Repetitive Strain Injury Treatment

• Pain: Typically this is the first and most prominent symptom. It’s often starts as a diffuse aching but can also be sharp and intense, and worsens with continued activity.
• Stiffness: This is a common symptom that causes restricted mobility and difficulty moving the affected joints through their normal range. It gets more pronounced with inactivity.
• Weakness: Muscular weakness in the affected limb is common and results in difficulty exerting normal strength when grasping or lifting objects.
• Numbness and Tingling: Sensations like “pins and needles” or reduced feeling in the fingers or hands can be caused by inflammation or nerve compression.
• Reduced Coordination: Clumsiness, impaired dexterity and dropping objects can indicate nerve impairment.
• Swelling: Localized swelling, redness and warmth around affected joints indicates inflammation.
• Crepitus: Grating, cracking or popping sounds when moving affected joints indicates cartilage, tendon or a soft tissue injury.
• Triggering: Catching or locking of fingers when bending them is a common characteristic of trigger finger.

Symptoms often start gradually and become worse over time. They’re frequently activity-related, improving with rest but returning when you resume the aggravating motions. Early diagnosis and intervention is your best chance of avoiding long-term damage.

There are many different types of RSIs depending on the location and nature of the injury. Some of the most common repetitive strain injuries include:

Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the narrow carpal tunnel at the wrist. Symptoms include numbness, tingling, weakness and pain in the thumb, index, middle and ring fingers. Carpal tunnel often occurs in people who perform repetitive hand motions like typing or manufacturing work.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow refers to inflammation of the tendons that attach to the bony lump on the outside of the elbow. Pain occurs on the outer side of the elbow and can radiate into the forearm and wrist. It’s commonly caused by repetitive movements, like grasping and twisting motions of the forearm. Interestingly enough, despite the name, tennis players account for less than 5% of cases.

Golfer’s Elbow (Medial Epicondylitis)

This type of elbow injury affects the tendons on the inner side of the elbow instead of the outer side. Pain occurs at the bony lump on the inner elbow and can radiate into the forearm. It’s often caused by repetitive wrist flexing or forearm twisting. As with “tennis elbow”, the term “golfer’s elbow” is a bit of a misnomer since it can be caused by any activity requiring repetitive elbow movements.

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis involves inflammation and irritation of two key thumb tendons as they pass through the first dorsal compartment of the wrist. Symptoms include pain at the base of the thumb that worsens with grasping or thumb motions. It’s often caused by repetitive movements such as pinching, grasping, twisting and other hand motions. It’s commonly experienced by new mothers repeatedly lifting and caring for their baby. 

Trigger Finger

Trigger finger (stenosing tenosynovitis) causes pain, catching, locking and popping sensations in the affected finger(s). It occurs when inflammation thickens the pulley tendons, preventing smooth gliding through the sheath. Forceful, repetitive grasping is often the cause. It can affect any finger, but most commonly the thumb, ring and middle fingers. Prompt diagnosis and treatment is important to relieve locking and improve function.

Guyon’s Canal Syndrome

Guyon’s canal syndrome refers to compression of the ulnar nerve as it passes through the Guyon’s canal section of the wrist. It causes numbness, tingling and muscle weakness in the ring and little fingers. It often occurs in cyclists from repetitive gripping and vibration, but also results from occupations with repetitive tasks using similar hand motions.

Extensor Tendinopathy

Extensor tendinopathy refers to wear-and-tear damage and degeneration of the extensor tendons on the back of the forearm that pull the wrist, fingers and thumb backwards. It’s caused by repetitive motions like typing, gaming, cleaning, production work and playing instruments. Extensor tendinopathy leads to a dull ache and soreness on the back of the forearm, wrist or hand. 

Flexor Tendinopathy

Flexor tendinopathy is similar to extensor tendinopathy, but it affects the flexor tendons on the palm side of the forearm. It causes an ache and soreness in the palm or underside of the forearm from overuse through repetitive grasping and gripping motions. It’s common in manufacturing workers, cleaners, mechanics, construction workers and those in similar occupations.

Myofascial Pain Syndrome

Myofascial (muscle) pain syndrome occurs when the overuse of certain muscle groups leads to the development of trigger points – highly irritable taut bands within the muscle fibres. It’s most common in the forearms, shoulders, neck and back through repetitive manual work and computer use. Myofascial (muscle) pain syndrome causes localized pain that can restrict movement and radiate in characteristic patterns.

Thumb Osteoarthritis

Repetitive use of the thumb over many years can accelerate wear-and-tear osteoarthritis of the thumb joints. It causes painful, stiff and swollen thumb joints that are exacerbated by pinching and grasping activities. This type of osteoarthritis is more common in middle-aged and older adults as cartilage gradually thins over time.

Rotator Cuff Tendinopathy

Repetitive reaching, lifting and overhead motions can lead to fraying and inflammation of the rotator cuff tendons in the shoulder. This causes pain and weakness that worsens with shoulder use. It’s common in manual workers and athletes who perform a lot of overhead activity.

