Concerns about the use of the term repetitive strain injury

The term 'repetitive strain injury' assumes a cause as well as a diagnosis (whereas some of the conditions casually lumped under these headings may also have well-recognised non-occupational causes).

• problem is reflected in the confused position of previous legal judgements
  • in 1981 an enquiry over arm complaints in an Inland Revenue office accepted that disorders such as lateral epicondylitis and tenosynovitis could sometimes arise from the use of a visual display unit (VDU)
  • in 1991 the High Court ruled that two British Telecom keyboard operators had 'repetitive strain injury (RSI)' induced by their work (a high number of key strokes per hour, bonus for higher totals, long hours in constrained positions on defective seating)
    • complaints here were tenosynovitis and epicondylitis
  • in 1994 a legal secretary received an award for tenosynovitis provoked by periods of intense typing
  • in contrast, in 1993 the complaints of a Reuters journalist were dismissed and it was ruled that 'RSI did not exist'
    • ruling plainly does not disprove the existence of lateral epicondylitis and tenosynovitis
      • whether these disorders arise from repetitive work, and whether there is a condition of non-specific arm pain which presently defies clinical diagnosis and which arises from repetitive work, are points at issue
• some use 'RSI' to refer to chronic upper arm pain for which no diagnosis can be made and which has been ascribed to occupational over-use
  • features of suspected RSI (1):
    • tends to show common features of gradual-onset diffuse pain, paraesthesiae, subjective swelling, and complaints of anxiety, irritation, mood change, fatigue and sleep disturbance
    • clinical signs seem generally to be absent

Reference:

• (1) ARC (October 2006). Work-Related Disorders of the Upper Limb.