The following is a glossary of terms that you're likely to hear from medical professionals and equipment vendors.
Repetitive Strain Injury Synonyms
The following are general, umbrella terms used to describe a number of specific injuries resulting from overuse of the body's soft tissues, such as tendons, nerves, circulatory system, etc.
Cumulative Trauma Disorder
Occupational Overuse Syndrome
Repetitive Motion Injury
Repetitive Strain Injury, or Repetitive Stress Injury
Upper Limb Disorder
Modifiers Frequently Used in Addition to Above Terms:
Upper Extremity (i.e. UEMSD)
Work-Related Upper Limb Disorder (i.e. WRULD)
Work-Related Upper Extremity Musculoskeletal Disorder (i.e. WUMSD)
These are specific injuries that are typically related to the general terms noted above.
Adverse Mechanical Tension (AMT)
Also known as 'neural tension', this is where the nerves running down to your arm have become contracted and possibly compressed as a result of muscle spasms in the shoulders and elsewhere. AMT can often misdiagnosed as or associated with one of the other RSIs. It is largely reversible and can be treated with physiotherapy (brachial plexus stretches and trigger point therapy).
Carpal Tunnel Syndrome (CTS)
A condition of inflammation and damage (in severe cases) of the median nerve as it passes through the so-called "carpal tunnel" in the wrist. This is a space surrounded on three sides by carpal bones of the wrist and on one side by the flexor retinaculum or transverse carpal ligament. The median nerve shares the carpal tunnel with nine tendons which flex the fingers. If these tendons swell from cumulative trauma or other conditions, such as pregnancy, the median nerve suffers from compression. The pressure in the tunnel reduces the blood supply of the nerve, causing numbness, tingling, and pain into the thumb, index, middle, and ring fingers. Eventually, weakness of the thumb results. Surgery would only rarely be necessary, as early correction of the offending risk factors nearly always alleviates the problem.
Chronic pain and Stress
Cubital Tunnel Syndrome
Cubital tunnel syndrome is a condition that affects the ulnar nerve where it crosses the elbow. The symptoms are very similar to the pain that comes from hitting your funny bone. The funny bone is actually the ulnar nerve on the inside of the elbow that runs in a passage called the cubital tunnel! Sometimes this area becomes irritated from repeated injury or pressure, leading to a condition called cubital tunnel syndrome. Symptoms are tingling and numbness over the little finger.
De Quervain's Tenosynovitis and Intersection Syndrome
Pain on the side of the wrist and forearm just above the thumb may be DeQuervain's Tenosynovitis. This is a common problem that is usually easily diagnosed. Like many other problems caused by repetitive injury to the hand and arm, this disorder results when the tendons (and the covering of the tendons called the tenosynovium) become inflamed.
A tendonitis of the elbow from excessive, repetitive, or forceful movements of the wrist. That’s right, muscle-tendon units moving the wrist originate at the elbow. Lateral epicondylitis occurs at the origin of the lateral epicondyle, the major bony prominence on the outside of the elbow. This usually occurs from excessive extension of the wrist or holding the wrist up in extension as a static posture. It can also be caused by repeatedly creating large divots in the grass while playing golf, and for this reason is also called "golfer’s elbow." The pain of medial epicondylitis is located where the wrist flexors originate at the medial epicondyle, the major bony prominence at the medial or inner aspect of the elbow. This is also known as "tennis elbow" since forceful overhand shots place stress on this tendon.
Lateral epicondylitis is sometimes referred to as Tennis Elbow - not because only tennis players get the problem, but because the backhand swing in tennis is a common activity that can cause the problem. There are many other activities that can result in lateral epicondylitis - such as painting with a brush or roller, running a chain saw, and using many types of hand tools continuously. Each of these activities use the same muscles and can result in lateral epicondylitis when these muscles are overused.
Medial epicondylitis is sometimes referred to as Golfer's Elbow - not because only golfers get the problem, but because the golf swing is a common activity that can cause the problem. There are many other activities that can result in medial epicondylitis - such as chopping wood with an ax, running a chain saw, and using many types of hand tools continuously. Each of these activities use the same muscles and can result in medial epicondylitis when these muscles are overused.
