RSI

Computer use is a common cause of RSIs - as is playing musical instruments.

Many RSIs which are related to computer use appear to arise as a result of damaged tendons executing a sawing action - resulting in inflammation and pain in surrounding tissues.

There are other common muscular disorders associated with computer use which also arise as a result of computer use - including muscular indurations in the shoulder - as a result of continuous strain in muscles stabilising the head and arms.

Many RSIs often heal gradually over time - but healing can be a time-consuming process - and sufferers often find that even minor levels of activity aggravate the disorder - and reduce the rate of recovery.

Recovery often takes years in young healthy individuals who have the opportunity to rest. Age, or loss of control over ones working environment may cause the process to take longer still - and there are some who never recover.

News

RSI studies

Reviews

• Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review.
• What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management.
• Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials.
• A systematic review of conservative treatment of carpal tunnel syndrome.
• Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome.
• Conservative interventions for carpal tunnel syndrome.
• Which nonsurgical treatments for carpal tunnel syndrome are beneficial?
• Management of carpal tunnel syndrome.
• Carpal tunnel syndrome: modern diagnostic and management techniques.
• Repetitive strain injury. 2. Diagnostic and treatment tips on six common problems. The Goff Group.

Splints

• Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome.
• Neutral wrist splinting in carpal tunnel syndrome: a comparison of night-only versus full-time wear instructions.
• Splinting for carpal tunnel syndrome: in search of the optimal angle.
• Conservative interventions for carpal tunnel syndrome.
• Clinical versus electrodiagnostic effectiveness of splinting in the conservative treatment of carpal-tunnel syndrome.
• Electrodiagnostic evaluation of conservative treatment in carpal tunnel syndrome.

Splints vs steroids

• A prospective study to assess the outcome of steroid injections and wrist splinting for the treatment of carpal tunnel syndrome.
• Conservative management of carpal tunnel syndrome: a reexamination of steroid injection and splinting.
• Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome.
• Carpal-tunnel syndrome. Results of a prospective trial of steroid injection and splinting.
• Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study.

Ultrasound

• Ultrasound and laser therapy in the treatment of carpal tunnel syndrome.
• Ultrasound treatment for treating the carpal tunnel syndrome: randomised "sham" controlled trial
• Ultrasound therapy effect in carpal tunnel syndrome.
• Effect of ultrasound thermotherapy in mild to moderate carpal tunnel syndrome.
• Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail.
• The value of iontophoresis combined with ultrasound in patients with the carpal tunnel syndrome.
• Extracorporeal shock wave therapy in the treatment of chronic tendinopathies.
• Pulsed ultrasound treatment accelerates the repair of Achilles tendon rupture in rats.

Acupuncture

• Carpal tunnel syndrome: clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies--an open protocol study.
• Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow.
• The analgesic effect of acupuncture in chronic tennis elbow pain.
• Sham device v inert pill: randomised controlled trial of two placebo treatments.
• Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis.
• Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture.

Low Level Lazer

• Treatment of medial and lateral epicondylitis - tennis and golfer's elbow - with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients.
• Double-blind randomized controlled trial of low-level laser therapy in carpal tunnel syndrome.
• Photobiomodulation of pain in carpal tunnel syndrome: review of seven laser therapy studies.
• Successful management of female office workers with "repetitive stress injury" or "carpal tunnel syndrome" by a new treatment modality-application of low level laser.
• Treatment of carpal tunnel syndrome with polarized polychromatic noncoherent light (Bioptron light): a preliminary, prospective, open clinical trial.
• Treatment of repetitive use carpal tunnel syndrome

TENS

• Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study.
• Carpal tunnel syndrome: clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies--an open protocol study.
• Treating carpal tunnel syndrome with lasers and TENS. [No abstract]
• Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint.

Yoga

• Yoga-based intervention for carpal tunnel syndrome: a randomized trial.
• Yoga.
• Palpatory diagnosis and manipulative management of carpal tunnel syndrome.

Nerve and tendon gliding exercises

• Nerve and tendon gliding exercises and the conservative management of carpal tunnel syndrome.
• Treatment of carpal tunnel syndrome with nerve and tendon gliding exercises.
• Can we use nerve gliding exercises in women with carpal tunnel syndrome?

