Repetitive Strain Injury

• Repetitive strain injury is an umbrella term that refers to soft tissue irritation, microtrauma and strain resulting from repetitive activities. It can affect the muscles, tendons and nerves.
• Lateral epicondylitis (tennis elbow) is a specific example of a repetitive strain injury.
• Causes of repetitive strain injury

  • Working on an assembly line in a factory, doing the same movements over and over
  • Using a computer mouse or keyboard (affecting the wrist and forearm)
  • Having a poor posture for an extended period whilst reading or using a computer (affecting the neck and shoulders)
  • Texting or scrolling on a smartphone (affecting the base of the thumb)
• Characteristics increasing the risk of repetitive strain injury

  • Small repetitive activities (e.g., scrolling on a smartphone)
  • Vibration (e.g., using power tools)
  • Awkward positions (e.g., painting a ceiling)
• Activities that increase the risk of repetitive strain injury

  • Small repetitive activities (e.g., scrolling on a smartphone)
  • Vibration (e.g., using power tools)
  • Awkward positions (e.g., painting a ceiling)
• Examination for repetitive strain injury

  1. Area may be tender to palpation

  2. Mild swelling in the area

  3. Recreating pain by having the patient perform specific movements that add resistance to affected soft tissues
• Diagnosis of repetitive strain injury

  1. Usually made clinically based on history and examination findings without investigations

  2. Investigations may be necessary to rule out other differential diagnoses (e.g., arthritis, inflammatory conditions, nerve compression)
• Investigations for repetitive strain injury

  • X-rays (e.g., to look for osteoarthritis)
  • Ultrasound (e.g., to look for synovitis in rheumatoid arthritis or rotator cuff tears)
  • Blood tests (e.g., inflammatory markers and rheumatoid factor for rheumatoid arthritis)
• Management of repetitive strain injury

  1. RICE mnemonic: Rest, Ice, Compression, Elevation

  2. Rest and adapting activities are essential

  3. Discussing duties with the occupational health department at work to amend work tasks

  4. Other potentially helpful options include analgesia (e.g., NSAIDs), physiotherapy, steroid injections in specific scenarios
• Last updated

  August 2021