There are a number of factors that can contribute to the development of repetitive strain injuries:

• Repetitive Motions: Performing the same hand, wrist, elbow or shoulder motions over and over again throughout the day (e.g., typing, using a mouse, grasping tools, etc.) can fatigue tissues and impair healing.
• Awkward Postures: Working with your wrists bent or reaching overhead for long periods puts strain on your muscles and joints. Static postures can also pinch nerves and reduce blood flow.
• Excessive Force: Gripping, pinching, pulling, lifting or carrying heavy objects forces soft tissues beyond their physical limits.
• Localized Pressure: Pressing against hard or sharp edges (like resting wrists on a desk) compresses your nerves and tendons.
• Vibration: Exposure to vibrating hand tools and machinery increases your risk by constricting blood vessels and damaging tissues.
• Cold Exposure: Prolonged exposure to cold air reduces your circulation and makes your tissues more prone to injury.
• Underlying Medical Issues: Conditions like rheumatoid arthritis, diabetes and thyroid disorders increase your vulnerability.

Combinations of these factors along with inadequate rest periods often underlie many RSIs. Genetics and hand dominance can also play a role in some cases. True acute traumas like falls and impacts which cause different injury patterns are much less common.

Common Activities That Lead to a Repetitive Strain Injury

Any repeated motions using your hands, wrists and arms can contribute to an RSI when done over long periods of time without rest. Common higher risk activities include:

• Computer Work: extensive typing, mouse use, small keyboarding
• Assembly or Manufacturing Work: repetitive motions in factories or on production lines
• Construction or Trade Work: hammering, sawing, digging, lifting
• Cashier Work: scanning goods, making change, bagging items
• Food Service Work: chopping, stirring, flipping, buffing for hours
• Playing Sports: racquet gripping, swinging bats or clubs, squeezing balls
• Playing Musical Instruments: prolonged practicing and performing
• Knitting and Needlework: intricate hand motions for extended times

Knowing if your work or hobbies involve high-risk repetitive motions is key for early intervention and for modifying activities to prevent a repetitive strain injury.

If you have symptoms of a repetitive strain injury, the first step is to get an accurate diagnosis from an experienced health professional. Part of this process will include detailed questions about:

• Your Symptoms: location, nature of discomfort, aggravating motions, relieving factors, timing, impact on function
• Medical History: any previous injuries or conditions affecting the area
• Your Work and Recreational Activities: repetitive motions, postures, forces involved
• Onset and Progression: when symptoms started, how quickly they developed
• Other Associated Symptoms: numbness, weakness, swelling etc.

Your assessment will also include a physical examination to assess your joints, muscles, nerves and ligaments for injury characteristics like swelling, pain, strength and range of motion. Special tests can help pinpoint specific tissue involvement and may include:

• Palpation: feeling for tenderness in ligaments, tendons or muscles
• Stress Tests: manipulating joints and tendons to replicate symptoms
• Neurological Tests: assessing nerve function and provoking symptoms
• Resistance Testing: testing strength and pain response on resisted muscle contraction
• Vascular Tests: examining blood flow and circulation to the area

Early intervention with proper treatment can optimize your recovery and prevent your injury from becoming a chronic condition.

The primary goal of any RSI treatment is to relieve pain, improve range of motion, restore strength and prevent recurrence. This can be achieved through a combination of various treatment options. The specific approach will depend on the severity of your symptoms and the underlying cause of your repetitive strain injury. Here’s a quick overview of treatment options:

• Getting Rest & Modifying Activities: Taking regular rest breaks from repetitive tasks to allow recovery. This may include changing movements and postures to avoid overloading tissues and allow healing. Workstation adjustments, technique correction, braces and job rotation can also help to vary physical demands and stress.
• Medication: Oral anti-inflammatory drugs and pain medication provide symptom relief when needed. Topicals also help.
• Physiotherapy / Occupational Therapy: Many techniques like soft tissue mobilization, joint mobilizations, therapeutic ultrasound, laser and more to aid recovery.
• Cold and Heat Therapy: Alternating use of cold and heat therapy eases pain and inflammation. Heat therapy should be used with caution if neuropathy is involved.
• Stretching and Strengthening Exercises: A focused and carefully considered program will allow for increased range of motion and will rebuild strength in the injured area.
• Bracing or Splinting: Custom braces and night splints can allow injured joints to rest and prevent harmful movements.
• Cortisone Injections: These can help reduce inflammation and pain in very targeted areas. These injections are best provided though a highly trained medical specialist.
• Improving Ergonomics: Addressing activity technique, equipment adjustments and work environment issues helps to reduce stress and prevent further injury or recurrence.
• Health Counseling: This includes advice on managing contributing health conditions such as your diet, sleep, stress management and more.

The right combination of these approaches tailored to your unique injury promotes optimal healing. The key is not to delay in seeking help. Early RSI treatment enhances recovery. The longer you wait with ongoing symptoms, the harder they become to resolve. 

There is generally no risk involved with treating injuries from repetitive strain injury. Of course, it’s important to speak with an experienced healthcare professional to obtain a proper diagnosis and a customized treatment plan. This will ensure you’re using the most appropriate treatment options based on your specific condition and needs.

If you perform repetitive manual tasks for work or leisure and are experiencing any of the following, you should seek professional help:

• Ongoing symptoms lasting more than 2 weeks
• Disruptions to your work, sleep or daily activities
• Loss of coordination, dexterity or the dropping of objects
• Noticeable loss of strength or limited motion of your joints
• Intense pain not relieved by rest or over-the-counter medications

At Physiomed, our experienced physiotherapists are experts in assessing and treating all types of RSIs. We will conduct a thorough assessment to pinpoint the source of your condition and will develop a customized treatment plan using proven techniques to relieve your symptoms and restore your functionality so that you can get back to living life on your terms.

Don’t live with the pain and the restrictions of a repetitive strain injury. Contact us today to book your assessment and let us show you why, at Physiomed, Healthier Starts Here.