• An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome.
• A longitudinal study of predictors of research-defined carpal tunnel syndrome in industrial workers: findings at 17 years.
• The relationship of obesity, age, and carpal tunnel syndrome: more complex than was thought?
• Predictors of carpal tunnel syndrome: an 11-year study of industrial workers.
• Obesity and obesity-related illnesses in borderline patients.
• Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements.
• Association of obesity, gender, age and occupation with carpal tunnel syndrome.
• An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome.
• A longitudinal study of industrial and clerical workers: predictors of upper extremity tendonitis.
• Carpal tunnel syndrome in railroad workers.
• Influence of body mass index and work activity on the prevalence of median mononeuropathy at the wrist.
• The relationship between body mass index and the diagnosis of carpal tunnel syndrome.
• Obesity as a risk factor for slowing of sensory conduction of the median nerve in industry. A cross-sectional and longitudinal study involving 429 workers.
• A case-control study of obesity as a risk factor for carpal tunnel syndrome in a population of 600 patients presenting for independent medical examination.
• Incidence of carpal tunnel syndrome among automobile assembly workers and assessment of risk factors.
• Risk factors for visiting a medical department because of upper-extremity musculoskeletal disorders.
• Hand abnormalities of the patients with diabetes mellitus.
• [The diabetic hand]

Blood sugar control

• Tunnel syndromes and blood glucose anomalies.
• Carpal tunnel syndrome and routine blood chemistries.

Carpal bone mobilisation

• An investigation to compare the effectiveness of carpal bone mobilisation and neurodynamic mobilisation as methods of treatment for carpal tunnel syndrome.

General exercise

• Effects of an aerobic exercise program on median nerve conduction and symptoms associated with carpal tunnel syndrome.
• Effects of exercise on carpal tunnel syndrome symptoms.
• Long-term follow-up of conservatively treated chronic tennis elbow patients. A prospective and retrospective analysis.

• Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis.
• Chronic Achilles tendon pain treated with eccentric calf-muscle training.
• Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy -- a randomized trial with 1-year follow-up.
• Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: a prospective randomised study.
• Current concepts in the management of tendon disorders.
• Chronic Tendinopathy: Effectiveness of Eccentric Exercise.
• Eccentric exercise in treatment of Achilles tendinopathy.
• Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up
• Heavy-Load Eccentric Calf Muscle Training For the Treatment of Chronic Achilles Tendinosis
• Athletes strain to avoid Achilles tendon problems - popular article with references.
• Common Overuse Tendon Problems: A Review and Recommendations for Treatment - popular article with references. PMID 16156339

Ligament traction

• New carpal ligament traction device for the treatment of carpal tunnel syndrome unresponsive to conservative therapy.

Topical creams

• Use of Arnica to relieve pain after carpal-tunnel release surgery.

Treatments combined

• Comparison of three conservative treatment protocols in carpal tunnel syndrome.

Massage

• A pilot study comparing two manual therapy interventions for carpal tunnel syndrome.

Soft tissue mobilisation (e.g. ASTYM)

• Innovative approach for the treatment of cumulative trauma disorders.
• A review of treatment for carpal tunnel syndrome.
• A pilot study comparing two manual therapy interventions for carpal tunnel syndrome.
• Rat tendon morphologic and functional changes resulting from soft tissue mobilization.
• Fibroblast responses to variation in soft tissue mobilization pressure.
• Treating lateral epicondylitis.

Pricking collateral blood therapy

• Control study on effect of pricking collateral blood therapy combined with massage on mild carpal tunnel syndrome

Heat therapy

• Continuous low-level heat wrap therapy is effective for treating wrist pain.

Drugs

• Oral drug of choice in carpal tunnel syndrome. - corticosteroids
• A randomised clinical trial of oral steroids in the treatment of carpal tunnel syndrome: a long term follow up.
• Local corticosteroid injection for carpal tunnel syndrome.
• Local insulin injection improves median nerve regeneration in NIDDM patients with carpal tunnel syndrome.
• Treating carpal tunnel syndrome. - corticosteroids
• A novel approach of local corticosteroid injection for the treatment of carpal tunnel syndrome. - corticosteroids
• Carpal tunnel syndrome treatment. - corticosteroids
• The safest location for steroid injection in the treatment of carpal tunnel syndrome.
• Steroid injection and splinting in the treatment of carpal tunnel syndrome.
• Corticosteroid injection vs. nonsteroidal antiinflammatory drug and splinting in carpal tunnel syndrome.
• Evaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome.
• Pharmacotherapy of carpal tunnel syndrome.
• Steroid injection for carpal tunnel syndrome.
• Local corticosteroid injection for carpal tunnel syndrome.
• Local vs systemic corticosteroids in the treatment of carpal tunnel syndrome.
• A prospective study of the long-term efficacy of local methyl prednisolone acetate injection in the management of mild carpal tunnel syndrome.
• A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome.
• Determination of sensitive electrophysiologic parameters at follow-up of different steroid treatments of carpal tunnel syndrome.

