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Work related upper limb disorder (WRULD)

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Work related upper limb disorder (WRULD) Content Supplied by NHS Choices

Repetitive strain injury (RSI) is a general term used to describe the pain felt in muscles, nerves and tendons caused by repetitive movement and overuse.

It's also known as work-related upper limb disorder, or non-specific upper limb pain.

The condition mostly affects parts of the upper body, such as the:

  • forearms and elbows
  • wrists and hands
  • neck and shoulders

Symptoms of RSI

The symptoms of RSI can range from mild to severe and usually develop gradually. They often include:

  • pain, aching or tenderness
  • stiffness
  • throbbing
  • tingling or numbness
  • weakness
  • cramp

At first, you might only notice symptoms when you're carrying out a particular repetitive action.

But without treatment, the symptoms of RSI may eventually become constant and cause longer periods of pain. You may also get swelling in the affected area, which can last for several months.

What to do if you think you have RSI

If you develop symptoms of RSI and think it may be related to your job, speak to your employer or occupational health representative.

It may be possible to modify your tasks to improve your symptoms.

See your GP if symptoms continue, despite attempts to change how you work.

Read more about diagnosing RSI.

What causes RSI

RSI is related to the overuse of muscles and tendons in the upper body.

Certain things are thought to increase the risk of RSI, including:

  • repetitive activities
  • doing a high-intensity activity for a long time without rest
  • poor posture or activities that require you to work in an awkward position

Cold temperatures and vibrating equipment are also thought to increase the risk of getting RSI and can make the symptoms worse. Stress can also be a contributing factor.

A variety of jobs can lead to RSI, such as working at an assembly line, at a supermarket checkout or typing at a computer.

It's important to work in a comfortable environment which has been appropriately adjusted. Your employer has a legal duty to try to prevent work-related RSI and ensure anyone who already has the condition doesn't get any worse.

Read more about workplace health.

How RSI is treated

The first step in treating RSI is usually to identify and modify the task or activity that is causing the symptoms. If necessary, you may need to stop doing the activity altogether.

To relieve symptoms, your GP may advise taking a course of anti-inflammatory painkillers (such as aspirin or ibuprofen), or using a heat or cold pack, elastic support or splint.

You may also be referred to a physiotherapist for advice on posture and how to strengthen or relax your muscles. Some people find that other types of therapy help to relieve symptoms, including massage, yoga and osteopathy.

Read more about treating RSI.

How to prevent RSI

Most employers carry out a risk assessment when you join a company to check that your work area is suitable and comfortable for you. You can request an assessment if you haven't had one.

There are also things you can do to help reduce your risk of RSI, such as:

If you work at a computer all day, make sure your seat, keyboard, mouse and screen are positioned so they cause the least amount of strain.

See tips on preventing RSI for more detailed advice about using a mouse and keyboard at work.

Diagnosing repetitive strain injury (RSI)

Repetitive strain injury (RSI) may be diagnosed when symptoms develop after a repetitive task and fade when the task is stopped.

Your GP will examine the area where you have pain and ask about your symptoms and medical history.

If your symptoms suggest you have swollen and inflamed tissue, you may have an underlying medical condition, such as:

  • bursitis - inflammation and swelling of the fluid-filled sac near a joint, such as the elbow or shoulder
  • nerve entrapment, such as carpal tunnel syndrome
  • Dupuytren's contracture - a thickening of the tissues in the hand, which causes one or more fingers to bend into the palm
  • epicondylitis - inflammation of the area where bone and tendon join, such as the elbow
  • rotator cuff syndrome - inflammation of the tendons and muscles around the shoulder
  • tendonitis - inflammation of a tendon
  • tenosynovitis - inflammation of the sheath that covers the tendons, most commonly in the hand, wrist or forearms
  • trigger finger - where swelling in a tendon running along one of the fingers makes it difficult to either bend or straighten the affected finger
  • ganglion cyst - a sac of fluid that forms around a joint or tendon, usually on the wrist or fingers
  • Raynaud's phenomenon - a condition where the blood supply to extremities such as the fingers is interrupted, especially when exposed to cold
  • thoracic outlet syndrome - compression of the nerves or blood vessels that run between the base of the neck and the armpit
  • writer's cramp (a type of dystonia) - a condition that occurs from overuse of the hands and arms

If your symptoms don't immediately suggest one of the above conditions, you may be referred for further tests.

For example, you may be given an X-ray to test for osteoarthritis, or blood tests to rule out inflammatory joint diseases.

If no other condition is found after having tests, you may be diagnosed with "non-specific upper limb pain syndrome".

Treating repetitive strain injury (RSI)

Treatment for repetitive strain injury (RSI) depends on your symptoms and whether a specific condition has been diagnosed.

Workplace health

If your RSI is caused by repetitive activity at work, the first step is to speak to your employer or occupational health representative.

It may be possible to modify your tasks to relieve the symptoms. Small changes to your lifestyle and working environment can often help.

Think about your working environment and what activity may be causing the problem. Take steps to reduce how much time you spend doing this activity or change how you do it.

If you can't stop doing it completely, take regular, short breaks to stretch and move about. Software packages that remind you to take regular breaks from the keyboard can be useful.

It can also be helpful to get advice from an occupational health representative at work on how to set up your work station.

Read more about workplace health, including:


Some people with symptoms of RSI find that including exercise in their daily routine, such as walking or swimming, also eases their symptoms.

Read about:

Treatment options

See your GP if your symptoms continue, despite attempts to modify your work activities. A number of treatments are available that may help people with the condition.

If your doctor can diagnose a specific medical condition, well-established treatments can often be recommended. These include self-help measures, medication, or even surgery, in some cases.

Some of these treatments may help even if your doctor can't diagnose a specific medical condition from your symptoms. However, in these cases, their effectiveness may be limited.

Possible treatment options for RSI include:

  • medication - including short-term use of anti-inflammatory painkillers (such as ibuprofen) or pain receptor-blocking medications, such as some forms of antidepressants, if you're getting severe symptoms or interrupted sleep
  • cold packs, elastic supports or a splint
  • physiotherapy - including advice on posture and stretches or exercises to help strengthen or relax your muscles
  • steroid injections to reduce inflammation in an affected area (these are only recommended if an area has definite inflammation caused by a specific condition, such as carpal tunnel syndrome)
  • surgery to correct specific problems with nerves or tendons (for example, if you are diagnosed with carpal tunnel syndrome or Dupuytren's contracture) if other treatments haven't helped

Physical and complementary therapies

"Hands-on" therapies, including physiotherapy, massage or osteopathy, may be available after a referral from your GP, but in some cases there may be a long wait for an appointment.

If you're thinking about private treatment, make sure your therapist is registered with a professionally recognised organisation.

Many long-term sufferers of RSI try other types of complementary therapies and relaxation techniques to help relieve the symptoms of RSI, such as:

However, while some people with RSI do find these helpful, there's little scientific evidence to suggest these approaches are consistently effective for RSI.