What is RSI / Carpal Tunnel ?

Carpal Tunnel Syndrome is the name given to a common source of pain and hand numbness. It is caused by increased pressure and hence strain on a nerve passing through the hand through the confined space of the carpal tunnel. It is a small part of the bigger problem which is RSI. Repetitive strain injury or Repetitive stress injury (RSI) is a term used to describe many different types of soft tissue injury. It is an injury to the muscles, tendons, ligaments, nerves or joints especially when they are kept tense for very long periods of time, due to poor posture and/or repetitive motions. RSI in an overuse syndrome and may include a group of conditions as: Occupational Overuse Syndrome (OOS), Cumulative Trauma Disorder (CTD), Work Related Upper Limb Disorder (WRUD). 

What are the Symptoms of RSI ?
RSI usually refers to an upper extremity syndrome, involving the neck, shoulder girdle, elbow, forearm, wrist, thumb, and hand. RSI is usually localized to the tissue being overused, but as the injury becomes more severe, the symptoms may radiate to other areas. Also the symptoms may be constant or intermittent. The following symptoms may indicate the onset of RSI.
• Recurring pain or soreness in the neck, shoulders, upper back, wrists, or hands.
• Tingling, numbness, coldness or loss of sensation, loss of dexterity.
• Loss of grip strength, lack of endurance, weakness or fatigue.
• Pain or numbness while lying in bed.
• Stiff or tight muscles in the hands, wrists, fingers, forearm, elbow, shoulder.
• Loss of coordination in hands.
• Cracking in the joints or muscles.
• Swelling of hands and forearm.
• Muscle spasms and muscle weakness.
• Locking up or freezing of fingers, hands and wrists.

 


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There may be two stages of injury
Mild pain, aches, or tiredness of wrists, arms, shoulders, or neck during work which improves overnight. This stage may last weeks, or months but is reversible ( threatened overuse injury)


Recurrent pain, aches, or tiredness that may persist. Physical signs may be visible such as a cyst- like swelling near a joint or a tender swelling in the affected area. This may last for several months.

What are the Types of RSI  ?
There are two categories of RSI: Distinct RSI and Diffuse RSI.
 

Distinct RSI
• Carpel Tunnel Syndrome (CTS)- This is the most widely recognized RSI. Patients suffering from CTS experience swelling of membrane linings and surrounding tendons in the base of the palm, compressing nerve, resulting in numbness and aching of the inflamed area. There occurs pain in the wrists, thumb and first three fingers, with loss of strength and dexterity.
• Bursitis: Individuals experience inflammation of the bursa(sac filled with fluid that acts as cushion between tendon and bone) against tendons attaching muscles to the shoulder or elbow, causing joint pain, stiffness, and limited movement.
• Epicondylitis: Also known as tennis or mouser’s elbow, includes inflammation or tear of the tendons, that attach muscles of forearm to the elbow. There may be tiny ruptures of muscle and tendon around the bone on the inside of the elbow, causing a lot of pain.
• Tendonitis: It causes inflammation of the tendons, often in the wrists, forearm, elbow, or shoulder.
• Tenosynovitis or Trigger finger: This injury causes swelling of the tendon in the finger or thumb, interrupting movement of the tendon.


Diffuse RSI
Diffuse RSI have multiple areas of diffuse pain in the muscles, caused by compression of the nerve in areas where the latter is susceptible to pinching from joint movement, such as hands, wrists, shoulders, arms.

 

What are common RSI causes ?
RSI is a potentially debilitating condition resulting from overuse of muscles, nerves or tendons when they become inflamed or irritated. Some of the causes are:
• Small rapid movements that are repeated over and over.
• Awkward sitting or standing positions without moving regularly
• Using force or moving heavy loads.
• Lack of rest.
• Repeated contact with sharp edges of tools, or workstations.

RSI is often reflected in people who have developed arthritis as a result of sports/workplace injury. Cold temperatures, vibrating equipment can aggravate the condition. Stress is often a factor. Conditions such as diabetes, hypertension, pregnancy have also been shown to contribute to the development of RSI. RSI generally occurs in those over age 30 as a result of normal wear and tear.

 

What is a Possible Treatment for RSI ?
Initially treatment aims to help with pain and enable strength and mobility to return. Icing helps decrease pain and inflammation. Medications include administration of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) helps reduce pain and swelling, eg, aspirin, ibuprofen, naprosyn, relafen,etc. If inflammation persists steroids such as cortisone may be administered. After pain and swelling subsides, light exercise may be recommended. Massage treatment by a trained therapist may be helpful sometimes. RSI very well responds to treatment with acupuncture. Pain, inflammation can all be reduced or even eliminated with a single treatment and repeated treatments can help prevent a recurrence of the injury. Further treatment options may include electrical stimulation, osteopathy, or surgery, depending on the diagnosis.

RSI may be prevented by taking proper rest between works, proper attention must be paid to posture while working. Regular aerobic exercise, adequate sleep, drinking enough water may also help prevent RSI.

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Article Contributed By: Shaonli Dasgupta

 

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