Talk:Repetitive strain injury

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Remove this
This is not science. This is based in fabrication, disinformation, panic and greed. This article should be removed, now. Historygypsy (talk) 14:25, 7 November 2010 (UTC)


 * Nonsense. This is a genuine condition, recognised by many medical professionals and organisations around the world, including the UK's NHS - see http://www.nhs.uk/conditions/repetitive-strain-injury/Pages/Introduction.aspx
 * Because a clear physical often cause cannot be found, it seems that people jump to the "all in the mind" conclusion. This ignores the possibility of physical causes which are hard to detect. Dr Andrew Dilley and others have been carrying out research into subtle differences in how the median nerve moves in RSI patients vs controls. Some details and links to medical papers can be found here: http://www.unisoneastern.org.uk/documents/en/RSI/RSI_Action_Newsletter_Issue_13__-_June_2010.pdf Arganoid (talk) 15:56, 4 February 2011 (UTC)

Reply The UK NHS recognises it?, Wow! ""Makes it official then". (apologies to Geoffery Rush).Historygypsy (talk) 18:26, 17 May 2011 (UTC)
 * What is more relevant is that the World Health Organization recognises this as disorder and has classified it in ICD-10 under category . Beeswaxcandle (talk) 06:47, 5 July 2011 (UTC)

-
 * Response to Arganoid

Please do not use intemperate epithets like "Nonsense", it is rude and not helpful. The President of the Royal Australian College of Physicians made an unprecedented statement that RSI was not a genuine medical condition.

I can name dozens of "Conditions" once thought to be genuine that are no longer accepted. The WHO is not an organization of treating doctors, but a vast bureaucratic organization that creates mountains of paper but never sees a single patient. As a doctor who has taught medicine in 3 universities in 2 countries and who knows who fabricated, promoted and profited from this non-disease, I stand by every word. Repetition was never quantified, and injury was simply assumed because the claimant was a worker. Some of the so-called causes were not even repetitive. Strain was never demonstrated, some of the so-called causes are not strenuous and injury was simply assumed to fit into the left wing views of judges, lawyers and unions in Sydney, Australia where the condition was fabricated. It spread from work-place to work-place and then from industry to industry, but seldom access the border into other similar work places in other states. The spread followed the epidemiological pattern of an infection, but in this case the carriers were not insect borne microbes but media and Union borne scare mongering. The unions were simply doing their job, the media were beating the drum with scary, uninformed and misleading publicity that we all recognize as an every day event when they have a "Good story that will run". The lawyers, some tied to unions, did what they are paid to do, represent the claimant. The doctors who promoted and benefited disgraced their profession. I read of "Experts" under oath say such unbelievable nonsense as to beggar the imagination.

The epidemic occurred when the Australian economy (especially small business) was under siege, with companies downsizing, amalgamating, moving location, outsourcing and dissolving. The government civil services were being scaled down due to the advent of desktop computers that removed such jobs as filing clerks, archivers and type writer operators. Factories were installing computer operated machinery to remain able to compete with cheaper imports. The workforce, many immigrant and uneducated, semi or unskilled, had no hope of another job. Many were women, holding the families second and vital source of income, sometimes the only source. The panic that was caused by lurid scare mongering caused these desperate people to accept anything that would save the family from destitution. Unions had seen a mass departure of membership once compulsory unionism was banned and collective bargaining allowed. They now moved in with relish to promote a cause, and added fuel to the fire. They demanded (and got) "RSI co-ordinators" in every work place and whenever a worker's job was threatened, the Union Doctor came in and asked if they ever had pain. Of course the answer was yes, if it was not, they were advised to think again. A claim was filed including the nebulous concept of damages for "Pain and suffering". The Union of Labour Lawyers dominated the workers' Compensation courts, both as advocate and judges. Huge damages were awarded and as a result, insurances for companies soared. Companies were forced out of business due to the campaign of terror and massive payoffs, as well as "Contributions" to unions to keep the peace, as well and rising insurance premiums. This added to the growing unemployment, and a vicious cycle ensued. Union representatives visited their "Comrades" overseas, but only after it was pointed out that RSI was unheard of outside of Australia and rare outside Sydney. A prediction was made that the Unions would pick this up and export the problem, and within months, that is exactly what occurred.

Regretfully, some patients were actually coached to fabricate an injury, in order to get a payout when they were made unemployed. This led to a weird collection of bizarre presentations that were clearly not medical, but still, the courts accepted them an the testimony of "Expert" witnesses. Further, if the worker was unable to get another job. I was approached more than once to "Help" someone who stated clearly that he or she perfectly healthy, but "need the money". I refused.

The entire epidemic of panic ended when the laws were amended to stop the nonsense, proof positive that this was panic, not injury.

But the damage has been done. Genuine illnesses and genuine injuries related to work (and there are many) are mis-labelled as RSI, causing incorrect treatment and giving a stigma to the worker that makes them unemployable. That is the real tragedy, a compensation system that was rightly created to protect an injured worker became so distorted that it ended up doing exactly the opposite.

