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Mark asked...

Would physio help my RSI?

I have been suffering with RSI in both hands/wrists/arms for about 18 months now. I have had tests to rule out Carpal Tunnel.

I take Ibuprofen daily, both hands are in splints virtually all day. I work at a computer all day and have been given an ergonomic keyboard and take regular breaks.

I feel as if it is spreading and getting worse. It's really getting me down, would physio/massage of some sort help or should I just learn to deal with it?

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The answer

Repetitive strain injury is a frustrating condition to manage for both patient and clinician; it can also lead to low moods. It would appear that you, your employer and doctor have all the right interventions in place to prevent further injury and help your wrists, hands and arms to heal themselves. There are two types of repetitive strain injury, Type 1 and Type 2. Type 1 repetitive strain injury has a clearly defined cause, which could be carpal tunnel syndrome, tendonitis or tenosynovitis. These conditions have micro trauma causing inflammation within the tissues of these conditions and the body finds it difficult to heal these tissues because of movement, a poor blood supply and how these tissues heal.

It would appear that your General Practitioner has ruled out conditions that are causing Type 1 repetitive strain injury. Sometimes carpal tunnel syndrome, tendonitis or tenosynovitis can be managed with surgery or steroid injections.

Typically, repetitive strain injuries resolve within 3 – 6 months and there can be exacerbations of the symptoms in the future. If the symptoms persist for longer as in your case, sometimes a change in job may be recommended or the use of tricyclic antidepressants (primarily for pain relief) has been found to be beneficial. Occupational therapists and physiotherapist as you suggest, may help prevent further trauma and recommend the use of splints. There is little research evidence to suggest that massage, acupuncture or osteopathy is beneficial for managing the condition, but some people have benefited from these hands on therapies.

Repetitive strain injuries and especially Type 2 repetitive strain injuries are very debilitating both physically and psychologically, and you may benefit from a further discussion with your General Practitioner regarding a referral onto a pain management specialist or for psychological support, if that is felt to be clinically appropriate.

Answered by Health at Hand nurses.

 

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