repetitive strain injury

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repetitive strain injury

n. Abbr. RSI
Damage to tendons, nerves, and other soft tissues that is caused by the repeated performance of a limited number of physical movements and is characterized by numbness, pain, and a wasting and weakening of muscles.

repetitive strain injury

A work-related injury caused by overuse of a particular musculoskeletal group to perform a task that is repeated hundreds to thousands of times in day-to-day work; repetitive motion injury affects workers in the textile industry, meat-packers, keyboard operators and others.

repetitive strain injury

A disorder of motor function caused by any often-repeated activity that is persisted in beyond a particular threshold, especially if the activity involves an inherently awkward or uncomfortable position of the body. RSI particularly affects musicians, keyboard operators, cleaners, packers and machine operators. There is acute pain and cramp-like stiffness, and sometimes total inability to continue in the associated occupation. Initially, the condition explicitly, and by definition, excluded all disorders of known cause, but this led to many legal and other difficulties, and accounts now list numerous causes. RSI is, however, often stress-related and in many cases no muscular, tendon or neurological abnormality can be found, except that affected people often have raised thresholds for the appreciation of vibration. In some cases it appears analogous to WRITER'S CRAMP. Changes in the proportions of the different types of muscle fibres and an increase in the number of muscle cell MITOCHONDRIA have been described. The condition is usually managed by rest and rationed periods of work.

tenosynovitis

inflammation of tendon and synovial sheath
  • acute simple synovitis traumatic synovitis; due to over-/unaccustomed use causing tendon and synovial sheath inflammation; characterized by pain/crepitus on movement, local swelling and tendon warmth; treated by rest, appropriate padding and strapping, orthoses, shoe advice (especially for tenosynovitis of extensor hallucis longus)

  • acute suppurative synovitis infected synovitis due to puncture of the tendon sheath (e.g. a 'spike' injury of tendo Achilles) or breakdown of tissue deep to a persistent corn (e.g. overlying prominent extensor hallucis longus tendon; characterized by acute infection (see sepsis); treated as an infected lesion (see Table 1) with systemic antibiosis

  • chronic simple synovitis; repetitive strain injury; RSI chronic inflammation of tendon/sheath (due to repetitive overuse), together with subserved muscle weakness/wasting; treated as chronic inflammation; note: cause must be established and resolved to achieve permanent resolution

Table 1: Treatment of local sepsis
MnemonicRationaleTreatment modality
OOperateRemove the cause of the infection where possible, e.g. remove focal hyperkeratosis/foreign body/nail spike
CCleanseIrrigate area/cleanse cavity with Warmasol delivered under pressure from a sterile syringe
HHeatAssist drainage of pus/exudate by applying heat, e.g. immersion in a warm hypertonic NaCl bath
AAntisepticApply a liquid or powder antiseptic (e.g. Betadine)
DDressCover the lesion with a sterile dressing (e.g. sterile gauze; Lyofoam)
RRestImpose rest, e.g. deflective padding; shoe modification; walking cast; crutches, as necessary
AReappointArrange to review case in 24-72 hours
RReviewAt the subsequent appointment, review progress
If resolution has been initiated, continue to treat as above (O-A) and review weekly until healing is complete
If the infection has not improved, arrange for antibiosis, and continue to review and dress until healing is complete
RReferRefer for specialist review via GP: remember, slow-to-resolve infection can characterize undiagnosed diabetes, or other 'at-risk' patient category

Use all normal preoperative procedures; keep infected lesions covered until ready to treat; take a swab for pathology laboratory analysis of any exudate; use a sterile dressings pack; follow the OCH-A-DRARR treatment mnemonic.

'At-risk' patients presenting with infection or patients presenting with acute or spreading infection should be treated using the OCH-A-DRARR protocol, but provided with or referred for immediate antibiosis.

repetitive strain injury,

n a family of conditions characterized by pain, stiffness, numbness, and inflammation in joints and muscles; caused by chronic overuse. Also called
cumulative trauma disorders, CTD, or
repetitive motion injuries.

repetitive strain injury (RSI),

n a loose group of injuries that occur to muscles, nerves, and tendons as a result of repetitive movements of particular body parts. It is caused or aggravated by frequently repeated movements, such as computer strokes or the use of vibrating equipment. Symptoms include pain, tingling, or swelling of the affected body part. Also known as
overuse syndrome or
cumulative trauma disorder.
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