An Australian prominent in the compensation field summed it up thus ---"The pain of strain lies mainly on the Brain" (a Parody on to Lerner & Loewe's My Fair Lady")

This Wiki article needs to be removed. It is not based on fact, but on folk lore.70.83.10.55 (talk) 16:18, 26 July 2011 (UTC)


 * Sorry for heated language but perhaps my frustration will be more understandable if you read my account of what I've been through with my condition over the last four years: http://argnet.fatal-design.com/rsi.php . Contact me on Skype if you like, email me via my site for details.
 * I also recommend reading recent comments below by Laguna Greg and Grevillea Arganoid (talk) 14:26, 31 August 2011 (UTC)

Text messaging
Editors may be interested in: Texting Can Be a Pain in the Neck, Shoulders. -- Wavelength (talk) 20:37, 26 November 2009 (UTC)

The historygypsy is biased. I work on computers and have done for 20 years. I have a reptitive strain and it ****** hurts. It's extremely painful and has resulted in loss of use of my right arm at times. I haven't made a claim or anything but thanks to this *ick head I think I will now. — Preceding unsigned comment added by 80.231.29.104 (talk) 12:58, 29 August 2012 (UTC)

REPLY
SORRY, PAIN IS NOT STRAIN. NOR DOES PAIN AUTOMATICALLY BECOME AN INJURY Historygypsy (talk) 00:39, 28 July 2011 (UTC)

I said I have a strain injury. I know I have a strin injury because it has been investigated and recognised by medical staff. The strain involves pain and they are linked. You cannot have a strain that doesn't cause some form of discomfort (involving pain) otherwise you wouldn't know if you had it! You obviously have no personal experience of strain in the context of a very long term repetitive working environment, but for no good reason you seem to think you are the all knowing being of this subject. Grow a brain and talk to people who knoe what they're on about and have physical experience not just theory - you're wating your own time and everyone else's time. — Preceding unsigned comment added by 80.231.29.104 (talk) 13:03, 29 August 2012 (UTC)

The Australian Epidemic of nonsense: a rant by HistoryGypsy
I lived through the creation of this nonsense, that was created and nurtured by Unions, Lawyers, people who were out of work, and I am ashamed to say, fellow doctors. The left wing media added fuel to the fire with uneducated and at times, fabricated articles warning of permanent crippling due to simple repetitive tasks, tasks that had been undertaken for prior decades without any complaint., let alone injury.

The "Epidemic" was largely restricted to certain sections of businesses who were either closing, re-locating, downsizing or being taken over. At the same time, workers doing similar tasks in the same company, or in similar companies did not report symptoms. Further, the epidemic was largely restricted to the city of Sydney, although, once the civil service started to be cut back, it appeared in the national capital, Canberra.

One cannot blame the workers who were facing retrenchment with no prospect of re-employment. At the same time, Unions, had suffered huge losses in membership due to laws that banned compulsory unionism, which became voluntary. Many left the Union movement due to high fees, intimidation and in some cases, mis-management. These were afforded the right of " Collective Bargaining" instead.

The Unions seized the opportunity, and published lurid, frightening booklets and leaflets claiming that "RSI" could led to crippling. The overwhelming claims were from women. Many of the process workers under siege were immigrants, not literate or articulate in English, and were frequently holding down the families second (and in some cases the only) source of income. The Unions appointed "RSI Co-ordinators" in companies, and scared the workers into claiming even minor fatigue aches. A union "Trade Workers' Clinic" compounded the problem by making claims that were not only outlandish, but clearly spurious. A "Workers' Compensation Court" was expanded, with a sizeable number of socialist judges belonging to a caucus called "The League of Labour Lawyers". The result was predictable, the epidemic spread like an infectious disease, jumping across oceans and land borders, but always selectively. The epidemic spread to other countries, after it was pointed out that the problem did not exist in other countries. It was at that time said that the Unions would hear of this, and would make sure that the problem would cross the oceans, and within a short time, that is exactly what happened.

No injury was ever demonstrated, not by organ imaging of any type, biopsy, electrical studies or by simple examination. Carpal tunnel syndrome, which was annexed heuristically to RSI is not due to strain. Further, most of the claimants were doing simple repetitive tasks that could be tiring, but each movement alone was not strenuous. If you do not strain yourself once, then you cannot claim strain to be repetitive, since you cannot compound nothing. On the other hand, there were some undoubted cases of clear cut strain injuries due to excessive or mis-applied force, and if that force was repeated, then the term RSI could be valid. The classic example is hitting a tennis or golf ball with an incorrect action, when, if repeated can lead to Golfers' or Tennis elbow". I had Tennis elbow from just this folly of not stopping at the first twinge of pain. In these and other cases, the nature and the site of injury was easily demonstrated in anatomic and physiologic terms.

There were increasing numbers of claimants that had been coached by unscrupulous professionals. The problem was that frequently the claimants either forgot, or were unable to reproduce, or just fabricated incapacity. This led to a variety of bizarre non-explainatory signs that, true to form, were than claimed to be "typical of, and diagnostic of, RSI".