An underdiagnosed disorder of unknown etiology affecting over 5% of the patients in a general medical practice and an estimated 2-4% of the general population, women more often than men. Patients complain that they ache all over. A large number of other symptoms are often present, particularly fatigue, morning stiffness, sleep disturbance, paresthesias, and headaches. On examination, areas of focal tenderness called tender points can be demonstrated in characteristic locations. Most patients can be helped substantially with treatment. (W.R.I.S.T. Related Information/Links)
"Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual" by Devin J. Starlanyl M.D. and Mary Ellen Copeland M.A. M.S., copyright 1996 New Harbinger Publications Oakland CA, 800-748-6273, http://www.sover.net/~devstar/physinfo.htm
FMS is a systemic neuroendocrine condition with, among other things, a disrupted adrenal-hypothalamus-pituitary axis. It is nonprogressive (although it may seem so), nondegenerative, and noninflammatory. It is responsible for diffuse body-wide pain, tender points that hurt but don't refer pain, and sleep disturbances.
Ganglion or Ganglionic Cyst
A round, localized swelling of a tendon sheath. They are most common about the wrist and appear as slightly firm, moveable knobs, usually about one centimeter (1/2 inch) in diameter. They are very common, even in those who do not use computers (yes there are still a few holdouts). Ganglia are not dangerous. They sometimes become inflamed, at which time some anti-inflammation medication is useful (for those who can take these medications). Surgery should only very rarely be considered as a treatment.
Guyon's Canal Syndrome
Guyon's canal syndrome is a common nerve compression affecting the ulnar nerve as it passes through a tunnel in the wrist called Guyon's canal. This problem is similar to carpal tunnel syndrome, but involves a completely different nerve! Sometimes both conditions can be causing a problem in the same hand.
The shoulder is a very complex piece of machinery. Its elegant design gives us the ability to do many things. This design gives the shoulder joint great range of motion but not much stability. As long as the parts of this elegant machine are in good working order, the shoulder can move freely and painlessly. An injury to the shoulder, or wear and tear in the parts of the shoulder, can lead to pain with movement or stiffness in the shoulder. Many people are probably familiar with the term bursitis. Any pain in the shoulder is sometimes mistakenly referred to as bursitis. The term bursitis really only means that the part of the shoulder called the bursa is inflamed. In reality, there are many different problems that can lead to symptoms from inflammation of the bursa, or bursitis. Impingement is one of those things that can cause bursitis.
Intersection Syndrome is a painful condition that affects the thumb side of the forearm where two muscles cross over - or intersect - two underlying wrist tendons.
Myofascial Pain Syndrome
Chronic MPS is a musculoskeletal chronic pain syndrome. It is nonprogressive (although it may seem so), nondegenerative and noninflammatory. It is composed of many Trigger Points (TrPs), which refer pain locally or to a distance, and cause other symptoms in very precise, specific patterns. It seems progressive because each TrP can develop satellite and secondary TrPs, which can form secondaries and satellites of their own. With treatment of the TrPs and underlying perpetuating factors, however, these TrPs can be "reversed" and minimized or eliminated.
Pronator Teres Syndrome
Occurs when nerves are compressed between muscles in the forearm right below the elbow. This compression results when the forearm is repeatedly rotated, especially with wrist flexion or extension, or with forceful movements.
Radial Tunnel Syndrome
Radial tunnel syndrome is a condition that can cause aching in the forearm just below the elbow. The symptoms of radial tunnel syndrome can be confused with lateral epicondylitis - or tennis elbow. Radial tunnel syndrome can be difficult to diagnose because the tests that are available to look for the problem are not very accurate. This means that your doctor must rely mostly on the history that you give and the physical exam to make the diagnosis.
Raynaud's Syndrome, white finger
Reflex Sympathetic Dystrophy
Rotator Cuff Syndrome
Inflammation of the rotator cuff, a band of tendons from muscles in the back of the shoulder that course in a narrow slot under the collar bone. Unless posture is correct, the tendons become pinched or "impinged" by the bones in the shoulder. The tendons form a cuff at they insert onto the humerus (upper arm bone). Constant reaching forward for the mouse or keyboard tends to cause or aggravate rotator cuff tendonitis.
