Osteopathy for Repetitive Strain Injury (RSI)

TMJ and jaw pain can be treated with osteopathy

Repetitive strain injury (RSI) has been with us for thousands of years. However more recently it has become far more prevalent, affecting not only keyboard operators, but also musicians, carpenters, factory workers, in fact anyone whose job involves long hours of repetitive movements.

What is RSI?

RSI usually begins with mild pain, which gets worse as the day goes on. It may ease on your days off, but will reappear when you go back to work. As the condition progresses, the pain will appear earlier and earlier in the day, and then will start to affect other everyday activities involving fine movements of your hands and fingers.

The pain of RSI can be severe and long term and may be accompanied by numbness, tingling, weakness and cramps. In the most serious cases, it causes a loss of grip strength. Without treatment, it may progress until you are unable even to hold a cup of coffee or turn the pages of a book.

Repetitive strain injury includes a number of disorders which are caused by repetitive movements. These include tennis elbow, tendinitis, tenosynovitis and de Quervain’s syndrome. Over time, repetitive overuse of a muscle may lead to fatigue, inflammation and pain in the muscle or its tendon. It may also affect the joints of the wrist and hand, leading to inflammation and eventually arthritis.

Inflammation of the tendon is known as tendinitis. The tendons in our hands move within a lubricated sheath, which reduces friction. In severe cases of RSI, this sheath becomes inflamed and you will feel a crackling sensation as you move your finger. This is known as tenosynovitis. More recently a condition known as diffuse RSI has been identified. This is due to nerve damage, and causes widespread pain, with numbness, tingling and loss of grip.

What Causes Repetitive Strain Injuries?

RSI is caused by a variety of factors including repetitive movements, badly designed workstations and prolonged periods of work without adequate breaks. However not everyone will develop RSI under these conditions. You are more likely to develop RSI if you have poor posture or if reduced mobility in your elbow or shoulder forces your wrist to compensate.

What about Tennis Elbow and Golfer’s Elbow?

Tennis elbow isn’t just for tennis players. It can also occur in builders, bricklayers and people who spend a lot of time at their computer. It’s characterised by pain on the outside of the elbow (the same side as your thumb), and it is caused by inflammation in the part of the tendon which is attached to the bone – it’s known as lateral epicondylitis, as it is the lateral epicondyle where the tendon attaches. You may also notice pain and tension in the forearm muscles which you use to extend your wrist (ie pull your hand up).

Golfer’s elbow is the same type of problem, but it occurs on the other side of the elbow, and is related to tension in the muscles you use to flex your wrist.

If you are suffering from tennis or golfer’s elbow, it is worth investing in a good quality brace, such as the Epi-Med Elbow Epicondylitis Clasp. This takes the strain off the epicondyle, by “clamping” the tendon to the bone just below the elbow.

How can I avoid a repetitive strain injury?

  • Split your work up and change from one task to another, rather than concentrating on one job all day.
  • Take a 10 minute break at least hourly, stand up and do some stretches. If possible install a programme on your computer such as KAZ or WorkRave, which will remind you to take breaks.
  • Learn to touch type if you work on a keyboard. This uses all your fingers and enables you to look upwards instead of down.
  • Adjust the height of your chair relative to your desk, so that your hips, knees, shoulders and elbows are at 90° . If your feet do not reach the floor, find something to rest your feet on. Sit close enough to the desk so you can rest your hands on the keyboard and make sure your lumbar spine is supported.

What should I do if I start to develop RSI?

    • If you do start to feel pain in your hand, arm or neck, reduce the time you spend on the activity which is causing the pain, and take extra breaks.
    • Visit an osteopath or other health professional to get treatment and advice. Remember you should seek professional help as soon as possible, because these problems are easier to correct if they are caught early.
    • Taking pain-killers is not the answer. It simply masks the pain and allows you to carry on working, causing further injury. However you may ice the sore area for 10 minutes when you’ve finished work to reduce inflammation.
    • Wear a wrist brace at night, to keep your wrist straight. This will aid repair of the injured tissues. Put the brace on fairly loosely so as not to reduce circulation.
  • Eat plenty of fruit and vegetables (raw or lightly cooked) as nutrition is important for healing. Drink more water and less tea and coffee. It is important not to become dehydrated.

Links and Resources for RSI