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Treating and Managing Repetitive Stress Injuries

Repetitive stress injuries (RSIs) include a range of conditions that can occur due to certain sports or other activities that involve repeated use of a joint or muscles. Although it can occur in any part of the body, it is mostly observed in the arm, leg and hip region. The condition generally results in an inflammatory condition that includes symptoms like pain, swelling and in some cases redness, deformity, and loss of mobility. The condition can be as classified into three degrees of severity, including mild, moderate and severe. In severe cases, partial or complete tearing of muscles, ligaments, and tendons can occur along with bone or nerve damage. Since there is a variety of different conditions that can result, the approaches for treating and managing repetitive stress injuries also differ for each condition. It is observed that an RSI injury to one part of the body can impact the other parts as well, and if the psychological condition of the patient is under stress, the condition can worsen.

The everyday risk factors that can increase the chances of experiencing an RSI include:

  • Lifting weight
  • Direct compression or pressure
  • Repetitive movement such as using a shovel, tennis racket etc.
  • Prolonged stress on a body part
  • Stressful tasks
  • Staying in the same posture for a long time
  • Overusing a specific body part
  • Strong vibrations due to use of tools
  • Low temperatures

Repetitive stress injuries are mostly a result of ergonomic problems, compression of nerves, vibrations, forced exertion, repetition of movement and staying in the same position for a prolonged period of time. The condition is also known as repetitive strain injuries and overuse injuries. This health condition is as old as human activities that involve the repetitive movement of the same area. Therefore, it is not only associated with sports or occupational hazards. It can also occur from common everyday tasks such as gardening, working on house chores, or working on repairs at home. There are numerous conditions that can result from repetitive stress injuries. Each one is characterized by the location of the injury, body part affected, the type of body structure effected i.e. bones, muscles, nerves, tendons, ligaments etc. and the severity of the condition. Here are some of the most common types of repetitive stress injuries that can result from everyday activities due to repeated movement.

Carpal tunnel syndrome: Characterized by pain due to nerve compression in the wrist.

Shin Splints: Characterized by acute pain in the leg or shin area due to prolonged movement of legs.

Cubital tunnel syndrome: Characterized by stretching or compression of the ulnar nerve resulting in pain, numbness and tingling in the arm, fingers, and hand.

Bursitis: Characterized by inflammation of the Bursa in the joints such as shoulder, knee or elbow resulting in pain and inflammation.

De Quervain syndrome: Characterized by pain in the wrist due to damage of the tendons.

Dupuytren’s contracture: Characterized by injury to the tissue of the palm resulting in the bending of fingers and pain.

Intersection syndrome: Characterized by inflammation of the arm muscles resulting in pain.

Tennis and Golfer’s elbow: Characterized by damage to the outer and inner part of the elbow resulting in loss of mobility and pain.

Radial tunnel syndrome: Characterized by pain in the arm due to irritation or damage of the nerve.

Rotator cuff syndrome: Characterized by rotator cuff damage in the shoulder resulting in an inability to move and pain.

Tendonitis: Characterized by inflammation of the tendon.

Tendinosis: Characterized by deterioration of the collagen in the tendons.

Writer’s cramp: Characterized by damage to the muscles in the arm resulting in cramps.

 

Symptoms

Repetitive stress injuries can express a variety of symptoms which greatly depends on the location of the injury, the type of body part injured, the type of structure damaged, and the severity of the condition. While pain and difficulty in the movement are the primary symptoms, the other signs may include:

  • Damage to the sensory response
  • Weakness in the injured area
  • Numbness and tingling sensation
  • Tenderness in the area
  • Pulsating and throbbing pain
  • Difficulty in movement or complete loss of mobility

 

Treatment

There is a wide variety of options for treating and managing repetitive stress injuries, such as:

Rest

Resting is among the most effective and the oldest way to treat any condition option for the injuries and inflammatory conditions. Repetitive stress injuries require immediate medical attention and proper rest. It is important to ensure that the patient avoids using the injured body part entirely if possible.

RICE

The RICE protocol stands for Resting, Icing, Compression, and Elevation. It is among the most popular and effective approach for treating and managing repetitive stress injuries. It cannot completely cure the condition, but effectively alleviates the symptoms of pain and swelling. It can also stop the condition from getting worse and may reverse the condition and aid in healing and recovery.

Correcting posture and mechanics

In some cases, RSI can occur solely due to a wrong posture or mechanics over a prolonged period of time. By correcting these things and making some minor changes, we can make a big difference.

Over the counter drugs

There are certain painkillers and another anti-inflammatory over the counter drugs that can help the patient deal with the symptoms. These drugs usually include Ibuprofen and Aspirin etc. Usually, it is the first line of treatment for most injuries ranging from mild to moderate.

Steroids

If the OTCs and other drugs are not showing results, the patient may be prescribed NSAIDs, anti-inflammatory drugs and other steroids and corticosteroids. In severe cases, steroids are administered to the patient in the form of injectables.

Physical Aids

To avoid secondary injuries and allowing the injured area to rest, physical aids can be used, such as braces, straps, supporting pads and other things that can limit movement and help the injured area get enough rest for healing.

Physical therapy

Although it is sometimes recommended that the injured area should not be moved at all, it is also important that mild and correct exercises should be done under the supervision of a physical therapist to avoid locking of the joint. The exercise that should be performed in successfully treating and managing repetitive stress injuries may vary depending on the area of injury and its severity.

Heat and Cold treatment

Alternating between the two extremes of temperature can help soothe the symptoms. Heating pads and cold ice can be used to alternatively heat and cool down the injured area.

Massaging and acupuncture

Massaging and acupuncture are good ways to improve the blood flow to the injured area. The blood carries oxygen and nutrients to the injured area, which can help in the recovery and accelerate the healing process.

Platelet Rich Plasma

In moderate and severe cases, this relatively new technique for the treatment can be utilized to improve the healing process. This technique involves the concentration of platelets from the blood extract of the patient using a centrifuge process. The rich platelets are then injected back into the injured area of the patient. It has shown to significantly boost the recovery.

Cortisone injections

When the injury is not responding to other forms of treatment, cortisone injections can be used to alleviate the severe symptoms of inflammation, pain, and swelling.

Surgery

In severe cases, such as complete tearing of the tissue or detachment of the bone from the muscles, surgery may be necessary. Nonetheless, it is used as a last resort. The type of surgery again varies depending on the location and type of injury.

Prevention

If the condition occurs, the approach for successfully treating and managing repetitive stress injuries requires the patient to get medical assistance immediately and start the treatment. Delayed treatment could easily worsen the condition.

However, apart from that, there are several things we can do to prevent such an injury, such as:

  • Taking rest if you are doing a prolonged work
  • Keep changing positions
  • Keeping correct posture
  • Using the right technique
  • Alternating the use of left and right arm or leg
  • Stand up if sitting, sit down if standing
  • Move around
  • Be careful
  • Learn ergonomic ethics
  • Do not bend your joints
  • Do not work for prolonged periods in extreme temperatures

 

 

 

References

Van Tulder, M., Malmivaara, A., & Koes, B. (2007). Repetitive strain injury. The Lancet, 369(9575), 1815-1822.

Brooks, P. (1993). Repetitive strain injury. BMJ: British Medical Journal, 307(6915), 1298.

Helliwell, P. S., & Taylor, W. J. (2004). Repetitive strain injury. Postgraduate Medical Journal, 80(946), 438-443.

Tyrer, S. (1994). Repetitive strain injury. Journal of psychosomatic research, 38(6), 493-498.

 

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