Repetitive stress injury (RSI) is caused by repeated or excessive movement of the shoulders and arms.
In order for the shoulder, arms, and hands to move, the muscles of the upper body must contract. Repetitive stress injury occurs when certain movements are made repeatedly, causing:
Causes of repetitive stress injury include:
If RSI is not successfully treated, nerve and tissue damage may cause a decrease in feeling and range of motion. There may be chronic pain or soreness in affected area. Disability or loss of employment may also occur.
RSI conditions include:
Symptoms of repetitive stress injury may occur anywhere in the shoulders or arms. Usually they first occur during the repetitive movement. These first symptoms may include tired muscles, aches, and pain.
Later, if repetitive movement continues, the symptoms worsen and may include:
The diagnosis of repetitive stress injury begins with a complete medical history and physical examination. The healthcare provider may order tests, such as:
Avoiding overexertion of the arms and shoulders can prevent many cases of RSI. Warming up and stretching the muscles before activity may decrease the risk. Using proper body mechanics may also lessen the risk of injury.
Ergonomics is the practice and study of arranging work equipment to allow for more comfort and less strain on the body. There are many ergonomic products, such as wrist pads, height adjusters on keyboard holders, and wrist support braces. These products are intended to decrease the stress on muscles, tendons, tissues, and nerves of the arms.
Taking regular breaks during repetitive activities, and doing strengthening exercises may help. Learning proper methods of sitting, positioning the feet, lifting, and bending may also decrease the risk of RSI. Many causes cannot be prevented.
Minor pain or injury may require RICE therapy:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may be used to reduce inflammation and discomfort. In some cases, a corticosteroid may be injected into the affected area.
Physical therapy or strength training exercises may help increase the strength of the tendons and muscles. Ultrasound may be used to warm the muscles and improve blood flow. If conservative treatment is not successful, surgery may be necessary.
NSAIDs can cause stomach upset and allergic reactions. Surgery poses a risk of bleeding, infection, and allergic reactions to anesthesia.
In mild cases of repetitive stress injury, no further treatment is needed for minor pain and inflammation. For more serious disease or injury, treatment may continue. Physical therapy and daily strengthening exercises may be recommended.
Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eileen McLaughlin, RN, BSN
Date Written:
Editor:Duff, Ellen, BA
Edit Date:10/09/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:08/09/01
Harrison's Principles of Internal Medicine, 1998, Fauci et al.
Complete Guide to Symptoms, Illness, and Surgery, Griffith, 2000
www.ama-assn.org/insight/spec_con/patient/pat059.htm