Repetitive strain and overuse problems: assessment and care in Kettering.
Repetitive strain injury (RSI) is a term used for pain brought on by repeated movement — typing, tool use, decorating, hairdressing, assembly work or repetitive sport. It can affect the shoulders, elbows, forearms, wrists and hands, and usually starts gradually. RSI is not one condition, so the useful first step is working out which tendons, muscles, nerves or joints are actually involved. This page covers overuse problems generally; specific hand and wrist conditions such as carpal tunnel syndrome are covered on our hand and wrist page.
Call 999 if you have sudden weakness or numbness on one side of the body (including one arm), facial drooping or difficulty speaking — these can be signs of a stroke.
Most repetitive strain symptoms build gradually and are not urgent. Get urgent GP or NHS 111 advice if you have:
- loss of feeling in part or all of the hand
- a hot, swollen or discoloured joint, or you feel unwell with a high temperature
- severe pain, or pain following an injury with a snap, pop or change in shape
These need medical assessment rather than self-management. Guidance: NHS — Wrist pain: urgent advice · NHS — Stroke symptoms.
How repetitive strain can feel.
- Burning, aching or throbbing pain in the forearm, wrist, hand or shoulder that builds through the working day
- Stiffness and weakness — a grip or pinch that tires quickly
- Tingling, pins and needles or numbness in the hand or fingers
- Muscle cramps or a sense of the arm feeling heavy after repetitive tasks
- Mild swelling or tenderness over the affected tendons
- Symptoms that ease at weekends or on holiday and return with work
What may be involved.
- Repetitive tasks — typing and mouse work, hairdressing, decorating, assembly or checkout work
- Regular use of hand-held or vibrating power tools
- Sports with repeated movements such as golf, tennis or climbing
- Poor posture or an awkward workstation set-up sustained for long periods
- A sudden increase in workload or a new task without a build-up period
- Often a combination of factors — including general health and age — rather than one cause
How we approach repetitive strain problems.
Identify the specific problem
'RSI' is an umbrella term rather than a single diagnosis. Symptoms may come from tendons, muscles, nerves or joints anywhere from the neck to the fingers. We take a careful history of your work and activities and examine the whole arm and neck to work out what is actually irritated.
Hands-on care where appropriate
Soft-tissue work and gentle articulation of the forearm, elbow, shoulder and neck where these appear to be contributing, with your consent. Hands-on care cannot be promised to resolve tendon or nerve problems; where it is used it supports comfort and movement alongside the changes below.
Load, pacing and workstation changes
NHS advice is to keep active while limiting the provoking activity at first and building back gradually, and not to rest completely for more than a few days. We help you work out what to modify, how to pace tasks and what to raise with your employer — such as changes to the way you work.
Exercise and review
Progressive strengthening and posture work as symptoms settle, reviewed with you. If symptoms are not improving or are getting worse, we will direct you to your GP, who can consider physiotherapy, occupational therapy or other options.
Realistic task rotation, breaks and the conversation with work.
NHS advice for RSI is to keep active while limiting the provoking activity to start with and gradually increasing it, not to rest the affected area for more than a few days, to use an ice pack wrapped in a towel for up to 20 minutes, to ask a pharmacist about suitable pain relief, and to speak to your employer about changes to the way you work. How much to limit, and for how long, depends on what is irritated — we work that out with you rather than applying one rule.
Rotate tasks. Alternate the provoking activity with genuinely different work in blocks — typing with calls or reading, tool work with checking or planning — so no single tendon or muscle group is loaded continuously.
Short, frequent breaks. Brief pauses every so often to change position and let the arm relax are more useful than one long break. A reminder on your screen or phone helps until it becomes habit.
Build back gradually. Once symptoms have settled, increase the provoking task in steps rather than returning to full volume in one go; if symptoms flare, reduce the task and seek advice if symptoms persist or worsen.
Talk to your employer or occupational health. Adjusted duties, altered hours, equipment changes or a workstation assessment are legitimate requests. An occupational therapist can also help identify what is driving the problem.
Sport and hobbies. The same applies to golf, racquet sports, climbing or instruments: reduce volume or intensity for a period and rebuild, rather than pushing through.
Stop and seek advice rather than pushing through significant or worsening pain; the urgent symptoms above always take priority over any self-management plan.
How we know whether the plan is working.
Goals are framed around your actual tasks — a full shift without a flare, a set typing or tool time, a return to a hobby — and checked at each visit. If symptoms are not improving or are getting worse despite sensible changes, or you have persistent tingling, numbness or weakness, we direct you to your GP, who can consider physiotherapy, occupational therapy or other options.
- Hours at the provoking task without a flare
- Symptom-free evenings and mornings
- Grip and fine tasks
- Return to hobby or sport
- Adjustments agreed at work
There is no fixed number of sessions and no promised timeline. If symptoms are persistent or worsening despite a reasonable plan, we will direct you to your GP or the NHS community musculoskeletal (MSK) service rather than continue with the same approach.
What to expect.
Every appointment includes a careful history of your work and activities, an examination from neck to fingertips, a clear explanation of the findings and — where appropriate — hands-on care and a practical pacing plan.
Book online or see your osteopath and fees above.
- 1.
Detailed history of your work, hobbies and sport — tasks, hours, tools, breaks and what has changed recently.
- 2.
Examination of the neck, shoulder, elbow, forearm, wrist and hand, including nerve tests if you have tingling or numbness.
- 3.
A clear explanation of which structures appear to be involved and whether your GP should be involved.
- 4.
Hands-on care where appropriate, a pacing and workstation plan and simple exercises to build up gradually.
Frequently asked.
Is RSI a real diagnosis?
Repetitive strain injury is a term used for pain caused by repeated movement rather than a single condition. Underneath it may sit tendon problems, nerve irritation such as carpal tunnel syndrome, or muscular overload. Working out which applies to you is the useful first step, because the advice differs.
Should I stop working or rest completely?
Usually not. NHS guidance is to keep active, limiting the provoking activity to start with and gradually increasing it, and not to rest the affected area for more than a few days because prolonged rest leads to weakness and stiffness. Talking to your employer about adjustments is encouraged.
Will it go away on its own?
RSI-type symptoms often improve with sensible changes to activity and workstation, and many people manage without further treatment. If symptoms persist or worsen, see your GP, who may suggest physiotherapy, occupational therapy or, occasionally, steroid injections.
Can osteopathy cure RSI?
No cure can be promised. What an osteopathic assessment offers is a clear picture of which structures are involved, hands-on care where appropriate, and practical help with pacing, posture and gradual strengthening. Nerve compression that is not settling needs GP assessment.
What should I change at my desk?
Common starting points are screen at roughly eye level, keyboard and mouse close to the body with relaxed shoulders, forearms supported, regular short breaks and changes of position, and varying tasks rather than long unbroken stretches of one activity. We will go through your specific set-up.
Do you offer dry needling?
Neil also offers dry needling. If you are interested, he can discuss whether it is appropriate for you as part of your appointment.
When should I see a GP?
See a GP if symptoms are not going away or are getting worse, if you have persistent numbness or weakness, or if you have diabetes. In many areas you can also self-refer to the NHS community musculoskeletal service. Sudden severe pain, a hot swollen joint or feeling unwell with a high temperature need urgent GP or NHS 111 advice.
Ready to book a repetitive strain assessment?
Call, WhatsApp or book online. We'll take a careful history at your first visit and be honest about whether osteopathic care looks appropriate for your situation.