Occupational Overuse Syndrome (OOS) was previously referred to as Repetitive Strain Injury (RSI) and is one of a number of conditions increasingly referred to as Gradual Process Injury (GPI).
Signs and symptoms
Symptoms tend to develop gradually and worsen over time if left untreated. Symptoms mainly occur in the shoulders, arms and hands. Early symptoms of OOS include:
- Muscle discomfort
- Aches and pains
- Hot or cold feelings
- Muscles tightness and spasms
- Numbness and tingling.
Where pain and inflammation occurs in a localised area. These conditions can usually be easily treated and recovery is usually quick. Examples of localised inflammations include tennis elbow (inflammation of the tendons on the outside of the elbow joint) and rotator cuff syndrome (inflammation of the tendons around the shoulder joint).
Where swelling in the muscles and soft tissues compresses the nerves. Pain tends to be more widespread, treatment is more involved and recovery can take several weeks. An example of a compression syndrome is carpal tunnel syndrome, where the median nerve in the forearm is compressed as it travels through the wrist.
These are much more complex conditions that develop over a period of time. Pain is persistent and widespread and is often associated with emotional symptoms such as depression and anxiety. Treatment is difficult and recovery takes months or years. An example of a pain syndrome is fibromyalgia – where pain trigger points develop in the muscles and soft tissues.
Muscles use energy supplies derived from the blood to function. The blood is supplied to the muscles via small blood vessels that travel through the muscles. When the muscles are tense these blood vessels are constricted, slowing the flow of blood. If the blood flow is restricted for too long, the muscles work inefficiently. This uses energy very quickly, tires the muscle, and leads to a build-up of acid waste products. This causes pain and the muscle stiffens, making it harder still for the muscle to work.
The muscles and tendons can withstand fatigue and are able to recover if their movements are varied and they are regularly rested. If “overuse” occurs the muscles and tendons may be strained beyond their capacity.
Factors that can lead to OOS developing include:
- Awkward or constricted postures
- Repetitive movement
- Prolonged muscle tension
- Forceful holding or movement
- Poor ergonomics
- Poor work practices eg: poor time management, poor work techniques, lack of training
- Psychosocial factors eg: excessive workload, deadlines, social and work environment.
Diagnosis and Treatment
Diagnosis of OOS is often difficult. It is important for the doctor to take a full medical history and conduct a physical examination. Other causes for the symptoms need to be ruled out. Once a diagnosis of OOS has been made, and the specific OOS condition has been identified, appropriate treatment will be recommended. This may involve referral to an occupational or musculoskeletal specialist and may involve input from healthcare professionals such as occupational therapists and physiotherapists. Treatment may include:
- Rest from activities
- Changing work practices
- Postural correction
- Pain relieving and anti-inflammatory medications
- Exercise and stretching
- Relaxation exercises
- Additional treatments that may be recommended include massage and acupuncture.
There are a number of steps that can be taken to prevent OOS. The Occupational Safety and Health division of the Department of Labour highlights five main ways to prevent OOS in the workplace:
- Design equipment and tasks with people in mind eg: ergonomic workstations
- Organise a reasonable workload
- Pay attention to work environment eg: good lighting
- Train and educate all staff
- Use safe work methods.
The following general factors play an important role in OOS prevention:
- Stop activity when discomfort is felt
- Maintain correct posture
- Take regular breaks
- Exercise regularly
- Maintain a good level of general fitness
- Maintain a healthy balanced diet
- Manage stress levels
- Don’t smoke
- Avoid prolonged, repetitive movement or activity
- Educate yourself about OOS prevention.
Support and information
NHS choices (2016). Repetitive strain injury (RSI) [Web Page]. London: National Health Service. http://www.nhs.uk/Conditions/Repetitive-strain-injury/Pages/Introduction.aspx [Date accessed: 21/03/17]
O’Toole, M.T. (Ed.) (2013). Repetitive stress injury. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby
Occupational Safety and Health Service (1991). Occupational overuse syndrome: Guidelines for prevention and management [Article PDF]. Wellington: Department of Labour. http://www.worksafe.govt.nz/worksafe/information-guidance/all-guidance-items/occupational-overuse-syndrome-oos-guidelines-for-prevention-and-management/oos-prevention-guide.pdf