Non-specific pain

Non-specific pain syndrome (diffuse RSI)
Most industrial and manufacturing activities throughout the ages, which have involved any form of repetitive movement, have had their own overuse syndromes. Soft tissue injuries to muscles, tendons and nerves in the hand, arms, neck and shoulders are known by a variety of names. Tenosynovitis, for example, is a recognised industrial injury for occupations involving frequent or repeated movements of the hand or wrist and in the late 1990s many thousands of miners and gas workers received compensation for Vibration White Finger.

In recent years, office workers in particular have been reporting a variety of symptoms sometimes in different parts of the body. With these ‘diffuse’ conditions, doctors have often been unable to see any signs of injury and the nature of non-specific RSI has become a controversial subject. In the absence of a pathology, psychogenic or ‘all-in-the-mind’ theories have flourished.

Research carried out at University College London by physiotherapist Jane Greening and neurologist Dr Bruce Lynn indicates that one possible cause of non-specific pain syndrome may be nerve damage similar to a number of other painful neurological conditions.

Their studies showed that RSI patients have a reduced sensitivity to vibration and more painful responses to test stimuli. MRI scans also revealed marked restrictions in the mobility of the median nerve, which supplies information back to the brain about sensations felt in the hand. This pattern of evidence points towards RSI having a neuropathic cause and they propose to investigate other possible sites of nerve entrapment, for example, the shoulder.

Though each case of diffuse RSI is quite individual and non-occupational factors should also be investigated, generally some changes will be needed at work. Areas to consider include pacing, rest breaks, reducing repetition and force, posture, and the use of ergonomically designed tools and equipment to reduce the risk of further damage.