Breaking This Injurious Cycle
17 January 2025
When small motions lead to big problems: a guide to repetitive strain injury.
Repetitive strain injury (RSI) is a growing concern in Malaysia, as modern lifestyles increasingly involve long hours of repetitive movements, often linked to office work, factory jobs, or extensive use of mobile devices.
According to Sunway Medical Centre, Sunway City consultant hand and microsurgeon Dr Liew Siew Khei, RSI is a condition caused by the overuse of muscles, tendons, and nerves due to repetitive motions or sustained positions.
“It’s known by a few terms, including repetitive stress injury, repetitive stress disorder, cumulative trauma disorder, or overuse syndrome,” she reveals.
While RSI is traditionally associated with industrial or manual labour, the rise of computer-based work has shifted the burden onto desk workers, typists, gamers, and other digital professionals.
“It commonly affects the wrist and thumbs, elbow, shoulder and lower back as well.
“RSI actually covers a range of disorders in the musculoskeletal system – any muscle, tendon or nerves. In the upper limb, the common presentation is through trigger finger, carpal tunnel syndrome, nerve compression syndromes, tendinitis, tennis elbow, golfer’s elbow and ganglion in the upper limb.
“We don’t have official figures for the incidence of RSI in Malaysia as it covers a very broad spectrum of disorders. But in the US, it’s estimated to be about 9% of those above 18 years old. The highest incidence is of those between 35 and 49 - about 10% - and those between 50 and 64, 11%.
“Only about 51% of these people seek a medical opinion about their condition. The rest tend to cope on their own,” notes Dr Liew.
Symptoms of RSI
Common physical manifestations of RSI include muscle pain and tenderness, tingling or numbness, loss of coordination, and swelling around the affected tendons which makes movement difficult.
Dr Liew warns that RSI can lead to chronic pain and long-term disability if left untreated.
“Early recognition of symptoms should prompt you to seek medical help. If you seek help early, we can break the cycle of repetitive trauma, and early intervention can prevent worsening of symptoms.
“On the other hand, late presentation will need longer duration or more invasive treatment, and also high chance of recurrence.”
RSI is caused by several factors. This includes poor posture where long periods spent sitting in front of a computer without ergonomic support can lead to muscle fatigue and joint stress.
While tasks like typing may seem low-impact, repetitive forceful actions over time place strain on the wrist, hand, and fingers. Holding the same posture for extended periods without adequate movement, such as hunching over a desk or phone, also contributes to muscle fatigue.
“So if you subject yourself to repetitive movements and strain in your work or leisure activities, you’re at risk of RSI,” she adds.
Managing RSI: treatment and recovery
If you suspect you have RSI, it’s important to seek medical advice early. Treatment for RSI generally focuses on reducing pain, improving mobility, and preventing further injury.
The first step in managing RSI is to reduce or eliminate the activities that are causing strain. This might involve modifying work tasks or taking time off from repetitive activities to allow the affected area to heal.
In the acute stage, Dr Liew says that ice compression and rest are cornerstones of treatment. A splint, either over-the-counter or custom-made type, can be used to prevent further strain on tendon or joint. Non-steroidal anti-inflammatory drugs (NSAID) painkillers are prescribed to treat pain and reduce inflammation.
If conservative treatment is ineffective, the next step is injections with steroids. These reduce inflammation and damage to the affected area.
“Further investigations such as ultrasound or MRI will be carried out to see if there are significant tears that require surgery for repair. However, this is usually considered only after other treatments have failed,” she says.
Physiotherapy can be highly effective in managing RSI. A therapist can guide patients through exercises to strengthen and stretch the muscles, improving flexibility and reducing pain.
RSI that is treated early usually see improvement in two to three weeks, says Dr Liew. The average treatment time is a month to six weeks. For those who come in late, the outlook is not as optimistic, and it will take some time to treat the condition.
Prevention of RSI
Preventing RSI requires a combination of ergonomic practices, regular breaks, and awareness of proper body mechanics. Here are some strategies to reduce the risk:
> Ergonomic workstations: Chairs should provide good lumbar support, and computer monitors should be at eye level to avoid neck strain. Using ergonomic keyboards and mice can also help reduce strain on the wrists.
> Frequent breaks: Taking regular breaks is essential, especially for those involved in repetitive tasks.
> Proper posture: Maintain a neutral posture during work, and avoid hunching or slouching while using a smartphone. Workers should ensure their back is straight, shoulders relaxed, and elbows at a 90-degree angle.
> Stretching and strengthening: Regular stretching exercises can help improve flexibility and reduce muscle tension.
RSI is becoming increasingly common in Malaysia due to changing work patterns and lifestyle habits. It is a preventable condition, but addressing it requires a concerted effort from both individuals and employers.
Implementing workplace policies that encourage regular breaks and ergonomic assessments can significantly reduce the incidence of RSI.
With proper awareness, early intervention and prevention, and management strategies, RSI can be mitigated, thus leading to maintaining a healthy and productive workforce.
Source: The Star
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