Hypnotherapy

• Hypnotically-induced vasodilation in the treatment of repetitive strain injuries.

Placebo effect

• Therapeutic touch in the treatment of carpal tunnel syndrome.
• Clinically significant placebo analgesic response in a pilot trial of botulinum B in patients with hand pain and carpal tunnel syndrome.

Magnetic therapy

• The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome.
• Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review.

Pulsed electromagnetic field therapy

• Pulsed magnetic and electromagnetic fields in experimental achilles tendonitis in the rat: a prospective randomized study.
• Chronic lateral humeral epicondylitis--a double-blind controlled assessment of pulsed electromagnetic field therapy.
• Pulsed electromagnetic field therapy of persistent rotator cuff tendinitis. A double-blind controlled assessment.
• Localized pulsed magnetic fields for tendonitis therapy.
• Noninvasive treatment of inflammation using electromagnetic fields: current and emerging therapeutic potential.
• The effect of pulsed electromagnetic fields on flexor tendon healing in the rabbit.
• The effect of pulsed electromagnetic fields on flexor tendon healing in chickens.
• Pulsed magnetic field therapy increases tensile strength in a rat Achilles' tendon repair model.

Nitric oxide

• Using nitric oxide to treat tendinopathy.
• Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow: a randomized, double-blinded, placebo-controlled clinical trial.

Cryotherapy

• A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release.

Platelet-rich plasma

• Treatment of chronic elbow tendinosis with buffered platelet-rich plasma.
• How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation.
• Platelet rich plasma (PRP) enhances anabolic gene expression patterns in flexor digitorum superficialis tendons.
• Platelet concentrate injection improves Achilles tendon repair in rats.
• Independent and additive stimulation of tendon repair by thrombin and platelets.

Other injections

• Bone morphogenetic proteins and tendon repair.
• Tendon healing stimulated by injected CDMP-2.
• OP-1 has more effect than mechanical signals in the control of tissue differentiation in healing rat tendons.
• CDMP-2 injection improves early tendon healing in a rabbit model for surgical repair.

Pyridoxine - Vitamin B6

• Pyridoxine hydrochloride treatment of carpal tunnel syndrome: a review.
• Vitamin B6 (pyridoxine) therapy for carpal tunnel syndrome.
• Therapy with vitamin B6 with and without surgery for treatment of patients having the idiopathic carpal tunnel syndrome.
• Clinical results of a cross-over treatment with pyridoxine and placebo of the carpal tunnel syndrome.
• Biochemical evidence for a deficiency of vitamin B6 in the carpal tunnel syndrome based on a crossover clinical study.
• Vitamin B6 deficiency in patients with a clinical syndrome including the carpal tunnel defect. Biochemical and clinical response to therapy with pyridoxine.
• Response of vitamin B-6 deficiency and the carpal tunnel syndrome to pyridoxine.
• Carpal tunnel syndrome and vitamin B6.
• Carpal tunnel syndrome and vitamin B6. - 1987
• Enzymology of the response of the carpal tunnel syndrome to riboflavin and to combined riboflavin and pyridoxine.
• Pyridoxine metabolism in carpal tunnel syndrome with and without peripheral neuropathy.
• The relationship of vitamin B6 status to median nerve function and carpal tunnel syndrome among active industrial workers.
• Carpal tunnel syndrome: current theory, treatment, and the use of B6.
• Treatment of carpal tunnel syndrome with vitamin B6.
• Electromyographic data differentiate patients with the carpal tunnel syndrome when double blindly treated with pyridoxine and placebo.
• Using pyridoxine to treat carpal tunnel syndrome. Randomized control trial.
• Pyridoxine as an adjunct in the treatment of carpal tunnel syndrome.
• Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study.
• Vitamin B6, vitamin C, and carpal tunnel syndrome. A cross-sectional study of 441 adults.
• Brief communication: effect of pharmacologic doses of vitamin B6 on carpal tunnel syndrome, electroencephalographic results, and pain.
• Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome.
• Survey and new data on treatment with pyridoxine of patients having a clinical syndrome including the carpal tunnel and other defects. [No abstract]
• Successful therapy with vitamin B6 and vitamin B2 of the carpal tunnel syndrome and need for determination of the RDAs for vitamins B6 and B2 for disease states. [No abstract]
• Clinical aspects of treatment of carpal tunnel syndrome with vitamin B6. [No abstract]
• Vitamin B6, vitamin C, and carpal tunnel syndrome. [No abstract]
• Vitamin B6 in carpal tunnel syndrome. [No abstract]
• Vitamin B6 in carpal tunnel syndrome. [No abstract]
• Pyridoxine in carpal tunnel syndrome. [No abstract]
• The carpal tunnel syndrome as a probable primary deficiency of vitamin B6 rather than a deficiency of a dependency stat [No abstract]
• Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal tunnel syndrome. [No abstract]

