What is RSI? back to: specialization index

This difficult and painful condition can be treated well with techniques from the English RSI specialist Prof. J. Greening and with the trigger point therapy developed in New Zealand. Supplemented with a spinal column treatment and medical training therapy, this approach gives very good results! If desired, a video recording can be made of your posture during computer work, for example, to achieve an optimal working posture.

Search on the internet what RSI is and you will find 1001 different descriptions. Moreover, there are many other national and international terms for the same group of disorders, such as Work-related Complaints to the Movement Equipment or Occupational Overuse Syndrome. However, RSI seems to be the most widely used and known term worldwide. RSI stands for Repetitive Strain Injury. RSI in itself is not a disease, but an understanding of a certain degree of disorders and complaints in the 'work area of ​​RSI'.

General description RSI

RSI is a collective name for complaints, symptoms and syndromes that occur in upper back, neck and shoulder area, arms, elbows, wrists, hands and fingers.

The complaints are usually caused by repetitive movements, a prolonged static posture or a combination of both. Furthermore, personal and work-related factors can play an important role in the development, worsening or maintenance of RSI. RSI occurs in many professional groups.

Scientific description

On behalf of the Minister of Health and the State Secretary for Social Affairs and Employment, a committee of the Health Council has carried out research into the state of science concerning RSI. In 2000, this committee released a report (download here) and, among other things, formulated a scientific definition of RSI.

For a complex condition such as RSI, the following complex description fits:

RSI is a multifactorial symptom syndrome affecting disability or participation problems at the neck, upper back, shoulder, upper and lower arm, elbow, wrist or hand or a combination thereof characterized by a disturbance of the balance between load and load capacity, preceded by activities with repeated movements or a static posture of one or more of the said body parts as one of the presumed etiological factors.

The complaints

The use of the three phases (explanation) to indicate the severity of the complaints or problems is fairly common with both patients and practitioners. According to the Health Council report, this frequently used classification is unclear and there is no clear relationship between the different phases and the prognosis of the complaints.

However, the committee recognizes the existence of different grades of severity of RSI complaints. Starting complaints are characterized by the symptoms without any participation problems. Participation problems are central in a second stage. Finally, there is a stage where chronic pain complaints dominate.

The RSI association as well as the medical world are increasingly moving away from the generally used phase format.

The main reason is that it can lead to wrong conclusions, both on the severity and the approach, and on the prognosis:

It is a misconception that the complaint progression from phase 1 to 2 and 3 always takes place gradually. Coming complaints can also develop into serious complaints within a very short time.

Another false impression that could arise is that long-term starting complaints would be less serious than having temporary serious complaints. Timely intervention remains of great importance.

The complaints can vary enormously per person. The complaints mentioned are generally recognized, but it does not show exactly in which phase someone is. This must not affect the approach to complaints.

Finally, the main misconception: in the past phase 3 often linked the prognosis to 'irreparable'. This prospect can lead to depression and resignation. The vast majority recognize a slow but certain progression towards recovery.

Diagnostics: specific and non-specific RSI

Many diagnoses fall under the umbrella of RSI. To the specific RSI we can count on the demonstrable disorders such as tendinitis, epicondylitis, Thoracic Outlet Syndrome (TOS), Carpal Tunnel Syndrome, Rotator Cuff syndrome, Tension Neck syndrome, and Quervain syndrome. Aspecific RSI is a form of RSI in which no specific disorders are found. It is of course important that good research is carried out into specific and non-specific disorders. Unfortunately, in practice, this is often omitted. The Health Council assumes a ratio of 87% non-specific RSI and 13% specific RSI. With better research into the disorders, this relationship might be very different.

The RSI center describes RSI as a dome diagnosis. It is stated that many studies can contribute to the diagnosis of RSI, such as a description of the history and symptoms, a function test and the exclusion of other disorders. A clear understanding of the complaints and the right treatment are necessary, according to the RSI center.

In February 1998, by order of the Ministry of Social Affairs and Employment, guidelines were drawn up for the determination of work-related disorders of the musculoskeletal system of the upper extremity. With these guidelines the link between a disease and work can be determined.

These guidelines can be found in the Saltsa report drawn up by the Netherlands Center for Occupational Diseases / Coronel Institute for Work, Environment and Health of the Academic Medical Center of the University of Amsterdam.

Work definition RSI

How can RSI be recognized? What is the complaint pattern of RSI? In order to improve the recognisability of RSI among the people who suffer from it, Jip Driehuizen & Carien Karsten launch a new work definition of RSI syndrome in their book Dealing with RSI.

This description gives a practical and recognizable picture of how the complaints occur and we therefore consider it worth mentioning. Note: even if you do not fully recognize the below, there can still be RSI complaints. More information about the complaints procedure.

According to Jip Driehuizen & Carien Karsten in "Coping with RSI, how to prevent it from becoming chronic" (2002), RSI syndrome is described as:

The complaints are longer than about six weeks.

There is pain or unpleasant, diffuse feelings, deaf feelings or tingling in at least more than one of the following locations: a certain spot between the shoulder blades, in the shoulder muscle, around the shoulder joint, around the elbow (left, right or both), in the forearm (back, front or both), in the wrist or in one or more fingers.

The symptoms worsen quickly by fine movements and sit in the same position for a long time. The most mentioned are: computer work and driving. Often the pain worsens after the job.

The complaints are provoked when force is applied with the hands (wringing, lifting).

Complaints can manifest in stressed conditions (in case of stress).

Complaints often arise during or just after a period of dedication to a certain task, pressure and / or stress.

The symptoms decrease as a result of rest, but they immediately return to the start of the provocative actions.

There is sometimes talk of awkwardness: for example, the handwriting is less beautiful or people drop things.

Points of attention during physical examination

In the case of good physical examination, the care provider finds (source: Jip Driehuizen & Carien Karsten in "Dealing with RSI: how to prevent it from becoming chronic" 2002):

A high tension of the neck / shoulder muscles and often also of the forearm muscles.

Painful points when touching between the shoulder blades, on the shoulder muscle, around the shoulder and on the back of the forearm.

Often a stiff walking wrist movement.

Very often a reduced elastic joint capsule of the shoulder joint.

An irritable large nerve strand in the arm when stretched.

Less good circulation of the arm when lifting that arm.

Sometimes a reduced ability to perform (very) fine motor movements.