Published by PMR of NY & CT
Maybe your wrist aches after hours at the keyboard, your thumb throbs after a long stretch of texting, or your shoulder complains when you reach overhead on the job. This kind of pain tends to creep in rather than start with one clear injury.
A repetitive strain injury (RSI) is pain and irritation in muscles, tendons or nerves caused by repeating the same motion many times, holding an awkward position for long periods, or both. Most cases improve with early changes to how you work, and many can be prevented.
What is a repetitive strain injury?
Repetitive strain injury, also called repetitive stress injury or overuse injury, is an umbrella term rather than a single diagnosis. It describes tissue that is being loaded faster than it can recover. Common examples include:
- Carpal tunnel syndrome: a squeezed nerve at the wrist
- Tendonitis in the wrist, elbow or shoulder, including de Quervain’s tenosynovitis on the thumb side of the wrist
- Tennis elbow: pain on the outside of the elbow from repeated gripping, common in people who have never played tennis
- Trigger finger: a finger that catches or locks as you bend and straighten it
RSI symptoms to watch for
Symptoms usually build slowly and may come and go at first:
- Aching, burning or throbbing that builds during a task and eases with rest
- Tingling, numbness or pins and needles in the hand or fingers
- Stiffness or tenderness over a tendon or joint
- A weaker grip or dropping things
Early on, pain may appear only during the activity. If it starts lingering after you stop or waking you at night, it's time to act.
Who is most likely to develop RSI
Desk work gets most of the attention, but assembly work, hairdressing, trades that use vibrating tools, playing an instrument, gaming and knitting carry similar risks. What they share:
- Many repetitions with little variety
- Forceful gripping, pinching or pushing
- Awkward positions, such as bent wrists or arms raised overhead
- Vibration from power tools
- Long stretches with too few breaks
Diabetes, thyroid disease, rheumatoid arthritis and pregnancy can also make nerve problems such as carpal tunnel syndrome more likely.
How to prevent a repetitive strain injury
Small, consistent changes make the biggest difference.
Set up your workspace around your arms
- Type with your wrists in line with your forearms rather than angled up, down or sideways.
- Let your elbows rest near your sides with your shoulders relaxed.
- Keep the mouse close to the keyboard so you aren't reaching.
- Type with a light touch, and use shortcuts or voice dictation to cut down on clicks.
Build in breaks and variety
Pause every 30 to 60 minutes to move and change position. Where you can, rotate between tasks that use different muscles.
Mind your grip and tools
Choose tools with larger, cushioned handles, keep blades sharp so you need less force, and use your whole hand rather than a tight pinch.
Treatment options for RSI
Most overuse injuries improve without surgery, especially when treated early. A typical plan combines several of these:
- Modify the activity. Cut back on the motion that triggers symptoms instead of resting the whole arm completely.
- Splints or braces. A wrist splint worn at night can ease carpal tunnel symptoms, and a forearm strap helps some people with tennis elbow.
- Ice or heat. Cold may calm a flare-up; heat can loosen stiffness.
- Over-the-counter pain relievers for short-term relief. Check with a doctor or pharmacist before using them if you take other medicines, are pregnant or have a chronic condition.
- Physical therapy to restore strength and change how you use your hands and arms.
- Medical massage or acupuncture, which may ease pain for some people as part of a broader plan.
If symptoms persist, a physician may recommend nerve testing, an injection or, for a small number of people, surgery. If your symptoms are tied to your job, report them to your employer early; our workers’ compensation injury care page explains how we help.
When to see a doctor
Make an appointment promptly for numbness or tingling that is constant or spreading, weakness or shrinking of the muscle at the base of your thumb, swelling with redness and warmth, or pain that isn't improving after a couple of weeks of changes.
Call 911 for sudden numbness or weakness in an arm, especially with a drooping face or trouble speaking, or for arm pain that comes with chest pressure, shortness of breath or sweating.
Frequently asked questions
Can a repetitive strain injury go away on its own?
Mild cases often settle once you cut back on the activity that triggered them and change how you do it. If you keep repeating the same motion the same way, symptoms tend to return or worsen. Prolonged pressure on a nerve can leave lasting numbness or weakness, so get persistent symptoms checked.
Is RSI the same as carpal tunnel syndrome?
Not exactly. Carpal tunnel syndrome is one type of RSI, caused by pressure on the median nerve at the wrist, and it typically brings numbness or tingling in the thumb, index and middle fingers, often at night. Tendon problems such as tennis elbow are also RSIs but need different care. An exam, and sometimes nerve testing, can tell them apart.
Do ergonomic keyboards and mice prevent RSI?
They help some people, but they aren't a fix on their own. Split keyboards and vertical mice keep your wrists and forearms in a more natural position, and many users find them more comfortable. Evidence that any single device prevents RSI is limited, though. How long you work without breaks and how hard you grip usually matter more.
Request an appointment at PMR
If repetitive strain is making work or hobbies painful, Physical Medicine & Rehabilitation of NY & CT (PMR) can evaluate your symptoms and build a plan that may include physical therapy and medical massage. Request an appointment and our team will contact you to schedule a visit at PMR of Danbury or PMR of Brewster.
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