Carpal Tunnel Syndrome
The Copenhagen official Fibromyalgia Syndrome definition states that you must have at least 11 out of 18 specified tender points to be diagnosed with FMS. Tender points hurt where pressed, but do not refer pain elsewhere -- that is, pressing a tender point does not cause pain in some other part of the body.
An inflammation of a tendon. Repeated tensing of a tendon can cause inflammation. Eventually, the fibers of the tendon start separating, and can even break, leaving behind debris which induces more friction, more swelling, and more pain. "Sub-acute" tendonitis is more common, which entails a dull ache over the wrist and forearm, some tenderness, and it gets worse with repetitive activity.
Inflammation of the tendon sheath surrounding a tendon. A common example is DeQuervain’s Disease, which occurs at the thumb (radial) side of the wrist. Sometimes this can result in a creaking sound when the tendon moves inside the inflamed sheath. Chronic tenosynovitis occurs when the repetitive activity is mild or intermittent: not enough to cause acute inflammation, but enough to exceed the tendon sheath's ability to lubricate the tendon. As a result, the tendon sheath thickens, gets inflamed, and you've got your problem.
Thoracic Outlet Syndrome (TOS)
The Thoracic Outlet Syndrome affects the nerves and blood vessels of the neck and shoulder. This disorder results from certain working postures which cause the bundle of nerves and blood vessels to be compressed or stretched. Example postures are: when the shoulder is pulled down and back, or when the shoulder is raised. Symptoms include numbness, tingling and burning sensations along the inner arm, forearm, hand and fingers. Serious damage to the tissues of the hand and arm can result if the condition goes untreated.
This condition is a very frustrating problem - both for the patient and for the physician. It is extremely difficult to prove that the diagnosis of Thoracic Outlet Syndrome is correct, because there is no test that has a high degree of accuracy in showing the problem. Usually, the diagnosis is made after all other causes of the symptoms have been ruled out - a frustrating and slow process sometimes!
Trigger Finger and Thumb
Trigger finger, and thumb, is a condition affecting the movement of the tendons as they bend the fingers or thumb toward the palm of the hand. This movement is called flexion.
Trigger Points (TrPs) are found as extremely sore points occurring in ropy bands throughout the body. They can also be felt as painful lumps of hardened fascia. The bands are often easier to feel along the arms and legs. TrPs can occur in the myofascia, skin, ligaments, bone lining, and other tissues. They can be caused by a surgical incision, as is often the case with abdominal surgery. You have probably never heard of TrPs, yet they are quite common. Each specific TrP on the body has a referred pain or other symptom pattern that is carefully documented in the Trigger Point Manuals.
Other RSI Terms
Physiatry derives from the Greek words physikos (physical) and iatreia (art of healing). A Physiatrist is a physician who creatively employs physical agents as well as other medical therapeutics to help in the healing and rehabilitation of a patient. Treatment involves the whole person and addresses the physical, emotional and social needs that must be satisfied to successfully restore the patient's quality of life to its maximum potential.
Referring to the muscles, nerves, tendons, ligaments, cartilage, bone, joints, and spinal discs.
Muscle Tendon Unit
All muscles have a tendon at either end to attach to two different bones. The collagen fibers that make up the tendon also go through the muscle. Although the tendons don’t shorten as the muscle does when it contracts, they are part of the assemblage which causes movement.
In neuromuscular training I learned that "trigger points" are highly irritable places in muscles or connective tissue that are painful and often refer pain to other sites. They are sites of neurological overload due to injury, overuse, etc. These painful sites respond positively to many massage techinques. Trigger points can be held at bay or eliminated entirely by regular bodywork, stretching exercises, lifestyle changes. (
Ba Duan Jin
These Chinese exercises were invented several thousand years ago and used by monks and soldiers to improve their strength and health. Ba Duan Jin employs gentle stretching to stimulate the blood circulation and relieve any aches or pains.
This Chinese discipline, which is related to Tai Chi Chuan, involves standing in certain positions that enhance the 'chi' or energy. It is very useful for short term pain relief and long term healing, and can also be used to prevent work-related health problems.
Kevin Byrne, MD - CorpMed, LLC; for use of glossary terms from Ergo Health training software.