Clearly, there were some genuine work injuries, but these were always in the category of well known afflictions. But the promotors of "RSI" in the Australian context were calling any pain, of any origin RSI. The problem was that strain was never demonstrated, repetition was never quantified and injury was simply assumed if the claimant was working. When it was pointed out that "RSI" had no diagnostic features, and fitted into no organ or physiological entity, the absurd claim was made that "The hallmark of RSI is that it has no diagnostic features"!! I had the experience of doctors telling me that they only diagnosed RSI "....because if I didn't, I would have no practice left". The tragedy was that the workers suffered. Many lost their jobs because companies were unable to afford escalating insurance costs, especially when a work place became a hotbed of claims due to fears of job loss. Such workers were then marked for ever as "suspect", and were locked out of the work force. This re-enforced the myth that RSI could cause permanent incapacity, a myth that the unfortunate ex-worker had to perpetuate in order to keep the compensation payments. This led to more bizarre and at times fabricated behaviour, since it was nigh impossible to remember how to maintain the illusion of injury.

The damage to the economy was enormous, due to companies failing, insurance payouts soaring and long term compensation payments reaching astronomic proportions.

Some doctors, lawyers, union and media folk are ultimately responsible for this tragedy which caused so much misery, which was initially motivated by a genuine fear held by hard working process workers, but fed by greed and power of those who knew better.

Finally, the epidemic died out. The demise of RSI as an epidemic was caused by a revision of the law, and by the loss of credibility attached to by those professionals who sought to capitalize on the epidemic for personal gain. doubtless, in the mad boom of the 1990's a resurgence of employment helped. But the myth lives on, and like a religion, it survives in the minds of those who do not know, or who do not wish to accept the facts. RSI is now an article of faith, and "It is harder to shake a belief than fact", (a quote from the master of dis-information, Adolf Hitler) Readers are urged to read the writings of the eminent occupational epidemiologist, Nortin Hadler Historygypsy (talk) 18:34, 28 July 2010 (UTC)


 * Please move your Godwin to the first line of your diatribe to minimize lost time of wikipedia discussion page readers.98.240.67.27 (talk) 06:23, 10 July 2011 (UTC)


 * This article should remain. RSI has most certainly not died out; it has not in the U.S., Canada, or Europe.  In fact, the Federal Bureau of Labor Statistics confirms that reported workplace injuries in this category are only slightly less per year now than they were in the early 90s, when the reported cases of the syndrome peaked.  Yes, there is still some controversy as to the all-inclusive nature and tertiary stages of the syndrome, but the American Medical Association, the American Physical Therapy Association and countless other professional groups accept this as a bona fide medical condition and have for over two decades.  Not to mention that the U.S. government funds numerous studies of the illness ever year, and major researchers in the field continue to study it and publish their results in peer-reviewed journals.Laguna greg (talk) 00:50, 27 August 2011 (UTC)

I am quite surprised to find that historygypsy no longer has an account page here at wikipedia, and their talk page has nothing in it but bot notices about how his comments or edits have been removed or reverted. Laguna greg (talk) 15:56, 13 June 2012 (UTC)

canbeKRONIK
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 * angls=120^-----Please note, I have &#91;&#91;Repetitive Strain Injury&#93;&#93; and find typing very hard. I use a form of shorthand, which may be difficult to understand. I can be contacted through MSN (sven70) or Skype (sven0921) if my meaning is unclear. (talk) 18:38, 9 August 2010 (UTC)

The "Psychosomatic?" Issue
Hi All. I have a problem with the emphasis in this article on the so-called "psychosomatic" nature of RSI, especially when this page gets almost 2k hits/day on a subject where information is generally lacking in the public domain. RSI/CTD has long been a recognized syndrome by so many medical groups, that I find it laughable that anyone would even be arguing this point any more. There is, quite literally, more than 100 pounds of studies I could cite, if I had the time, not only substantiating the syndrome but describing it histologically. So it seems highly prejudicial and slanted that such a topic, written in such a negative way, should be included at such GREAT length in an article about a vaguely related syndrome that is not under dispute any more. Any thoughts? And yes, if I have time, I will put together some corroborated information to include here, which the article is also sorely lacking. Cheers!Laguna greg (talk) —Preceding undated comment added 01:01, 27 August 2011 (UTC).


 * Agreed. Seems to suggest physical causes are the minor aspect and that it's mostly just in peoples minds - the position of a number of 'specialists' in the medical profession employed to 'confirm' things by certain health insurance agencies. Some medical/professional references to balance this out would be good. Also, there are no links to fibromyalgia which I understand is the end result of untreated RSI. 121.254.85.166 (talk) —Preceding undated comment added 18:22, 8 June 2012 (UTC)


 * I forgot to mention that the first clinical definition of RSI actually appeared in the 17th century, in a treatise on industrial injuries written by Ramazzini in London, with lots of subsequent documentation and research during the centuries that followed. I can't see how ANYBODY can say this is a new or trumped up fad. Laguna greg (talk) 22:59, 8 June 2012 (UTC)

