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Repetitive strain injury (RSI), also known as Cumulative Trauma Disorder (CTD), occupational overuse syndrome, non-specific arm pain[1] or work related upper limb disorder (WRULD), is the most recent manifestation of illness concepts that link use of the arm to injury or disease. Prior to typewriters or computers there was the concept of “writer’s cramp”.
The basis for this illness concept is the idea that one can overuse a tool, such as a computer keyboard or musical instrument in a way that causes tissue damage leading to pain. Conditions such as RSI tend to be associated with both physical and psychosocial stressors.
The following complaints are typical in patients that might receive a diagnosis of RSI[2]:
The symptoms tend to be diffuse and non-anatomical, crossing the distribution of nerves, tendons, etc. They tend not to be characteristic of any discrete pathological conditions.
The typical patient presents with a strong intuition that their pain indicates existing and ongoing tissue damage.[3] A good way to understand this is that they have a strong “pain alarm”–pain tends to be accepted as a sign of danger and they have difficulty modulating this intuitive uneasiness with pain (e.g. turning down or turning off the “pain alarm”.[4]
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