Examine individual changes

'{{redirect-distinguish|Gamer's thumb|Gamekeeper's thumb}} {{Infobox disease | Name = Repetitive Strain | Image = | Caption = | DiseasesDB = 11373 | ICD10 ={{ICD10|M|70}}, {{ICD10|X|50}}, {{ICD10|Z|57.7}} | ICD9 = {{ICD9|E927.1}}, {{ICD9|E927.3}}—{{ICD9|E927.9}}, {{ICD9|727.2}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = pmr | eMedicineTopic = 97 | MeshID = D012090 }} ('''RSIs''') are "injuries to the [[musculoskeletal]] and [[nervous system]]s that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward positions".<ref name=NJ>[http://www.state.nj.us/health/eoh/peoshweb/ctdib.pdf Public Employees Occupational Safety and Health Program of the New Jersey Department of Health and Senior Services]</ref> RSIs are also known as ''cumulative trauma disorders'', ''repetitive stress injuries'', ''repetitive motion injuries or disorders'', ''[[musculoskeletal disorders]]'', and ''occupational or sports overuse syndromes''. owaais smells ==Definition== Repetitive strain injury (RSI) and cumulative trauma disorders are [[umbrella term]]s used to refer to several discrete conditions that can be associated with repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained/awkward positions.<ref name=NJ/><ref name=vanTulder2007>{{cite journal |author=van Tulder M, Malmivaara A, Koes B |title=Repetitive strain injury |journal=Lancet |volume=369 |issue=9575 |pages=1815–22 |date=May 2007 |pmid=17531890 |doi=10.1016/S0140-6736(07)60820-4 |url=http://www.researchgate.net/publication/6303661_Repetitive_strain_injury/file/d912f50c5ef67d0b27.pdf}}</ref> Examples of conditions that may sometimes be attributed to such causes include [[edema]], [[tendinosis]] (or less often [[tendinitis]]), [[carpal tunnel syndrome]], [[cubital tunnel syndrome]], [[De Quervain syndrome]], [[thoracic outlet syndrome]], [[intersection syndrome]], [[golfer's elbow]] (medial epicondylitis), [[tennis elbow]] (lateral epicondylitis), [[trigger finger]] (so-called stenosing tenosynovitis), [[radial tunnel syndrome]], and [[focal dystonia]].<ref name=NJ/><ref name=vanTulder2007/> Since the 1970s there has been a worldwide increase in RSIs of the arms, hands, neck, and shoulder attributed to the widespread use of typewriters/computers in the workplace that require long periods of repetitive motions in a fixed posture.<ref>{{cite web|url=http://www.rsi.org.uk/whatis/prevalence.html |title=Welcome to the RSI Awareness Website |publisher=Rsi.org.uk |date=2010-11-17 |accessdate=2014-07-17}}</ref> ===Popular terms=== Specific sources of discomfort have been popularly referred to by terms such as [[Blackberry thumb]], iPod finger, [[gamer's thumb]], Rubik's wrist or "cuber's thumb",<ref name=Waugh1981>{{cite journal |author=Waugh D |title=Cuber's thumb |journal=N. Engl. J. Med. |volume=305 |issue=13 |page=768 |date=September 1981 |pmid=7266622 |doi= 10.1056/nejm198109243051322|url=}}</ref> stylus finger,<ref>{{cite web|author=December 30, 2012 |url=http://ctsplace.com/5-injuries-made-possible-by-modern-technology.php/ |title=5 Modern Technology Strain Injuries &#124; Carpal Tunnel Syndrome |publisher=Ctsplace.com |date=2012-12-30 |accessdate=2014-07-17}}</ref> raver's wrist,<ref>[http://medical-dictionary.thefreedictionary.com/Raver’s+Wrist raver’s wrist]</a></ref> and [[Emacs pinky]], among others. == History == Although seemingly a modern phenomenon, RSIs have long been documented in the medical literature. In 1700, the Italian physician [[Bernardino Ramazzini]] first described RSI in more than 20 categories of industrial workers in Italy, including musicians and clerks.<ref>Ramazzini, ''De Morbis Artificum Diatriba'' (Diseases of Workers), Modena Italy,1700.</ref> Carpal tunnel syndrome was first identified by the British surgeon [[James Paget]] in 1854.<ref>Pearce JM (April 2009). "James Paget's median nerve compression (Putnam's acroparaesthesia)". Pract Neurol 9 (2): 96–9.</ref> The [[Swiss people|Swiss]] surgeon [[Fritz de Quervain]] first identified De Quervain’s tendinitis in Swiss factory workers in 1895.<ref>Ahuja NK, Chung KC, "Fritz de Quervain, MD (1868-1940): stenosing tendovaginitis at the radial styloid process", J Hand Surg., vol.29 #6 pp. 1164–70.</ref> The French neurologist [[Jules Tinel]] (1879-1952) developed his percussion test for compression of the median nerve in 1900.<ref>Tinel, J., “Nerve wounds” London: Baillère, Tindall and Cox, 1917</ref><ref>Tinel, J., ‘’Le signe du fourmillement dans les lésions des nerfs périphériques’’, “Presse médicale”, 47, 388-389,1915</ref><ref>Tinel, J. ‘’The "tingling sign" in peripheral nerve lesions’’ (Translated by EB Kaplan). In: M. Spinner M (Ed.), “Injuries to the Major Branches of Peripheral Nerves of the Forearm”, 2nd ed. pp 8-13, Philadelphia: WD Saunders Co, 1978.