Last paragraph in the psychosomatic section
Here is the paragraph: "A common theme among different subtypes of RSI is a stigmatization and demonization of hand use. Illness concepts that stigmatize hand use have the potential to create more illness as well-documented in the experience with the Australian RSI epidemic. RSI was first diagnosed in Australia in the 1980s. (Only later was it diagnosed in the US and Britain.) In the early Australian experience, RSI cases increased rapidly over several years, leading to widespread media coverage and worker protests. After a widely publicized court case in which a judge ruled an alleged RSI victim had no bodily injury and could not receive damages, complaints dropped off rapidly, as doctors adopted alternative diagnoses such as tendinitis. Many observers felt that the media coverage and social mobilization against the epidemic had actually helped spread it by causing psychosomatic symptoms in worried workers. This pattern has been seen in other psychosomatic illnesses." There's a few problems with this. I pulled up the article from the Journal of Bone and Joint Surgery and the resulting comments that it generated, and it doesn't support a lot of the statements that are implied here. The article itself actually says that the first major reports of these sort of problems were actually in Japan, not Australia. In one of the comments, a doctor looks at the same data sets and says "Thus, rather than “an epidemic of so-called work-related musculoskeletal problems,” the BLS data demonstrate a moderate and steadily diminishing number of cases, concentrated in just the sorts of jobs that one would expect: occupations requiring heavy lifting, gripping, and high-force/high-repetition work, which often are associated with awkward postures as well." Finally, one of the authors of the original article was a partner at the now-defunct firm Brobeck, Phleger & Harrison which represented companies in RSI-related lawsuits, and the language in the article is clearly not npov. General medical survey articles would be more appropriate sources. In any case, this part of the section is a mess. A13ean (talk) 22:03, 28 August 2011 (UTC)

Thanks to A13ean we now have a possible reason for the strong bias in the subsection on psychosomatic causes of RSI. The deleted paragraph is also logically flawed. Statements such as "This pattern has been seen in some other psychosomatic illnesses" are inappropriate. Firstly, parallel does not demonstrate relationship, especially when the author conveniently fails to consider other possible reasons for the pattern such as changed habits of medical diagnosis. Secondly, the statement as worded actually presumes that RSI is a psychosomatic illness, yet the earlier text makes it clear that this position is held by a minority of medical people.

With the current rise in RSI due to increased use of laptop computers (as ergonomics training courses present), it is important that Wikipedia make a useful and unbiased contribution to assist sufferers.Grevillea (talk) 05:32, 29 August 2011 (UTC)

Tablet Computers
This article says that tablet computers are useful for preventing RSI since they may be less straining than normal keyboards/mice. There are no references for this, and I was just listening to a story a week ago interviewing people who were saying that any extended use of tablets' thumb keyboards cause them pain. — Preceding unsigned comment added by 97.65.197.34 (talk) 13:25, 28 September 2011 (UTC)
 * I'm pretty sure they mean tablet computers where you can input text by writing with a pen, like the lenovo ones for example, rather than an ipad or the like. This should be clarified.  A13ean (talk) 14:22, 28 September 2011 (UTC)
 * Whoops, just reread that section and it actually says ipad in there, dunno. A13ean (talk) 14:23, 28 September 2011 (UTC)
 * I put in a "citation needed" tag. If no reference is provided within a month, we can delete the section on tablet computers.  -- JTSchreiber (talk) 05:02, 5 October 2011 (UTC)

Adding tendinitis and tendinosis (chronic tendinitis) to "see also" if that's ok
Repetitively hitting the keyboard has strained and inflamed my tendons (tendinitis), and neglecting it has lead to a chronic change in collagen composition (tendinosis – common injury in race horses, and treated with mesenchymal stem cells). When Cartman from south park yelled “carpal tunnel!” when playing Warcraft, he received an ice spray, which is actually indicative of tendinitis inflammation. There’s even an RSI book titled, “it’s not carpal tunnel”. I think tendinitis and tendinosis should just as much be on the “see also” section like carpal tunnel. Carpal = numbness and tingling. Tendinitis and tendinosis (chronic tendinitis) = aching and throbbing. — Preceding unsigned comment added by 68.149.158.238 (talk) 02:52, 6 February 2012 (UTC)


 * Carpal tunnel refers to a very specific condition which is pretty easy to identify since the medial nerve is being compressed. Unfortunately it seems to have become shorthand for a larger class of syndromes. This should probably be mentioned in the article.  a13ean (talk) 18:58, 10 June 2012 (UTC)

(Bad) Treatment Advice and Potential Liability
Hi All, I was looking over the article again and actually read what was suggested for treatments and therapies in this article. Most of this information deviates from what is accepted medical practice, to say the least. And some of it is exceptionally bad advice for the injured, especially the section about "accepting and working through pain". WHO ON EARTH PUT THIS IN? The professional societies for physical therapists and occupational therapists in the US repudiated these approaches at least 10 years ago, as they tend to make existing acute injuries worse. This is an area of potential liability for Wikipedia and, possibly, anyone who contributed to this particular section. I can easily imagine an RSI patient suing Wikipedia.org for following "medical" advice they got in this article that made their condition worse. The lone study cited here to corroberate this assertion was done by a couple of psychologists/sociologists, not doctors or physical therapists. So the whole approach is immediately suspect from a medical point of view. And I had no idea Wikipedia was in the business of offering advice or opinions on medical treatments. This section should just be removed.

