Repetitive Strain Injuries: How to Avoid Them While Working From Home

Repetitive strain injuries (RSIs) are among the most common and costly occupational health problems. Every year, they affect hundreds of thousands of American workers and cost more than $20 billion a year in worker’s compensation. Studies indicate that the more time you spend on the computer, the more likely you are to develop RSIs, especially musculoskeletal pain. 

The COVID-19 pandemic has dramatically changed the landscape of working from home. More people than ever are working remotely, in spaces that are often not well-suited to the demands of frequent screen time and computer use. RSIs appear to be on the rise with the increase of people working from home during COVID-19. 

Here, we’ll review the common types of RSI and discuss how to recognize, prevent, and treat them.

What are repetitive strain injuries?

Repetitive strain injuries — or repetitive stress injuries, as they are sometimes called — refer to a variety of disorders that lead to pain or damage to the: 

• Muscles

• Nerves

• Tendons

• Joints

These injuries are caused by repetitive motions and overuse in daily life. The most commonly affected areas are usually in the upper body, such as the:

• Hands

• Wrists

• Elbows

• Back (both upper and lower)

• Neck

• Shoulders

What causes repetitive strain injuries?

RSIs are most commonly caused by: 

• Frequent repetitions of the same motion or activity 

• Maintaining the same posture for long periods of time

• Maintaining an awkward position for a prolonged period of time (for example, using the neck to hold a phone headset) 

• Holding limbs with no support (for example, typing without sufficient wrist support)

• Lifting heavy objects

• Activities that involve vibration or mechanical compression

Quiz: Do I have carpal tunnel syndrome?

What are the most common types of repetitive strain injuries?

RSIs most commonly affect the upper body. They can lead to:

• Carpal tunnel: This is numbness and tingling in the hand and arm, often caused by an inflamed nerve in the hand and wrist.

• Tendonitis: This involves inflammation of a tendon and can occur in various parts of the body. For example, “texting thumb” is a type of tendonitis in which the thumb tendon gets inflamed from repeated texting, leading to pain and weakness. 

• Musculoskeletal strain of upper back and neck: This refers to musculoskeletal pain that is often worsened by spending many hours each day at the computer with poor posture.

• Lower back pain: Chronic low back pain is often related to excessive strain on the lower back muscles from sitting in positions with poor back support. 

• Epicondylitis: This is inflammation in the area where the tendons attach to the bone. The most common example is tennis elbow. Despite the name, tennis elbow often shows up in workers who perform repetitive motions with their arms, such as painters, plumbers, and carpenters. 

What are the signs and symptoms of repetitive strain injuries? 

Symptoms of RSI can range from mild and occasional, to severe and constant when untreated. 

Symptoms often include:

• Pain

• Weakness

• Tingling

• Numbness

• Stiffness

• Swelling of joints

Who is most at risk of developing repetitive strain injuries?

You are more at risk of developing an RSI if you:

• Engage in daily work with sustained, awkward, and repetitive movements, such as those described above

• Have underlying health conditions such as diabetes or obesity

• Have a previous injury, such as a rotator cuff tear or a wrist injury from prior trauma

• Work in a high-stress environment

• Don’t adapt your work environment in ways that are more ergonomic

How can I avoid repetitive strain injuries while working from home?

If you find yourself sitting in a chair for most of the day in remote work, here are some ways to decrease your risk for RSIs.

Make your workstation more ergonomic 

Ergonomics is the science of arranging people and objects so that people can work in the safest and most efficient way possible. Some principles that apply to desk work include:

• Adjust your computer so that the top of the monitor is at or just below eye level. Your eyes should look slightly downward to decrease neck strain. 

• Place the computer at an arm’s distance from you. This helps ensure that you can see the entire screen. 

• Arrange your chair so that your feet rest firmly on the floor with knees bent at 90°. Depending on the height of your chair and desk, this might involve purchasing a foot rest. 

• Find a chair that offers lower back support.

• Make sure your wrists are supported when typing. 

Avoid repetition when possible 

Repetitive movements put pressure on a small group of muscles and tendons. This can increase your risk of developing pain and injury. 

• Switch mouse hands: If your job entails frequent clicking with your mouse, consider switching your mouse to the other hand. This might have the added benefit of building new brain connections!

• Stand up: Try to avoid sitting for prolonged periods. Consider investing in a standing desk, or one that converts between sitting and standing. 

• Divide up your day: Make sure tasks that involve repetitive movements aren’t done for hours at a time but are divided into smaller chunks.

• Take breaks: Taking breaks is crucial to breaking up the repetition. Getting up every 30 to 60 minutes decreases your risk of RSI. Additionally, a study out of Columbia University indicates that spending less time sitting each day can decrease your risk of dying from heart disease or cancer. 

Reduce stress

Stress is a risk factor for RSI that can be modified. In this study from Washington State, people who reduced stress with mindfulness had better relief of chronic low back pain than those who did not. Common stress-reduction techniques include:

• Deep breathing: One common strategy is the 4-7-8 breath. Inhale with a count of 4, hold your breath for a count of 7, then exhale with a count of 8 

• Mindfulness meditation: This is a practice which involves paying attention to what you are feeling and sensing in the moment. Mindfulness has been linked to greater physical and emotional wellbeing.

• Guided visualizations: This is a practice in which you are guided to create a peaceful or joyful visualization, which is associated with relaxation. Sometimes, this is paired with progressive muscle relaxation, in which you imagine your muscles relaxing, one by one. 

• Exercise: Even 20 minutes per day of exercise can have widespread health benefits. 

Do stretching and strengthening exercises 

Strengthening your muscles and doing regular stretches helps to provide good blood flow to your body and reduce the risk for RSIs. These exercises can also work as stress-relievers as well. There are many office-based exercises you can do in 5 to 10 minutes, including:

• Six yoga exercises to do at your desk 

• These computer and desk stretches

• Some exercises can be targeted to problem areas, such as wrist exercises for those with hand pain, back-pain exercises, and neck stretches 

If I do develop a repetitive strain injury, what steps can I take to alleviate pain? 

If you are developing symptoms of an RSI, it’s important to pay attention to what your body is feeling and to take steps to eliminate the pain as soon as possible. When left untreated, the damage to muscles and nerves can turn into more long-lasting disability. Some of the steps you can take at home include:

• Limit activities that trigger pain.

• Stretch.

• Immobilize the area that has pain (use a splint).

• Take NSAIDs, oral medications that are both anti-pain and anti-inflammation. They can decrease your discomfort but should not be taken long-term.

When should I see a doctor or physical therapist for a repetitive strain injury? 

If your symptoms are not improving after taking the steps listed above, it is important to contact your healthcare provider. You may benefit from physical therapy. Here, a trained therapist will teach you specific stretching and strengthening exercises that will benefit your specific condition. For example, certain stretches for carpal tunnel are very effective in reducing pain. In more severe cases, cortisone injection shots or surgery might be necessary.

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Written by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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