</ref> The American surgeon [[George S. Phalen|George Phalen]] improved the understanding of the aetiology of carpal tunnel syndrome with his clinical experience of several hundred patients during the 1950s and 1960s.<ref>http://www.turner-white.com/pdf/hp_jul00_tinel.pdf</ref> ==Treatment== RSIs are assessed using a number of objective clinical measures. These include effort-based tests such as grip and pinch strength, diagnostic tests such as [[Finkelstein's test]] for Dequervain's tendinitis, [[Phalen maneuver|Phalen's Contortion]], [[Tinel sign|Tinel's Percussion]] for carpal tunnel syndrome, and [[electrophysiological|nerve conduction velocity]] tests that show nerve compression in the wrist. Various imaging techniques can also be used to show nerve compression such as [[radiological|x-ray]] for the wrist, and [[magnetic resonance imaging|MRI]] for the thoracic outlet and cervico-brachial areas. The most-often prescribed treatments for early-stage RSIs include drug therapies such as anti-inflammatory medications combined with passive forms of physical therapy such as rest, splinting, massage and the like. Low-grade RSIs can sometimes resolve themselves if treatments begin shortly after the onset of symptoms. However, some RSIs may require more aggressive intervention including surgery and can persist for years. General exercise has been shown to decrease the risk of developing RSI.<ref>{{Cite journal|title=Work-Related Repetitive Strain Injury and Leisure-Time Physical Activity|last=Ratzlaff|first=C. R.|author2=J. H. Gillies |author3=M. W. Koehoorn |journal=Arthritis & Rheumatism (Arthritis Care & Research) |volume=57 |issue=3 |date=April 2007 |pages=495–500 |pmid=17394178|doi=10.1002/art.22610}}</ref> Doctors sometimes recommend that RSI sufferers engage in specific strengthening exercises, for example to improve sitting posture, reduce excessive [[kyphosis]], and potentially [[thoracic outlet syndrome]].<ref>Carolyn Kisner & Lyn Allen Colby, Therapeutic Exercise: Foundations and Techniques, at 473 (5th Ed. 2007).</ref> Modifications of posture and arm use ([[human factors and ergonomics]]) are often recommended.<ref>Berkeley Lab. [http://www.lbl.gov/ehs/pub811/hazards/ergonomics.html ''Integrated Safety Management: Ergonomics'']. Website. Retrieved 9 July 2008.</ref> [[Image:Computer Workstation Variables.jpg|thumb|240px|Ergonomics: the science of designing the job, equipment, and workplace]] ==See also== * [[Carpal tunnel syndrome]] * [[List of Repetitive Strain Injury software]] * [[Sports Injury]] * [[Tendinitis]] * [[Tendinosis]] ==Notes== {{Reflist|30em}} ==External links== * {{dmoz|Health/Conditions_and_Diseases/Musculoskeletal_Disorders/Repetitive_Strain_Injuries/|Repetitive Strain Injuries}} * [http://osha.europa.eu/topics/msds Musculoskeletal disorders] from the European Agency for Safety and Health at Work ([[EU-OSHA]]) * [http://www.workrave.org/ Workrave] application for prevention of RSI * {{Cite journal|author=Amadio PC |title=Repetitive stress injury |journal=J Bone Joint Surg Am |volume=83-A |issue=1 |pages=136–7; author reply 138–41 |date=January 2001 |pmid=11205849 |url=http://www.ejbjs.org/cgi/pmidlookup?view=long&pmid=11205849}} * [http://www.rsi.deas.harvard.edu/ Harvard RSI Action] * [http://www.eecs.umich.edu/~cscott/rsi.html Prevention and Management of Repetitive Strain Injury] * [http://www.iom-world.org/pubs/IOM_TM9904.pdf Epidemiological and ergonomic study of occupational factors associated with syndromes of upper limb disorders in keyboard operators] by M Hanson and others. [[Institute of Occupational Medicine]] Research Report TM/99/04 * [http://www.iom-world.org/pubs/IOM_TM9008.pdf Development of an aid to identifying task elements, which may predispose individuals to work related upper limb disorders] by RA Graveling and others. [[Institute of Occupational Medicine]] Research Report TM/90/08 * [http://www.iom-world.org/pubs/IOM_TM8819.pdf Clinical epidemiological study of relations between upper limb soft tissue disorders and repetitive movements at work] by CJ English and others. [[Institute of Occupational Medicine]] Research Report TM/88/19 {{Use dmy dates|date=September 2010}} {{Occupational safety and health}} {{DEFAULTSORT:Repetitive Strain Injury}} [[Category:Musculoskeletal disorders]] [[Category:Occupational diseases]] [[Category:Overuse injuries]] [[Category:Physical ergonomics]] [[es:Enfermedad profesional#Enfermedades osteomusculares]]'