What is RSI? RSI is a syndrome, a collection of symptoms, which appear when there has been overuse and repetitive strain on muscles and the fascia and connective tissue surrounding muscles and joints. This produces adhesions – literally "stuck" areas – and trigger points, areas of permanently contracted muscle fibres which cause pain in related areas.
One of the most common forms of hand, wrist and arm pain is "Carpal Tunnel Syndrome" affecting the arms, wrists and hands. This is prevalent in busy office environments, where prolonged keyboard work is required. It is diagnosed as the impingement or entrapment of the nerves in the wrist, a narrowing of the wrist’s "carpal tunnel". The question is "why is the carpal tunnel blocked?" This is most often due to trigger points and fascial restrictions in the neck, the shoulders and across the chest – the problem is therefore often not primarily in the carpal tunnel (wrist) itself, but in the areas where there are restrictions which cause the impingement at the carpal tunnel.
Your RSI, carpel tunnel syndrome, or hand, wrist and arm symptoms may even have started with neck stiffness or pain, or headaches. These symptoms often accompany the arm and hand symptoms. At the Trauma Recovery Clinic we will treat the soft tissue problem where it originates, not just where the symptoms are.
When a movement has been carried out repetitively, for instance when using a mouse, or when a non-neutral posture has been held for a long time, tensing over a computer screen, RSI can be the result and you may experience some of the symptoms listed below.
• Throbbing and persistent pain down the arms into the wrists, hands and fingers
• Deep throbbing or dull pain, pain ‘like toothache’ at rest or when using the arms or hands
• Shooting pains, ‘nerve’ pains down the arms, in the wrists, hands or fingers
• Tingling, ‘pins and needles’, burning sensations
• Numbness, ‘cotton wool’ feelings
• Lack of any feeling in parts of the arms, wrists and hands
• Dull persistent pain at night
• Spread of pain across the chest and into the neck on using hands and fingers, as when typing or using a mouse
• Tightness or stiffness in the shoulders, neck or chest
• Pain on light massage just underneath the collarbones
• Weak grip or inability to grip or lift anything for long, e.g. a cup, fork, toothbrush
• Inability to turn door handles
• Inability to type or use a keyboard
• Inability to write or hold a pen
• Inability to drive, turn a steering wheel, change gear, operate the handbrake, etc.
• Reduction in range of movement or pain with movement
• Weakness, lack of strength, sometimes no strength at all
At the Trauma Recovery Clinic we use myofascial release and trigger point therapy for RSI conditions, backed up with remedial massage techniques such as soft tissue release, positional release, and other advanced bodywork modalities. With these techniques we release areas which are impinging on nerves, for instance in the wrist, and rebalance all the muscles and fascia, so that these structures can take the strain comfortably.
Using these techniques should bring about the following benefits:
• Diminishing or elimination of pain in the arms, wrists and hands
• Increased sensitivity to sensations and diminishment of numbness
• Decrease in sensations of pins and needles, ‘cotton wool’, tingling, or burning
• Increased strength in hands, wrists and fingers
• Improved grip for driving, lifting, and carrying out daily tasks
• Ability to type, write with a pen and perform fine motor functions with hands and fingers
• Decrease in autonomic nervous system (ANS) sensations of anxiety and panic associated with inability to use hands
• Decrease or elimination of pain and stiffness in neck and shoulders
Trigger points are areas of muscle fibres which are permanently contracted and sometimes painful to touch. They cause the entire muscle to shorten and tighten, and refer pain to other areas. Treatment involves locating and releasing trigger points which are referring pain to the affected areas and causing narrowing and adhesions.
Very often we will work in an area which is removed from the area of pain. The result is a significant reduction or elimination of pain in the affected area, although it has not been directly treated.
Trigger point therapy is always accompanied by local myofascial release, because if the fascia in the area of a trigger point has not been released, the trigger point is likely to return.
As well as trigger point release we look for areas of fascia which have been adhesed and are restricting normal functioning in their own and other areas. We use specific techniques for releasing fascia and the nerves and other structures it bears down on when restricted. We also use soft tissue release and myofascial stretching to release restricted areas.
Autonomic nervous system responses to physical, emotional or physiological stress or trauma always involve tensing of the connective tissues, either causing or contributing to RSI symptoms. We use Dr. Peter Levine’s Somatic Experiencing approach to allow stressful or even traumatic experiences resulting in PTSD to be integrated into the mind-body easily and holistically so that we can get on with life without ANS responses causing pain or restrictions.
When muscles, fascia and trigger points have been released we test again for movement, pain and strength levels and help you develop posture or ways of working which will prevent RSI from recurring. These may include exercises from Pilates or specific stretches. They will all be easily achievable and can usually be carried out discretely during the course of the day, even at the office.
Usually, between 6 and 8, 55 minute treatments at the Trama Recovery Clinic bring about substantial decrease in symptoms. In some cases, a difference in mobility or change in sensation is felt after the first or second treatment.
We strongly suggest that you seek treatment to eliminate the soft tissue causes of RSI and Carpal Tunnel Syndrome before you undergo surgery for the symptoms.
“For many years I experienced severe RSI in particular in the right arm. Last year this became extreme and made movement in my right shoulder very limited and painful.
After two sessions with Anne my shoulder began to improve significantly and the other symptoms of RSI reduced to a manageable level. After six treatments I am well on the road to being free of pain and have regained the majority of my flexibility lost some years ago.
I have found this treatment fantastic, especially as I have tried every other treatment – both conventional and complementary – with no particular effect. I have recommended it to many people and would tell anyone to give it a go!”