REPETITIVE STRAIN INJURY

Repetitive Strain Injury (RSI) is an ill-defined condition which most commonly affects the upper extremity. It is also referred to as Work-Related Upper Limb Disorder.

It is a common occupational disorder caused by chronic overuse of soft tissues of the arm and usually affects the wrist and forearm. Carpal tunnel syndrome sometimes falls into this category of condition when it is work-related.

As a syndrome there is limited evidence to demonstrate effectiveness as the condition is often multifactorial.

Chiropractors treat the components of RSI (which may include carpal tunnel syndrome, chronic extensor tendonitis, lateral epicondylitis and rotator cuff injury to the shoulder) and using a package of care that may include manual therapies, acupuncture, exercise prescription and onward referral when indicated.

Chiropractors are also well qualified to advise on ergonomics and often visit workplaces to conduct display screen equipment (DSE) assessments.

There is evidence to support this approach to care. This includes:

Konijnenberg HS, de Wilde NS, Gerritsen AA, van Tulder MW, de Vet HC. Conservative treatment for repetitive strain injury. Scand J Work Environ Health. 2001 (Oct); 27(5): 299-310.

TENNIS ELBOW (LATERAL EPICONDYLITIS)

Tennis elbow involves a chronic inflammation of the lateral epicondyle (the distal extensor attachment of the humerus). It may arise secondary to sport-related injuries or chronic repetitive injury. Pain is experienced on the outer aspect of the elbow and is aggravated by repeated activity.

Chiropractors treat tennis elbow using a package of care that may include manual therapies, ergonomic advice in the workplace, electrotherapy, acupuncture, use of supports and onward referral when indicated.

There is evidence to support this approach to patient care:

Bisset L, Paungmaili A. Vicenzino B, Beller E. A systematic review and metaanalysis of clinical trials on physical interventions for latearal epicondylalgia. Br J Sports Med 2005; 39:411-422

Bussieres AE, Peterson C. Taylor JA. Diagnostic imagine guideline for musculoskeletal complaints in adults – an evidence based approach – part 2: upper extremity disorders. J Manipulative Physiol Ther 2008 Jan;31(1):2-32