Treatment for RSI (WRULD)

Repetitive Strain Injury (RSI) is perhaps a more familiar term to most people than Work Related Upper Limb Disorder (WRULD). RSI is also possibly a more useful description as it is not limited to conditions involving only the upper limbs. It is not a diagnosis in itself but an umbrella term that describes many musculoskeletal pain conditions that are assumed to be a result of work related physical stress. These could include specific conditions such as carpal tunnel syndrome but also generalised bodily aches and pains with no obvious diagnosis. It often relates to ‘non-specific’ lower back and neck pains, but also to various upper limb symptoms particularly nowadays given that many people have sedentary jobs and work sitting down at computers. The vast majority of musculoskeletal pain does not start with a one-off forceful event resulting in damage to tissue. It is usually something that patients tell us starts more gradually over time and with no obvious injuring event. This means that the cause and effect relationships are not always totally clear and it is possible that lots of factors are involved in the onset of symptoms including work stress but also involving factors outside work as well. After all, many of the things we do in work are also the same things that we enjoy during leisure time like reading, using screens, laptops and phones. There is often conflicting opinion about the diagnosis of specific conditions from different healthcare professionals as well as arguments about causation where any litigation is concerned and this may complicate treatment goals and good clinical outcomes.

As clinicians who are motivated solely by getting patients to feel better, we prefer to consider all clinical and lifestyle variables that we feel can contribute to an individual patient’s ongoing pain problem rather than limiting ourselves to looking only at what happens to them at work. By adopting a structured approach and viewing persistent pain from a broad perspective it is less likely that anything important will be missed.