I have to say that, overall, the quality of the information and the way it's presented here are exceptionally poor. Large parts of the article are obviously biased, badly referenced and misleading. It is far out of step with what the medical profession is doing with RSI patients these days, or even has done historically. Above all, it is nowhere near an encyclopedia-quality article on what is a very technical subject that has over a 250-year-old body of research that, somehow, is not cited anywhere. If I ever get any time, I'm going to start a serious overhaul. Laguna greg (talk) 23:28, 8 June 2012 (UTC)


 * Agreed, I made a first pass and cleaned up a few sketchy things. It would benefit from the attention of someone in the field.  a13ean (talk) 01:13, 9 June 2012 (UTC)


 * I'm going to remove this secion today but save the material for later. Possibly, we can use it later under a different heading discussing the sociological ramifications but not in reference to the medical syndrome. Laguna greg (talk) 16:28, 13 June 2012 (UTC)

Material added to lede
However, according to other specialists in the field, "the concept that repetitive hand use can lead to hand injury is prevalent but lacks scientific support". In addition, the generally inaccurate presentation of RSIs and knowledge about their causes by the media can in fact increase the prevalence of RSIs, as shown by scientific studies: "Failure to provide a balanced scientific consideration of the role of activity in illness can stigmatize individuals and their activities. Such stigmatization can increase illness as exemplified in the recent Australian epidemic of so-called “repetitive strain injury”".

This material is referenced by a primary study in a low-impact journal which existed only for five years before being discontinued in 2011. It has been cited only once. It fails WP:MEDRS and in any case is inappropriate for WP:LEDE.

Let's be clear here: as mentioned in this article some RSI are partially or completely psychosomatic in origin. Similarly others, in particular carpal tunnel, correlate more strongly with biological factors such as diabetes than overuse. However, let's be equally clear that RSI are a broad class of conditions, many of which are directly linked to physical causes. There's a reason why tennis players often get tennis elbow, and many athletes who suffer from tendonitis were not "stigmatized" into it any more than I'll Have Another was. a13ean (talk) 23:25, 10 June 2012 (UTC)


 * I agree that the source is rather weak, because it is primary and because the journal is not very prominent. Also, PubMed shows no reviews of this source and only one secondary reference to it.  The secondary source  (from Mayo Clinic researchers) says that the media stignatization "may play a role."  So, if more were to be published on this idea by WP:MEDRS-approved sources, the role of media stigmatization could be added to the article some day.  So far, I haven't seen the sources to justify having that in the article now.  -- JTSchreiber (talk) 22:57, 10 June 2012 (UTC)


 * Let me add that RSI has very specific and objective clinical findings needed to establish its presence. Even if psychosocial issues are a contributing factor to these injuries peripherally (a dispuated point), that in no way changes the physiological existence of the syndrome.  These controversies do not belong in an article that describes a medical condition whose existence and physiological origins are not in dispute.  Let's put it someplace else.  Laguna greg (talk) 19:40, 13 June 2012 (UTC)

And about that material. Somehow, the lede avoids defining the syndrome! Does anybody want to do something about that? This definition comes from the New Jersey DOSH and, while it works fine in the arena of public policy, it's not accurate or rigorous enough for a clinical description. Short, medically accepted clinical definitions exist that would fit here perfectly. This is, of course, a problem with the entire article as it doesn't offer much of a real or useful definition anywhere. Laguna greg (talk) 16:22, 13 June 2012 (UTC)

...and one other thing. The 2nd and 3rd references in the lede are not from medical journals or textbooks, yet they are used to support a medical definition. The 2nd doesn't even say anything about "non-specific arm pain", and the 3rd is no longer available on line. The word "egregious" comes to mind. I'm removing them. Laguna greg (talk) 19:41, 13 June 2012 (UTC)

Definition Section?
The "definition" section has no references or citations. There are a number of clinical definitions of RSI/CTD that this contributor could have made from any of several textbooks on the subject, but none of them are included here. Most importantly, the "definition" does not define the syndrome, which actually has a clinically defined aetiology in the literature. I'm all for removing it entirely. Laguna greg (talk) 16:22, 13 June 2012 (UTC)

Move the Controversy
Hi All, there is just way too much controversial material here of a sociological or political nature, and very little clinical material. What would you say for removing all the hype to another article, and actually editing this into something that actually covers what medicine has to say about the syndrome itself? Or at least creating a new section/paragraph heading for all the debate, separate from the other? That would go for all the fringe alternative modalities as well. Really, the "Plague of the 90s", as Time Magazine called it, deserves its own article strictly as a sociological and economic phenomenon.

