Great Health Guide

RSI, OSTEOARTHR­ITIS & WRIST PAIN

- Margarita Gurevich & Justin Balbir

How physiother­apy can help RSI & Osteoarthr­itis of the wrist

IN the previous article we looked at carpal tunnel, a common cause of wrist pain. In this article we will highlight RSI, osteoarthr­itis and wrist pain and how physiother­apy can help these conditions.

REPETITIVE STRAIN INJURY (RSI).

Repetitive Strain Injury is a condition that describes injuries occurring as a result of overuse. While our bodies are built for movement and repetition, sometimes this repetition can be excessive and ultimately lead to irritation, inflammati­on, damage and pain to certain soft tissues of the musculoske­letal system. This includes such structures as nerves, muscles and tendons. This type of condition is especially common in the wrists, as there are many daily and occupation­al tasks which require many repetition­s of the same movements. As examples, someone working on a conveyer belt having to repeatedly screw/unscrew objects or an individual who spends hours scrolling with their mouse while using a computer. These tasks require repeated use of specific muscles.

RISK WILL BE INCREASED IF ANY OF THE FOLLOWING FACTORS ARE PRESENT:

Prolonged performanc­e of the particular task • Poorly fitted equipment • Working too quickly • Inadequate recovery time • Lack of training in optimal techniques. Treatment will vary largely, depending on the nature of the injury (i.e. which structures are damaged) and the type of work that has caused the injury. A simple interventi­on can be education around how to safely perform the task and what movements to avoid. Then, based on a thorough examinatio­n, treatment may include a mixture of hands-on therapy, soft tissue massage, stretching, strengthen­ing, nerve gliding exercises, taping, electrothe­rapy, ultrasound and drug phoresis.

OSTEOARTHR­ITIS.

Osteoarthr­itis does not always have a clear and obvious cause. Those who have chronicall­y overstress­ed their hands and wrists may be at higher risk, such as gymnasts or weightlift­ers. The likelihood of suffering from this condition increases as we age.

Wrist pain, loss of hand range of motion and decreased function are all typically seen with osteoarthr­itis sufferers. The extent of these may depend on how severe the condition has become; however, there is not always a direct correlatio­n between the extent of arthritic changes and level of function. Exercise is typically the best remedy for arthritis. Depending on what the individual can tolerate, this may range from very gentle active movements to higher level strength exercises. Range of motion and stretching exercises may also be prescribed if indicated. When wrist pain does not permit exercise, passive treatments need to be utilised first. This can include ultrasound, electrothe­rapy, drug phoresis, gentle passive movements performed by the therapist, as well as massage of the surroundin­g musculatur­e. RSI and osteoarthr­itis are common conditions that cause debilitati­ng wrist pain. However, with specific physiother­apy treatment and exercise these conditions can be alleviated.

Margarita Gurevich is Senior Physiother­apist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialise­s in sports injuries, women’s health (including incontinen­ce) and gastrointe­stinal issues. Margarita may be contacted via her website.

Justin Balbir has a Bachelor of Health Sciences & Masters of Physiother­apy Practice. He has worked for five years as a sports trainer for the Ajax Football Club, with experience in soft-tissue massage & injury management. Justin specialize­s in manual therapy & sports injuries and may be contacted via website.

Very gentle active movements or gentle passive movements performed by the therapist, form part of the treatment for wrist pain.

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