Wednesday, November 13, 2013

Repetitive Strain Injury: Chronic Pain's Annoying Little Brother

In my last article I discussed chronic pain.  This month I want to expand on one of Chronic Pain’s associates, Repetitive Strain Injury (RSI).

An RSI is the resulting injury to the musculoskeletal system or a part of the nervous system that is the result of a repetitive task involving repeated movements, forceful exertions, vibration, or sustained or awkward positions. 

RSI is actually an umbrella term for the hurts and ouches we develop at work, at play, in sports or driving.  They generally fall into two categories; tendinopathies and neuropathies.


Tendinopathies are probably the more familiar type including tennis elbow and carpal tunnel syndrome.*  These injuries involve the recurrent swelling and inflammation of a muscle and it’s tendon with the focus being at the point of attachment on the skeleton.  Because the activity that causes the tendinopathy is often a daily task, the region does not get sufficient time to recover from it’s exertion and so becomes further and further injured.

Neuropathies can be a little trickier to pin down as their pain patterns are often more diffuse.  A neuropathy can occur when the structures around the nerve are congested and inflamed thus placing pressure on the nerve.  Like everything in the body, the nerves are also wrapped in fascia, a tough fibrous tissue that keeps all our parts separated and organized.  If the compression on the nerve becomes great enough, then this fascia can also become inflamed putting the nerve itself at risk of more direct injury.  The most well known neuropathy is sciatica and it is often a result of spending a lot of time in a crouched or seated position. 


Carpal Tunnel Syndrome can actually be classified as either a tendinopathy or a neuropathy and sometimes even both.  In the former, the tendons that attach to the palm of the hand become inflamed within the Carpal Tunnel resulting in pressure on the nerve.  And sometimes the nerve itself can become inflamed or otherwise irritated, being a neuropathy.

So how does one deal with an RSI?  Better yet, how do you know if you have an RSI?  Consider whether the “mystery pain” crops up in association with specific tasks.  Perhaps after lots of computer work your shoulder hurts in that same spot.  Or maybe after a few games of aggressive volley ball your knees are inflamed.    If you can link your pain to an activity, it is very likely you are dealing with repeated strain. 

The best course of action with any RSI is to rest, stretch and ice the area.  Take breaks from your task as often as you can.  Allow yourself recovery time 100% away from the activity (facebook-ing does not count as a break away from computer work!).  Learn some stretches for the area that is hurting you the most and then DO THEM.  Frequently.  And hold them for 30-60 seconds.  Icing doesn’t have to mean frozen cubes of water directly on your skin.  Really you just want to have a significant enough temperature difference between the inflamed region and the cold pack to have an effect. 


But bare minimum, take a break!

Jen Fleming, RMT

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