Paul Tompkins Physiotherapy

Orthopaedic & Sports Injury Specialist

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Conditions treated - Repetitive Strain Injury (RSI)

Repetitive strain injury (RSI) can be caused by a variety of tasks at work, such as forceful or repetitive activity, or by poor posture.

The condition mostly affects parts of the upper body, such as the forearm, elbow, wrist, hands, shoulders and neck.

RSI is usually associated with doing a particular activity repeatedly or for a long period of time.

It often occurs in people who work with computers or carry out repetitive manual work.

Symptoms can include:

  • Short bursts of excruciating pain in the arm, back, shoulders, wrists, hands, or thumbs (typically diffuse – i.e. spread over many areas).
  • The pain is worse with activity.
  • Weakness, lack of endurance.

The symptoms tend to be diffuse and non-anatomical, crossing the distribution of nerves, tendons, etc. They tend not to be characteristic of any discrete pathological condition.


What causes RSI?

RSI is believed by many to be caused due to lifestyle without suitable ergonomic care, E.g. While working in front of computers, driving, traveling etc. Simple reasons like 'Using a blunt knife for everyday chopping of vegetables', may cause RSI.

Other typical habits that some people believe lead to RSI:

  • Reading or doing tasks for extended periods of time while looking down.
  • Sleeping on an inadequate bed/mattress or sitting in a bad armchair and/or in an uncomfortable position.
  • Carrying heavy items.
  • Holding one's phone between neck and shoulder.
  • Watching TV in incorrect position e.g. Too much to the left/right.
  • Sleeping with head forward, while traveling.
  • Prolonged use of the hands, wrists, back, neck, etc.
  • Sitting in the same position for a long period of time.


How can physiotherapy help?

Physiotherapists are highly skilled at supporting people with RSI. They will explain how you can manage the pain and contribute to your own recovery.

What will happen when I see a physiotherapist?

The physiotherapist will assess how the affected areas of your body are working and how this is impeding with good movement during routine activities. They will ask lots of questions, watch your movements and touch the affected area. Recommendations for treatment depend on the length of time that has passed since the injury. Any visit is likely to include:

  • exercises to do yourself
  • some manual therapy
  • advice on posture while sitting and sleeping, including practical advice on pillows
  • lifestyle advice, and activities to avoid.

It may also include:

  • applying heat or cold to the affected area.
  • TENS - to help with any pain.

The most often prescribed treatments for repetitive strain injuries are rest, exercise, braces and massage. A variety of medical products also are available to augment these therapies.

Since the computer workstation is frequently blamed for RSI, particularly of the hand and wrist, ergonomic (*) adjustments of the workstation are often recommended.

* Ergonomics - is the study of designing equipment and devices that fit the human body, its movements, and its cognitive abilities. For instance modifications of posture and arm use may be recommended.

Meanwhile, how can I help myself?

Some practical tips can help to reduce your risk of developing RSI and other related disorders that can arise from working with computers.

Make sure your desk equipment is properly set up and adjusted to your specifications is the first step in preventing RSI.

Additional advice can be found at the NHS web site which includes a guide on sitting in the right position and arranging your desk correctly.

The standard keyboard and mouse are adjustable devices with settings that you can change in the same way you might adjust your office chair.

Various types of non-standard keyboards are available. They may improve the positioning of the hands.

Some individuals find the standard mouse uncomfortable as they involve twisting the wrist. Alternative mice and other pointing devices are worth investigating.

You could also consider speech recognition software, which allows you to control your phone or a computer application by using your voice.

Your mouse
  • Slowing your mouse down can greatly reduce muscle tension in your hand.
  • Download “mousetool” OS software. It takes away the need to click on the mouse, which many people find painful. You may need to get permission from your employer in order to download the software.
  • Use “keyboard shortcuts” instead of the mouse to navigate and execute commands.
  • The “mouse keys” feature allows you to use the arrow keys on your keyboard’s number pad to move the pointer around the screen.

Your keyboard

  • You can adjust the keyboard’s key “repeat rate” to avoid mistakes that you then have to go back and correct.
  • Use “sticky keys” to avoid having to hold a modifier key down, such as Shift, Ctrl or Alt while pressing another key.
  • “Predictive text” and “auto-correct” features guess what you want to type and save you unnecessary keystrokes.

Take regular breaks

Don’t sit in the same position for long periods. Short, regular breaks can help prevent RSI and other upper limb disorders.

It lets the muscles relax while others take the strain. This can prevent you from becoming stiff and tense.

Most jobs provide opportunities to take a break from the screen, for example, filing or photocopying. Try to make use of them.

If there are no such natural breaks in your job, your employer should plan for you to have rest breaks.


Where can I get more information?

  • - The home of the NHS on the web. includes a lot of advice and useful information.

Disclaimer: The content on this page is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.

Note: You do not need a GP referral to receive physiotherapy if you self fund your treatment. However if you intend to claim all or part of your treatment costs back a GP referral is usually required by your insurance company.