Just a thought! Laguna greg (talk) 16:22, 13 June 2012 (UTC)

handwriting vs typing
I've marked as dubious the passage "also one can use digital pens to avoid the strain coming from typing itself", as it may well be the case that touch-typing is safer than handwriting, even though nowadays the former may be more associated with RSIs, but that may just be because typing is faster and a far more common method for constant/high volume writing, specially at work. More than ergonomics, handwriting [O]CR is perhaps a matter of convenience to not need to learn to touch-type for those who don't need to write so much. — Preceding unsigned comment added by 189.46.218.156 (talk) 19:34, 16 August 2012 (UTC)

Gloves will prevent RSIs--- ha
Is the first thing someone looking at this article will think. There are lots of things sold to prevent RSIs, but many of them will make it *worse*. There had better be medical journal citations for any treatments. Yes, you can use painkillers to "treat" RSIs, but you don't cure the underlying condition, and will make everything worse. That's how someone I know lost all use of their hands for 6 months, by not questioning the painkillers he was given until it was obviously making everything worse.

The treatment section should have a bigger emphasis on treatment via stretching and strengthening the muscles, i.e. physical therapy. Bonus if you link to some of the typical stretches given out. Anything else is a lot more dubious and opens one up to liability. Sorry, I live in the wrong country to edit this article.

Also somewhere the phrase "soft tissue injuries" should be added as a definition. Somehow that isn't mentioned at all! RSIs as a term seems to be a blanket phrase used to describe a collection of soft tissue injuries caused by overuse. It is silly to say that tennis elbow doesn't exist, or that tendinitis doesn't exist, and many things are included under the umbrella name of "RSI". By the time you walk into the doctor (a neurologist) saying "it hurts", you probably have more than one RSI, and a doctor can tell you which ones you have and what the actual names are. If they suggest surgery, walk out and see another doctor. This is pretty common advice, so surely there are cites out there for it. Don't turn this article into some kind of painkiller and surgery ad. — Preceding unsigned comment added by 198.144.209.8 (talk) 17:09, 23 August 2012 (UTC)


 * The article is undergoing a major overhaul. Please bear with us while we complete the work.  If you have any legitimate clinical references to use in citing these things, by all means put them.  I am looking for a good reference and definition for "soft tissue injuries" and will add the material as soon as I can find one.  If you beat me to the punch, put it right in! Laguna greg 17:47, 1 August 2013 (UTC)  — Preceding unsigned comment added by Laguna greg (talk • contribs)

Not all in the hands
"Repetitive strain injuries (RSIs) are "injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions""

That is the definition given at the top of the page. The rest of the article seems to be about hand injuries only. Anybody ever hear of tennis elbow? I picked up a second job delivering newspapers about a month ago and I throw 250 papers out of my car every day. My shoulder has started hurting when I move it, more so with increased range of motion. NOT COINCIDENCE. This is not a made up condition that's "all in the mind." By repeatedly preforming strenuous actions you can injure yourself, don't be fooled. — Preceding unsigned comment added by 173.22.155.148 (talk) 16:11, 5 October 2012 (UTC)
 * We are aware of the limitations of the article. In fact, RSIs can occur in any body part.  There is no dispute about the validity of the injuries.  Please feel free to make any additions you think will pass muster. Laguna greg (talk)  —Preceding undated comment added 04:19, 27 November 2012 (UTC)

Alternative keyboard layouts
In the Keyboards and keyboard alternatives section, I would like to add mentions of alternative keyboard layouts such as Dvorak and Colemak which are usually promoted as a solution to RSIs caused by the usual QWERTY keyboard layout. If you have any objections to this, please raise them now with supported explanations. Otherwise I will add them soon. -- ADTCTalk Ctrb. 10:29, 13 October 2012 (UTC)
 * Hi Agent, I don't think this is a bad idea. However, knowing the research literature as I do on this subject, you'll find very little to support the contention that QWERTY is responsible for RSI globally except in the brochures for Dvorak keyboards.  And, while having just rained on your parade, I will say that alternative keyboard designs should be included in this article.  However, there is so much more that needs to be done first, for example writing a better definition for the lede.  Before you go to all that trouble on a minor point, couldn't you work on the most important thing in the article first? Too much information has been added piecemeal to this article over time, and it shows. Laguna greg (talk) 00:36, 28 April 2013 (UTC)

Serious issues
This article seems to suffer from a number of serious issues, starting with a lack of citations where needed, and including the fact that the article makes no mention of the controversial connection of many of the conditions listed with RSI. Carpal tunnel syndrome, for example, is still being debated regarding RSI, and other conditions (like DeQuervain's) do not appear to have been linked with RSI at all. I'm not an expert in medicine, but it seems to me that it should be quite easy for an expert to find the needed sources for the article, and to provide a more balanced presentation of RSI. In the meantime, I trimmed the list of conditions by two, and inserted a number of cn tags in the articles for the conditions themselves, as they often lack any citation connecting the condition to RSI. If the tags don't generate any acceptable sourcing in a reasonable amount of time, I move that those conditions be removed from the list. siafu (talk) 21:08, 31 October 2012 (UTC)
 * Siafu, I have no problem with you making those changes here. But the "controversy" you imply is nothing of the kind but, rather, a recent sociological/economic phenomenon brought on by an upsurge in Worker's Comp claims that insco's just don't want to be burdened with, and the resulting media manipulation that tends to shape public policy while ignoring clinical findings.  The "problem" you see with de Quervain's syndrome is just that.  BTW, it is directly related to RSI aetiologically.  In point of fact, the syndrome has a clinical and field documentation going back over 400 years, and involving more than the upper extremity.  No one in the orthodox medical community is disputing the syndrome's existence, nor its cause.  But yes, this article needs a whole bunch of work.  Too many of the wrong people have had their hands in it. BTW, feel free to make additions as you see fit.  Laguna greg (talk) 04:17, 27 November 2012 (UTC)

