Repetitive Strain Injuries In Detail

A repetitive strain injury (RSI) is cluster of conditions resulting from continuous use of tools such as computer keyboard, musical instrument and activities that demand repeated movements.Although the cause of 'inflammation' associated with cumulative trauma have not been clearly elucidated, many factors including mechanical fatigue involving ligaments, tendons and soft tissues have been implicated.

Differential diagnosis first takes into account the location of the inflammation, and will include such disorders as tennis elbow, Carpal Tunnel Syndrome, shin splints, rotator cuff injuries, medial and anterior cruciate laxity, pinched nerves, tendinopathy, etc. Carpal tunnel syndrome is seen in all types of patients. Triangular fibrocartilage complex injury is less well known and presents as an injury of the cartilage of the wrist joint. Its symptoms include wrist pain arising from the ulnar side, a clicking sound during wrist movement and reduced grip strength. Patients with systemic sclerosis can also exhibit wrist pain as a result of osteonecrosis of the lunate bone. Patients with scleroderma are at increased risk of wrist pain derived from osteonecrosis. The scaphoid compression test is used to reveal the presence of scaphoid fracture when x-ray results are negative.

The scaphoid shift test is accepted as a definitive test for scaphoid instability using pressure against the scaphoid tubercle. Carpal tunnel syndrome (CTS) also known as median neuropathy at the wrist is the compression of the median nerve at the wrist leading to pain in the hand. Although most cases occur without a known cause, repetitive activities often cause Carpal tunnel syndrome (CTS). Although the cause of painful dorsal wrist ganglia remains unknown, a correlation between a painful dorsal wrist ganglion and wrist joint abnormality has been established. An injury to scapholunate ligament that maintains the proximal pole of the scaphoid adjacent to the lunate and stabilizes the palmar rotation force of the scaphoid against the dorsal rotation force of the lunate includes scaphoid fracture and dynamic scapholunate instability.

To diagnose a syndrome such as De Quervain's tensynovitis (where tendons in your thumb become inflamed and swollen, greatly limiting movement of the thumb), an x-ray of the bone will be needed. These x-ray images can help a doctor determine the appropriate diagnosis and subsequent treatment of joint pain in the hand or wrist.

Scapholunate injuries often coincide with distal radial fractures. Distal lunate joint instability is caused by conditions involving the distal radio-ulnar joints. Distal lunate joint instability is often found in patients suffering from rheumatoid disease or those who have fractured their distal radius. Known as Hamate fractures, these comprise 2% of all the carpal fractures related to recreational sports such as racquets, bats, and clubs. A hamate bone is triangular in shape and is made up of a body and a hook.

Repetitive Strain Injuries are especially common among information workers, who work at a computer for long hours. Often, RSIs can be avoided by following a few simple ergonomic rules.

- Frank Barnett