Repetitive Strain Injuries – A Growing Trend

Repetitive Strain Injuries (RSI’s) are on the rise affecting large portions of the population. Balance Systems Inc. (2006), an advanced research company in rehabilitation technology, reports “The status of Repetitive Strain Injuries has gone from Epidemic proportions to Pandemic Proportions during the past 5-years.” This includes upper extremity disorder such as Carpal Tunnel Syndrome, Lateral Epicondylitis and Rotator Cuff Disorders.

A Statistics Canada 2003 report concluded that 10% of the Canadian population experienced a repetitive strain injury with the possibility of numbers being higher because many people do not report their injuries or do not recognize them as injuries. This is a sharp increase compared to 8% of Canadian adults in 1996/1997, according to Statistics Canada. The reason for this, is that often these injuries accumulate over time and go unrecognized until the pain and limited movement become intolerable. Given the reality of the aging population and the “baby-boomers”, this number is likely to rise. Finally, combine it with the lack of previous education regarding RSI’s and the under-reporting of these injuries and we have a serious issue of one of the fastest growing trends in Canada and internationally.

A WorkSafe BC 2005 report on Occupational Disease in BC 1981- 2005 reports that the number of RSI claims rose from 6,566 (1981-1985) to 10,581 (2001- 2005). According to Balance Systems Inc. (2006): in the U.S. repetitive strain injuries affect 7% of the population; the U.S. National Institute of Occupational Health and Safety doubles this figure to 14%; and the American Academy of Orthopedic Surgeons (2000) raises the figure to 25% of the population.

Repetitive strain injuries can be debilitating, with variations between men and women. When someone reports the injury it is serious enough to affect their daily activities. The number of affected women is on the rise. In 2003, more women with high workplace stress had an association with RSI’s than men. The men often reported more stress outside of work. The most common activities outside of work that induce RSI’s are recreational sports activities, musical instrument playing, hobbies (craftwork), and repetitive movements.

Body Areas Affected

Most repetitive strain injuries affect the upper body and include tendonitis, bursitis, carpal tunnel syndrome, trigger finger, thoracic outlet syndrome, trigger thumb, tennis elbow, golfer elbow, rotator cuff injuries, epicondylitis, and most recently, the “blackberry thumb” resulting from the use of PDA’s. Occasionally the injury appears in the legs and lower back. The commonly affected areas are the muscles, tendons, and nerves from repetitive movements, forceful and repetitive movements, and prolonged unchanging or awkward positions. According to the Statistics Canada 2003 report: 25% involved the neck or shoulder, 23% the wrist or hand, 19% the back, 16% the elbow or lower arm, and the rest were located in the lower extremities or unidentified body areas.

Symptoms

According to the Institute for Work and Health of Canada (2006), symptoms include:

1. Inflammation

2. Swelling

3. Pain

4. Loss of strength and coordination

5. Stiffness

6. Decreased movement

7. Changes in sensation

8. A history of: 
    a. Clicking 
    b. Popping 
    c. Rubbing 
    d. Erythema (multiple blister like formations on one area of the body) or vascular associations; and

9. Tenderness and guarding behavior.

Drug-Free Treatment

First, the injured area is rested. Victoria, B.C. physical therapist Jeff Harvie, of Harvie Physiotherapy, states in an interview the best way to treat and prevent repetitive strain injuries is to teach proper body mechanics and movement of joints. This should be the first intervention before ergonomics are considered, according to Harvey. Dr. Laker (2006) states “Psychosocial factors have been implicated in overuse injuries for decades. A partial list includes work satisfaction, perceived physical health, perceived mental health, coping mechanisms of both patient and family, perception of work-readiness, and anxiety.” Therefore, counseling is important. Chiropractic and massage therapy are sometimes included. However, the most noted aspect of rehabilitation is educating the population about taking frequent breaks to do simple stretch and strength exercises.

Effects of Technology

According to MIT Information Services and Technology (2006) the advent of modern technology has increased the incidence of repetitive strain injuries through repetitive work tasks such as pipetting (measuring and transferring quantities of liquids), heavy lifting, and computer work. The most recent injury discovered is called “Blackberry Thumb.” Added to the malady is new manufacturing technology that requires repetitive small movements and excessive force.

On the other hand, technology has produced a wide array of products to reduce repetitive strain injuries and their effects. This technology is often used in modifying workplaces. According to the American Industrial Hygiene Association (2006) the technology includes computer / office ergonomics and industrial assistive devices. Others are (1) the Flextend glove and apparatus to help with stretch and strength, (2) Flextend kits to assist the area of injury, and (3) Coldflex a self cooling technology for inflammation and pain relief.

In a 2005 report, the Canadian Centre for Occupational Health and Safety recommended developing strong federal and provincial laws regarding ergonomics as the first priority. A strong ergonomic program that is implemented and assessed regularly seconds this. They also cited the need for a national body that recognizes occupational injuries.


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About the Author Charmaine has over 20 years experience in acute care nursing, and also has a diploma in Disability Management .  She will then pursue her Bachelor in Applied Human Services Management, and then on to receive her Masters in Disability Management. She occassionally writes for a global newspaper and has done a series on Disability Management for the business section.

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