Repetitive Strain Injury RSI

1
Repetitive Strain Injury (RSI)

• Professor T.C. Aw
• MBBS, PhD, FRCP, FRCPC, FFOM, FFPHM
• Head, Division of Occupational Health
• University of Kent

2
RSI Settlement

• Compensation totalling 10,000 is to be paid to
  30 poultry production workers at Beatrice
  International Foods of Lincoln who suffer from
  repetitive strain injury caused by handling
  birds. Out of court settlements from 2,000 to
  8,500 were agreed

3
IntMedJ 200434(7)416-419

• Repetitive strain injuries has the Australian
  epidemic burnt out?
• Awerbuch (2004)

4
CommHlthStud 198812(3)348-358

• The arguments about RSI an examination
• Brammer G, Martin B (1988)

5
Extent of problem (UK)

• Musculo-skeletal problems
• 0.5 million workers affected in the UK
• Increase of gt50,000 affected since 2001/02
• 2nd most common cause of sickness absence in many
  industries in the UK
• HSE Self-reported work-related illness survey

6
Extent of problem (UK)

• For upper limb (and neck)
• 5 million working days lost
• average of 3 weeks lost time per person
• HSE Self-reported work-related illness survey

7
Terminology

• Repetitive Strain Injury (RSI)
• Cumulative trauma disorder (CTD)
• Occupational overuse syndrome (OOS)
• Work-related repetitive movement injury (WRMI)
• Work-related upper limb disorder (WRULD)

8
Definition

• Pain and/or discomfort in the limbs due to
• Repetitive movements (dynamic stress), or
• Constrained postures (static stress)

9
Classification

• Specific entities
• Carpal tunnel syndrome
• De Quervains syndrome
• Tendonitis/Tenosynovitis
• Peritendinitis crepitans
• Epicondylitis
• Tennis elbow
• Non-specific diffuse arm pain

10
Exposure

• Repetitive movements
• - within normal range e.g.
• flexion extension
• pronation supination
• abduction adduction
• - extremes of range
• Constrained postures
• /- FORCE

11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
Courtesy of Dr. Syed Ahmed
18
Effect

• Symptoms
• Discomfort
• Pain
• Numbness
• Tingling
• Signs
• Localised swelling
• Warmth redness
• Loss of function
• Crepitus

19
Contributory factors

• Non-occupational factors
• Individual susceptibility
• Ergonomics
• Psychological overlay
• Trauma previous or recent
• Compensation?

20
(No Transcript)
21
Laboratory investigations

• Tendon acoustic monitoring
• CAT scan
• Nuclear magnetic resonance
• Thermography
• Electromyography
• Nerve conduction studies

22
Treatment

• Analgesics NSAIDs, Ibuprofen
• Rest/Exercise
• Local injection
• Surgery
• Physiotherapy
• Ultrasound
• Infra-red

23
Prevention

• Frequent rest breaks
• Posture
• Workstation design
• Tai Chi, yoga, Alexander technique,
  communicating with the subconscious?

24
(No Transcript)
25
(No Transcript)
26
Ref RSI Association
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
Threshold limit value (TLV)

• Hand activity level (HAL) 0-10 e.g.
• 2 Consistent, conspicuous long pauses or very
  slow motions
• 6 Steady motion/exertion infrequent pause
• 10 Rapid, steady motion/ difficulty keeping
  up or continuous exertion
• Peak hand force

NIOSH, 2006
31
(No Transcript)
32
(No Transcript)
33
Conclusions

• Getting the right person /or tools for the job
• Information, instruction training

34
(No Transcript)
35
 
 
t.c.aw_at_kent.ac.uk