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Repetitive strain injury (RSI)

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     A repetitive strain injury (RSI) is an injury to the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward positions. Treatment for repetitive strain injury (RSI):- depends on your symptoms and whether a specific condition has been diagnosed. RSIs are also known as cumulative trauma disorders, repetitive stress injuries, repetitive motion injuries or disorders, musculoskeletal disorders, and occupational or sports overuse syndromes. The first step is usually to speak to your employer or occupational health representative about ways you could modify your tasks to relieve the symptoms. Small changes to your lifestyle and working environment can often help. Think about your working environment and what activity may be causing the problem. 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 about.

   Software packages that remind you to take regular breaks from the keyboard can be useful. It can also be helpful to get advice from an occupational health representative at work on how to set up your work station.

   RSIs are assessed using a number of objective clinical measures. These include effort-based tests such as grip and pinch strength, diagnostic tests such as Finkelstein's test for Dequervain's tendinitis, Phalen's Contortion, Tinel's Percussion for carpal tunnel syndrome, and nerve conduction velocity tests that show nerve compression in the wrist. Various imaging techniques can also be used to show nerve compression such as x-ray for the wrist, and MRI for the thoracic outlet and cervico-brachial areas. The most-often prescribed treatments for early-stage RSIs include drug therapies such as anti-inflammatory medications combined with passive forms of physical therapy such as rest, splinting, massage and the like. Low-grade RSIs can sometimes resolve themselves if treatments begin shortly after the onset of symptoms. However, some RSIs may require more aggressive intervention including surgery and can persist for years. General exercise has been shown to decrease the risk of developing RSI. Sometimes recommend that RSI sufferers engage in specific strengthening exercises, for example to improve sitting posture, reduce excessive kyphosis, and potentially thoracic outlet syndrome. Modifications of posture and arm use (human factors and ergonomics) are often recommended. Some people with symptoms of RSI find that including exercise in their daily routine, such as walking or swimming, also helps ease their symptoms. See preventing RSI for more advice about reviewing your work activities.

Treatment options See your GP if your symptoms persist despite attempts to modify your work activities. There is no single treatment for RSI, but a number of treatments are available that can help people with the condition. If your doctor can diagnose a specific medical condition, well-established treatments can often be recommended. These include self-help measures, medication, or even surgery in some cases. Some of these treatments may also help even if your doctor cannot diagnose a specific medical condition from your symptoms, although evidence of their effectiveness in these cases is limited.

Possible treatment options for RSI include:
* Medication- including anti-inflammatory painkillers (such as aspirin or ibuprofen)
* Muscle relaxants
* Antidepressants and sleeping tablets (if your RSI is preventing you from sleeping) heat or cold packs
* Elastic supports or a splint
* Physiotherapy- including advice on posture and stretches or exercises to help strengthen or relax your muscles
* Steroid injections to reduce inflammation in an affected area (this is only recommended if an area has definite inflammation caused by a specific condition, such as carpal tunnel syndrome)
* Surgery to correct specific problems with nerves or tendons (for example if you are diagnosed with carpal tunnel syndrome or Dupuytren's contracture) if other treatments haven't helped
* Physical and complementary therapies
* "Hands-on" therapies- including physiotherapy
* Massage and osteopathy, may be available after a referral from your GP, but in some cases there may be a long wait for an appointment.

  If you wish to consider private treatment, make sure your therapist is registered with a professionally recognised organisation. Many long-term sufferers of RSI use other types of complementary therapies and relaxation techniques, such as yoga, acupuncture and the Alexander technique, to help relieve the symptoms of RSI. However, while some people with RSI do find these helpful, you should be aware that there is little scientific evidence to suggest these approaches are consistently effective for RSI.