Repetitive Stress

Repetitive stress injuries (RSIs) or repetitive motion disorders (RMDs) can be quite painful and debilitating. The Association for Repetitive Motion Syndromes says initial symptoms may include tingling, numbness or pain in the affected area (Read about "Paresthesia") and loss of flexibility or strength. Repetitive stress injuries may become progressively worse over time without treatment and may result in a complete loss of function in the affected area.

We're hearing a lot more about repetitive stress injuries as an increasingly common on-the-job hazard. The National Institute for Occupational Safety and Health says tens of thousands of injuries each year are caused be repetitive motions, including typing, repetitive use of tools and repetitive motions such as turning or grasping. Repetitive stress injuries can also occur when you use a computer mouse, a video game controller or do a lot of text messaging on a phone or other device.

Examples of RSIs include:

• carpal tunnel syndrome, a disorder of the hand, wrist and arm (Read about "Carpal Tunnel Syndrome")
• tendinitis and bursitis, which are inflammations of the soft tissue around the muscles and bones (Read about "Tendinitis & Bursitis")
• tenosynovitis, an inflammation of the tendon and tendon sheath
• stress fractures, which are tiny breaks in the bone (Read about "Bone Fractures")
• shin splints, which affect the muscles of the shin (Read about "Feet, Ankles & Legs")
• plantar fasciitis, a common heel ailment (Read about "Plantar Fasciitis")
• tennis elbow or lateral epicondylitis
• ganglion cyst, a fluid-filled sac on that causes a bump on the hand, wrist or elsewhere
• trigger finger, a condition which causes the finger to lock in a bent position
• repetitive stress injury of the thumb as a result of overusing gadget keypads
• De Quervain's tendinitis which occurs when the tendon on the thumb side of the wrist is irritated or constricted repeatedly

Causes of repetitive stress problems

According to the American Academy of Family Physicians, when muscles tense during any kind of repeated movement, blood flow becomes restricted. In addition, if the movement is repeated too often without breaks, the tendons surrounding the muscles can become inflamed. (Read about "Strains") Tendons are the tissues that connect the muscles to the bones. (Read about "Skeletal System") When they become inflamed, they can start to press against nerves, which can lead to peripheral neuropathy and symptoms such as numbness and tingling. (Read about "Peripheral Neuropathy") Discomfort, even pain, may also occur. Initially, the symptoms may stop when the activity stops; however, with continued stress, the inflammation may worsen to the point where the pain or discomfort doesn't go away even during rest.

RSIs are caused by too many uninterrupted repetitions of an activity or motion, unnatural or awkward motions such as twisting the arm or wrist, overexertion, incorrect posture or muscle fatigue. RSIs occur most commonly in the hands, wrists, elbows and shoulders, but can also happen in the neck, back, hips, knees, feet, legs and ankles. (Read about "The Shoulder" "Neck Pain and Work" "Back Tips" "The Hip" "The Knee") Symptoms can include:

• pain
• tingling
• numbness
• swelling or redness of the affected area
• loss of flexibility and strength

For some individuals, there may be no visible sign of injury, although they may find it hard to perform easy tasks.

Repetitive stress injuries can result from just about any activity that's repeated often enough, especially if the activity is done incorrectly. According to the National Institute of Neurological Disorders and Stroke (NINDS), RSIs generally affect individuals who perform repetitive tasks such as assembly line work, meatpacking, sewing, playing musical instruments and computer work. The disorders may also affect individuals who engage in activities such as carpentry, gardening and tennis. One common mistake when typing, for example, is to keep the wrists bent at an angle. This stresses the wrist. Keeping your wrist straight when typing, by using a wrist pad or splint for example, can reduce the stress and help avoid injury. If you have to use a phone or tablet for text messaging, make sure you vary the position of the device and take frequent breaks.

Avoiding repetitive stress

If you can't stop the activity causing repetitive stress, try to change the way you do it. When working, it's important to take regular breaks to relax the working muscles and to stretch them. It's also essential to avoid tensing muscles for extended periods of time. For employers, NIOSH suggests a number of changes in the workplace that can help workers avoid repetitive stress injuries. These include:

• adjusting the height of work surfaces
• varying tasks for workers
• encouraging short rest breaks
• reducing the size of items workers lift or providing lifting equipment
• using specially designed equipment for repeated tasks, such as curved knives for poultry workers

If you are experiencing pain or numbness, don't ignore the symptoms. Your doctor can diagnose whether repetitive movement is the cause. If it is, your doctor may recommend drugs to reduce inflammation. Medications such as pain relievers, cortisone and anti-inflammatory drugs can reduce pain and swelling, according to NIAMS. (Read about "Medicine Safety") Applying ice to the affected area can also help reduce swelling. Splints may be used for support. Once the pain subsides, a physical therapist can recommend exercises to help strengthen the muscles to prevent future injury. (Read about "Rehabilitation") In severe cases, surgery may be the best solution.

NIAMS says many people with RSIs recover completely and can avoid re-injury by changing the way they perform repetitive movements, the frequency with which they perform them and the amount of time they rest between movements. Without treatment, RSIs may result in permanent injury and complete loss of function in the affected area.