Repetitive strain injury (RSI) - Diagnosing repetitive strain injury (RSI)

There is no single test to check for repetitive strain injury (RSI) as the symptoms can be caused by a variety of things. Often no clear problems are found despite extensive tests.

RSI is often diagnosed when symptoms develop after a repetitive task and fade when the task is stopped.

Your GP will examine the area where you have pain and will ask about your symptoms and medical history. This will help them determine if you have RSI and what type you have.

Types of RSI

RSI is often split into two categories depending on your symptoms:

• Type 1 RSI – When a doctor can diagnose a recognised medical condition from your symptoms. It is usually characterised by swelling and inflammation of the muscles or tendons.
• Type 2 RSI – When a doctor cannot diagnose a specific medical condition, usually because you have no obvious symptoms other than pain. This is also known as non-specific upper limb pain.

Type 1 RSI

There are several medical conditions and injuries that can be classed as type 1 RSI. These include the following:

• bursitis – inflammation and swelling of the fluid-filled sac near a joint such as the elbow or shoulder
• nerve entrapment, such as carpal tunnel syndrome (pressure on the median nerve passing through the wrist)
• Dupuytren's contracture – a thickening of deep tissue in the palm of the hand and into the fingers
• epicondylitis – inflammation of an area where bone and tendon join in the elbow, causing either tennis or golfer's elbow
• rotator cuff syndrome – inflammation of the tendons in the shoulder
• tendonitis – inflammation of a tendon
• tenosynovitis – inflammation of the inner lining of the tendon sheath that covers the tendons, most commonly in the hand, wrist or forearms
• trigger finger – where swelling in a tendon running along one of the fingers makes it difficult to bend and straighten the affected finger
• ganglion cyst – a sac of fluid that forms around a joint or tendon, usually on the wrist or fingers
• Raynaud's disease – a condition where the blood supply to extremities such as the fingers is interrupted, especially when exposed to cold
• thoracic outlet syndrome – compression of the nerves or blood vessels that run between the base of the neck and the armpit
• writer's cramp (a type of dystonia) – a condition that occurs from overuse of the hands and arms

However, while the conditions above can be caused by work activities, many of them (including carpal tunnel syndrome and Dupuytren's contracture) can also develop as a result of other factors.

Type 2 RSI

If your symptoms don't immediately suggest you have one of the above conditions, you may be referred for further tests to check for other conditions.

For example, you may be given an X-ray to test for osteoarthritis or blood tests to rule out inflammatory joint diseases.

If no other condition is found after having tests, you may be diagnosed with type 2 RSI, which is also known as non-specific upper limb pain syndrome or diffuse RSI.