What is a "Repetitive Strain Injury"?
RSI, or repetitive strain injury, occurs when a particular motion is performed over and over again. Using a computer keyboard and playing a musical instrument are frequent causes for RSI but other repetitive motions can result in this type of pain as well. The cause of inflammation that stems from cumulative trauma has not been clearly defined. Theories that point to the fatigue of the soft tissues (muscles, ligaments and tendons) have been suggested.
Differential diagnosis depends upon the site of the inflammation and it includes the diagnosis of Achilles tendon injuries, tendonitis, Ankle degeneration, Acromioclavicular degeneration, Carpal Tunnel Syndrome, Anterior cruciate laxity, Gamekeeper's thumb, Elbow degeneration, Neck pain, Knee degeneration, Shin Splints, Suprascapular nerve compression, and tendinopathy. Carpal Tunnel is a very well known problem. Triangular Fibrocartilage Complex Injury, or TFCC, is injury of a little, cartilage-like area in the joint of the wrist. Symptoms include pain on the wrist's ulnar side, a clicking sound, and reduced grip power. Osteonecrosis of the lunate bone in the wrist in those with systemic sclerosis will also result in wrist pain. Osteonecrosis represents a significant reason for wrist pain, more so in scleroderma patients. A positive test for scaphoid compression confirms the presence of the fractured scaphoid in those with no visible fracture in the first x-ray studies.
The scaphoid shift test uses pressure against the scaphoid tubercle to uncover scaphoid instability. Carpal tunnel syndrome is also known as median neuropathy at the wrist and is characterized by the compression of the wrist's median nerve which causes pain in the hand. It is not known what causes this, but it has been associated with repetition strain. Even though it is not known what causes pain in the dorsal wrist nerves, there is an apparent link between a painful wrist nerve and a dysfunctional wrist joint. An injury to the scapholunate ligament can result from scaphoid fracture, and this ligament is crucial to maintaining the stability of the wrist joint during rotation of the hand and flexing of the wrist.
De Quervain's tenosynovitis is a condition where the sheath of the tendons on the thumb side of wrist becomes inflamed or swollen, restricting the tendons' movement. A bone X-ray can help indirect diagnosis of such syndromes. For example, radiographic imaging can often elucidate the etiology, and thus the treatment, of ulnar wrist pain.
It is not known just how widespread these intercarpal ligament injuries are or how they begin, but Scapholunate injuries have often been seen in conjunction with distal radial fractures. Injuries or the occurrence of rheumatism in the distal radius often precedes the discovery of distal lunate joint instability which has resulted from dysfunction of the distal radio-ulnar joint. The hamate bone has been found to be fractured in 2% of all carpal fractures resulting from sports injuries.
Repetitive Strain Injuries are especially common among information workers, who work at a computer for long hours. Often, RSIs can be avoided by following a few simple ergonomic rules.
Published November 24th, 2008
Filed in Health