Bad Ref's/NPOV Issue
Hi All, I moved this section here as the link to the one end note had gone bad, the rest is unsupported, and not NPOV. Laguna greg (talk) 00:52, 28 April 2013 (UTC) --

Doctors have recently begun making a distinction between tendinitis and tendinosis in RSI injuries. There are significant differences in treatment between the two, for instance in the use of anti-inflammatory medicines, but they often present similar symptoms at first glance and so can easily be confused.

The following complaints are typical in patients who might receive a diagnosis of RSI:


 * Short bursts of 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.

A Possible Source of Bias
I would like to suggest that a considerable amount of bias that was in the article and in this talk page, suggesting mental instead of physical origin of RSI, has been primarily the work of a certain controversial Australian psychiatrist and her followers. Mention of the 'Australian Epidemic' and psychosocialism/somatosis should be met with consideration of context, and held up to the standard scrutinzation of varied reliable medical resources that any medical information on Wikipedia should receive. Tom W (talk) 14:25, 12 May 2013 (UTC)
 * Hi Tom, yes, absolutely. Enough is coming out in print now about this bias that it can be documented as a sociological trend unique to that region, and it should be mentioned as such in this article.Laguna greg 19:57, 14 May 2013 (UTC)  — Preceding unsigned comment added by Laguna greg (talk • contribs)

Dvorak and Colemak
Is there any evidence these do anything to stop RSI? Adam Cuerden (talk) 15:41, 29 July 2013 (UTC)
 * I see no RS (or more specifically MEDRS) for this, but it seems like a lot of people do switch to Dvorak or similar in a belief that it will help alleviate RSI or similar. We could either phrase it more tentatively ("Some people use .. in the belief that ...") or just take it out.  a13ean (talk) 16:30, 29 July 2013 (UTC)
 * My first thought is, I don't think we should put in anything that can't be referenced in the research literature. My second thought is that we need a new section under "treatment" that deals with less-well documented forms of alternative care such as keyboard design. Give me couple of weeks to reformat this section entirely.  Laguna greg 17:51, 1 August 2013 (UTC)  — Preceding unsigned comment added by Laguna greg (talk • contribs)
 * My own experience says yes that it does help. I had it really bad and it went away after switching to Dvorak and an MS Ergo keyboard.  — Preceding unsigned comment added by 24.215.249.71 (talk) 04:58, 27 October 2013 (UTC)
 * As far as the sentence you tagged here, why does it matter whether they do anything to stop RSI? The text says that they're promoted as ways of mitigating the problem; it doesn't say whether they actually do the job.  In the same way, I could say "Bleeding has been promoted as a way of mitigating illness"; the statement would be quite true, even though bleeding doesn't work to mitigate illness.  Citations for these claims shouldn't be too hard to find.  Nyttend (talk) 15:51, 8 January 2014 (UTC)

Repetitive strain injury
I HAVE A REPETITIVE STRAIN INJURY FROM FPS'

LIKE PLANETSIDE 2 AND MEDAL OF HONOR

IN MY INDEX FINGER ON MY LEFT HAND FROM PRESSING D

MY RIGHT HAND INDEX FINGER HAD THE SAME

THE RIGHT HAND INDEX FINGER HAS NOW CLEARED

AND SO WILL THE LEFT HAND INDEX FINGER EVENTUALLY

HERE IS AN EXAMPLE OF FPS GAMING

https://www.youtube.com/watch?v=1wD6hZwUw2U

I HAVE GENUINE CONCERNS ABOUT THE VIABILITY AND REPETITIVE STRAIN INJURIES

THAT CHILDREN MAY INCURR AS THEY USE THEIR CONSOLES WITH THEIR TELEVISIONS

ESPECIALLY IN THE NECK

AS A CHILD I ONCE PLAYED A NEW GAME FOR 14 HOURS AND THEN MOVED MY NECK AND

IT WAS AGONY

https://www.youtube.com/watch?v=QY79E8nFAxg

http://en.wikipedia.org/wiki/Computer_addiction

90.198.117.67 (talk) 14:27, 6 February 2014 (UTC)

