repetitive strain injury
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repetitive strain injury
repetitive strain injuryA 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 injuryA 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.
tenosynovitisinflammation 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
|O||Operate||Remove the cause of the infection where possible, e.g. remove focal hyperkeratosis/foreign body/nail spike|
|C||Cleanse||Irrigate area/cleanse cavity with Warmasol delivered under pressure from a sterile syringe|
|H||Heat||Assist drainage of pus/exudate by applying heat, e.g. immersion in a warm hypertonic NaCl bath|
|A||Antiseptic||Apply a liquid or powder antiseptic (e.g. Betadine)|
|D||Dress||Cover the lesion with a sterile dressing (e.g. sterile gauze; Lyofoam)|
|R||Rest||Impose rest, e.g. deflective padding; shoe modification; walking cast; crutches, as necessary|
|A||Reappoint||Arrange to review case in 24-72 hours|
|R||Review||At 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
|R||Refer||Refer 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,
cumulative trauma disorders, CTD, or
repetitive motion injuries.
repetitive strain injury (RSI),
overuse syndrome or
cumulative trauma disorder.