Misc

• Conservative therapy in carpal tunnel syndrome.
• Primary care management of carpal tunnel syndrome.
• Nonoperative carpal tunnel syndrome treatment.
• Conservative treatment of carpal tunnel syndrome: an outcome study of adjunct exercises.
• Carpal tunnel syndrome.
• Nonoperative carpal tunnel syndrome treatment.
• A treatment for carpal tunnel syndrome: results of a follow-up study.
• Repetitive strain injury (cumulative trauma disorder): causes and treatment.
• Understanding work-related upper extremity disorders: clinical findings in 485 computer users, musicians, and others.
• Carpal tunnel syndrome: contribution of flexor tendons.
• Carpal tunnel syndrome in primary care: a report from ASPN. Ambulatory Sentinel Practice Network.
• Carpal tunnel syndrome in children.
• Work-related repetitive strain injury and leisure-time physical activity.
• Presentation and response of patients with upper extremity repetitive use syndrome to a multidisciplinary rehabilitation program: a retrospective review of 24 cases.
• The carpal tunnel syndrome: a clinical and electrophysiological study of 250 patients.
• Results of treatment of severe carpal tunnel syndrome.
• Acute bilateral carpal tunnel syndrome associated with human parvovirus B19 infection.
• Randomized clinical trial of surgery versus conservative therapy for carpal tunnel syndrome. [Study design only]

  The role of tension

  • Stress-induced muscle effort as a cause of repetitive strain injury?
  • Overuse syndromes of the upper limb and the upper limb tension test: a comparison between patients, asymptomatic keyboard workers and asymptomatic non-keyboard workers.

  The role of circulation

  • Forearm blood flow and oxygen consumption in patients with bilateral repetitive strain injury measured by near-infrared spectroscopy.
  • 99Tcm-MDP blood-pool phase in the assessment of repetitive strain injury.
  • Detection of increased blood flow to the affected arm in repetitive strain injury with radionuclide and Doppler ultrasound studies. A case report.
  • A vascular basis for repetitive strain injury.

  Wikipedia

• Carpal tunnel syndrome (Wikipedia)
• Repetitive strain injury (Wikipedia)

Tendonopathies

• Tendon and nerve displacement at the wrist during finger movements.
• Gliding characteristics between flexor tendons and surrounding tissues in the carpal tunnel: a biomechanical cadaver study.

Diagnosis

• Potential MR signs of recurrent carpal tunnel syndrome: initial experience.
• Carpal tunnel: MR imaging. Part II. Carpal tunnel syndrome.
• Median nerve compression can be detected by magnetic resonance imaging of the carpal tunnel.
• Carpal tunnel syndrome: diagnosis with high-resolution sonography.

Wrist scans

• CT of carpal tunnel syndrome.

Keyboard finger forces

• The effects of keyswitch stiffness on typing force, finger electromyography, and subjective discomfort. - praise for buckling springs
• Effect of keyswitch design of desktop and notebook keyboards related to key stiffness and typing force.
• Effects of key stiffness on force and the development of fatigue while typing.
• In vivo finger flexor tendon force while tapping on a keyswitch.
• Investigation of applied forces in alphanumeric keyboard work.
• Computer keyboard force and upper extremity symptoms.

Wrist angle

• Relationship between carpal tunnel syndrome and wrist angle in computer workers.
• Predictive models of carpal tunnel syndrome causation among VDT operators.
• Incidence of carpal tunnel syndrome among automobile assembly workers and assessment of risk factors.
• Guidelines for wrist posture based on carpal tunnel pressure thresholds.
• The impact of wrist extension provocation on current perception thresholds in patients with carpal tunnel syndrome: a pilot study.
• Reverse Phalen's maneuver as an aid in diagnosing carpal tunnel syndrome.

RSI - quackery

RSI - notes