The Point of This Article
This article aims to present accurate and verifiable medical information about these injuries. Information presented here must be at a level worthy of any scholarly encyclopedia. This is not a place to put in advertisements for your favorite software, or the keyboard designs that may have helped you recover. Anything you add here must be supported by good citations from reputable journals articles or widely used text- or reference books. If you can't support your additions with good research, then they will be removed from this page. Also, this is not the place to discuss your ideas about RSI and its politics. The sociology of RSI is a separate topic and deserves its own article. If you want to write about that, start a new article. If you want to share stories about your injury, you should do so on a public discussion blog focused on RSI/CTD, and not here. Any additions to this page that are unsupported or too far off topic will be removed. Laguna greg 19:47, 24 February 2014 (UTC)

Alternative Keyboards
This information, as noted above, lacks citations, is confusing and poorly presented. I moved the section here for the time being: Laguna greg 19:47, 24 February 2014 (UTC)

Keyboards and keyboard alternatives
Keyboard layouts such as Dvorak and Colemak are promoted as alternatives to mitigate some of the strain arising from the standard QWERTY keyboard layout. Various alternative keyboard designs intended to avoid strain, such as the vertical split-keyboard, have also been developed. Other solutions move the mode of input from one's hands entirely. These include the use of voice recognition software or pedals designed for ergonomics and gaming to supplant normal keyboard input.

Rollerbar Mouse
How about alternatives as a rollerbar mouse? Or a graphic tablet? These alternative input devices should be added.--Blaua (talk) 13:52, 15 May 2014 (UTC)
 * Writing tablets as mice was previously mentioned in the article, but was removed since there weren't any reliable sources about them being recommended as a palliative measure, only a few things that mentioned that people used them as such. Perhaps you can find more information about it now.  a13ean (talk) 18:37, 15 May 2014 (UTC)

“Pathogenesis of tendinopathies: inflammation or degeneration?” article and its mention of repetitive activities
“Pathogenesis of tendinopathies: inflammation or degeneration?” mentions repetitive activities that lead up to tendon injuries. I’m going to add this information at a later time if that’s all right.

Repetitive strain is mentioned twice:

Sports commonly associated with tendinopathy of wrist extensors include racket sports (tennis elbow) and, more generally, sports that involve a throwing action resulting in eccentric loading of the forearm muscles. In golfer's elbow the pronator teres and flexor carpi radialis tendons are more frequently involved. Triceps TP is observed almost exclusively in males undertaking regular heavy manual work and in throwing athletes. It results from repetitive resistance of elbow extension, resulting in a traction injury through the tendon's insertion into the olecranon.

Insertional patellar tendinopathy (at the proximal end of the patellar tendon) and injuries of the patellar tendon are common in athletes involved in some type of repetitive activity, such as jumping (volleyball, basketball, and so on), kicking (football), quick stops and starts (tennis, squash), and running (sprinters, endurance running).

Requested image
Even if it doesn't get used for this article, it would be very useful, and I can't spot one. HLHJ (talk) 09:06, 7 March 2015 (UTC)

HUF.UPDARTIKL'GEN??
GRRRR — Preceding unsigned comment added by 60.246.62.154 (talk) 12:26, 9 December 2015 (UTC)

"more likely affected"
Despite the recent confusing shift in meaning of "likely" from an adjective ("she is likely to suffer") to an adverb meaning the same thing as "probably" ("she likely suffers"), in the phrase "women are more likely affected [by RSI] than men" it is almost certainly intended in its adjectival meaning = "women have a higher probability of being affected than men" (and we know this for sure, for it's been measured), rather than its adverbial meaning = "women are probably more often affected than men" (but we don't know this for sure, so this is guesswork). The sentence would be clearer if "to be" were added: "women are more likely to be affected than men".84.243.236.9 (talk) 16:01, 19 February 2019 (UTC)

Too much emphasis on keyboards
Computer mice are usually the culprit, relative to computer keyboards. I think there is too little emphasis on computer mice in this article. Currently it is only mentioned in passing at the end, "mouse arm disease".

E.g. the picture in the info box could be of a computer mouse instead of a keyboard.

--Mortense (talk) 20:55, 4 December 2019 (UTC)

Proposal for a major change: Addressing RSI as a theory rather than an accepted diagnosis
There are important changes to consider on this page. It would be helpful to collaboratively discuss these changes and the reasoning behind them prior to making them. There are sensitive and debatable aspects that should be addressed on the page. It would be helpful to do so collaboratively. Let’s start with a discussion about the first proposed change in page content which is detailed below. The proposed edit is more accurate and reflects the range of debate regarding the diagnosis “repetitive strain injury.” Many hand and upper extremity specialists avoid this diagnosis because of its potential for inducing or reinforcing unhealthy thoughts and feelings about the body’s sensations.

Current version: A repetitive strain injury (RSI) is an injury to part of the  musculoskeletal  or  nervous system  caused by repetitive use, vibrations, compression or long periods in a fixed position.[1]

Recommended revision: “Repetitive strain injury (RSI) is an illness concept suggesting that  musculoskeletal  or  nervous system  pathophysiology can be caused by repetitive use, vibrations, compression, or long periods in a fixed position.[1]  The potential harms and potential benefits of this illness concept are a matter of debate. There is no experimentally verifiable pathophysiology in people who receive this diagnosis.