Why Repetitive Strain Injury is on the rise

Ever experience mysterious wrist or elbow pain? You could be one of the thousands of people suffering with RSI – and it's a good idea to get it checked, as Lisa Salmon reports

We don't have to be at work to risk RSI – posture due to smartphone use on the way there can contribute too
We don't have to be at work to risk RSI – posture due to smartphone use on the way there can contribute too

WITH the amount of time people spend typing on computers and texting these days, it's little wonder that repetitive strain injuries, known as RSI, are on the rise.

The latest Health and Safety Executive (HSE) figures indicate the problem – which mainly causes pain, stiffness, numbness or weakness in the arms, hands, shoulders and back – affects 730 working people in every 100,000, compared to fewer than 600 per 100,000 in 2011.

But other research suggests the problem could be even more widespread. A survey by pain relief brand Mentholatum found that one in five adults (21 per cent) have suffered from RSI.

Physiotherapist John Miles points out that although it's difficult to pin down statistics (as some studies bracket all musculoskeletal problems together, while others use terms like work-related upper limb disorders – or WRULD): "Whatever you call it, there's no doubt that RSI is becoming increasingly common."


Various factors have the potential to cause upper limb disorders, according to the HSE, including repetitive work, uncomfortable working postures, sustained or excessive force, carrying out tasks for long periods without suitable rest breaks, or a poor working environment – and, experts stress, RSI can lead to permanent disabilities, so needs tackling at an early stage.

Steve Fisher, chairman of the national charity RSI Action, developed such bad RSI in his back that he was unable to walk and was forced to take medical retirement from his job as an aerospace engineer.

He says computer use was responsible, and explains: "Many people are using computers at work, with a lot of mouse work, which creates a relatively heavy load on the small muscles of the lower arm and hand.

"That also causes movement of the nerves in the arm and shoulder, and it can build up problems over time."

"On top of that, when people are travelling to and from work, instead of their hands and fingers being relatively restful, they're using them on their smartphones, and bringing their head down to look at it, so their posture probably isn't very good either."

RSI is more common in older adults – a quarter (24 per cent) of 41-to-63-year-olds have had RSI, compared to one in six (16 per cent) of those aged 18 to 30.

Although repeated computer use is often cited as the main culprit, the HSE found the construction and manufacturing sectors have the highest incidence of work-related upper limb disorders, and health workers also have a high incidence of WRULD.


Wrists are the most common trouble spots, with seven out of 10 survey respondents (69 per cent) identifying this as the joint most likely to be affected, followed by fingers (29 per cent), forearms (23 per cent) and thumbs (20 per cent). Elbows and shoulders can also be stiff and/or painful, and even knees and feet can suffer if a job involves a lot of kneeling, or operating foot pedals on equipment.

Warning signs include pain or tenderness, stiffness, tingling or numbness, cramp, weakness and throbbing. There may be swelling, although in the form known as diffuse RSI, there's pain but no obvious sign of swelling or inflammation.

In the initial stages, the discomfort may only be felt when performing the action that's causing the problem, although if no remedial action is taken, it may eventually become constant and, in some severe cases, irreversible.


There are many different names for RSI, as it covers a wide range of injuries to muscles, tendons and nerves. It's sometimes called tenosynovitis, carpal tunnel syndrome, tendonitis, tennis or golf elbow, bursitis or housemaid's knee.

While there's been a peak in incidence since keyboards became part of everyday life, the condition has actually been recognised under different names for hundreds of years.

"We tend to think of RSI as a modern-day condition, but the truth is that it was first reported in 1700, when an Italian doctor identified more than 20 examples among musicians, clerks and other industrial workers of the period," explains Miles.

"Over the years, all sorts of different work-related problems which we would now recognise as RSI have been identified – writer's cramp, weaver's bottom, potter's wrist, housemaid's knee and so on.

"The high incidence of problems involving the lower arms is simply a reflection of changing work patterns and the amount of time we spend using keyboards and handheld devices."


RSI Action says affected workers should talk to their employer about ways to modify their working space to relieve symptoms and risk.

In addition, simple exercises incorporated into daily routines can help prevent it. For example, if you're sitting at a computer all day, Miles recommends stretching your wrist and fingers to loosen tightness. Starting with the right hand, gently extend the fingers back one by one, followed by taking them all back at the same time. Repeat several times.

"There are a variety of exercises you can do for different parts of the body," he says, "but always take time out of your day to stretch, as this will help reduce your risk of RSI."

Taking regular breaks is important – which means getting up from your desk – and applying heat and cold therapies to affected areas may also help.

Miles says: "It's important to look at your working environment to see what might be the issue. One simple step is to reduce the time doing one activity and to change how you do it, or simply take short breaks to stretch and move.

"Your employer should be able to advise on what changes you can make to your work space.

"Although prevention is better than cure when dealing with repetitive strain injury, it's important to address any issues as soon as you notice symptoms, as they're likely to get worse."

If symptoms persist despite altering how you work, see your GP.

Fisher adds: "Be aware of the risk, and if you see the first signs of aches and pains, don't ignore them. Unfortunately, a lot of people do ignore them until it stops them doing their job – by which time it's very difficult to do anything about it.

"Most people who develop serious RSI without doing anything will always have problems."

For more information on RSI, visit