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PubMed1990

The incidence and distribution of RSI in South Australia 1980-81 to 1986-87.

Despite the human and financial cost of repetition strain injury (RSI), comprehensive incidence data have been lacking. A unique opportunity exists to obtain such data in South Australia, where since 1980-81 the Australian Bureau of Statistics has assigned all injuries, not explicitly diagnosed as diseases but stated as having been caused by repetitive movement, to a unique "type of accident" code, and has subclassified them according to bodily location. The statistical profile of diseases and accidents affecting the upper limb resulting from repetitive movement is not simply one of a keyboard operators' epidemic. Rather, it has revealed a problem which is endemic in sections of the blue-collar workforce, in whom both the numbers and the incidence rates are higher than in keyboard operators, and were higher even when the incidence in keyboard operators peaked in 1984-85. These conditions have been especially frequent in particular sections of the female blue-collar workforce, and interventions which have resulted in (or coincided with) benefits to keyboard operators have failed to improve the situation in the former group. It is suggested that the groups most at risk are female workers performing unfulfilling, unskilled tasks, and that interventions to benefit these workers will have to give attention to more fundamental issues than those hitherto addressed.

Accidents↗
PubMed1992

RSI revisited.

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Cumulative Trauma Disorders↗
PubMed1992

In search of the pathogenesis of refractory cervicobrachial pain syndrome. A deconstruction of the RSI phenomenon.

OBJECTIVE: To discuss the clinical and social phenomenon of refractory cervicobrachial pain, more popularly known as repetitive strain injury (RSI), from the standpoint of medical knowledge and to present the phenomenon as a problem of chronic musculoskeletal pain in which clinical clues suggest a neuropathic pathogenesis. DATA SOURCES: Published articles from both medical and non-medical literature, primarily since 1980, were integrated with our clinical experience and observations. DATA SYNTHESIS: Three sets of formal responses to the issue--medical, psychiatric and sociological--were identified and analysed with respect to the validity of their conclusions, which formed the conventional wisdom. Clinical observation revealed clues to disturbed nociception in a carefully defined set of subjects with chronic cervicobrachial pain. Theoretical pathophysiological correlations of these led to the formulation of an hypothesis. CONCLUSIONS: We doubt that clinical method and diagnostic logic were rigorously applied to the RSI phenomenon, which helped to produce an unresolved controversy with widespread ramifications. Our hypothesis is that there is a central disturbance of nociception in this syndrome, induced by continual afferent barrage from nociceptors in anatomically relevant sites in the neck and upper limbs. Initial and proposed testing of this hypothesis are discussed.

Cumulative Trauma Disorders↗