper limb disorders (ULDs) in the workplace. Health and Safety Executive. www.hse.gov.uk, accessed 13 May 2011
  • Minimising risks: stress management. RSI Awareness. www.rsi.org.uk, accessed 31 May 2011
  • Carpal tunnel syndrome - management. Clinical Knowledge Summaries. www.cks.nhs.uk, published October 2008
  • Tennis elbow - management. Clinical Knowledge Summaries. www.cks.nhs.uk, published December 2008
  • Working with VDUs. Health and Safety Executive. www.hse.gov.uk, accessed 16 May 2011
  • Computer safety. Royal Society for the Prevention of Accidents. www.rospa.com, accessed 16 May 2011
  • Guide for young people: how to avoid RSI. RSI Action. www.rsiaction.org.uk, accessed 16 May 2011

This information was published by Bupa’s health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: August 2011

 

Related articles

Anger – you’ve probably experienced it at some point and to varying degrees in your life. It’s a natural human emotion like happiness, sadness and fear, and for...
This factsheet is for people who have back pain, or who would like information about it. Back pain usually affects the lower back. It can be a short-term problem, lasting a few...