Occupational overuse syndrome is a type of overuse injury, caused by repetitive movement, constant muscle contraction or straining, forceful movements, or awkward postures in a work environment.
Symptoms include persistent discomfort or pain in muscles, joints, tendons, nerves, and/or soft tissues. Treatment includes rest, pain medication, and physiotherapy. Making changes to workplace design and practices can reduce the risk of occupational overuse injury.
Jobs that can lead to occupational overuse syndrome include office work (eg: keyboard use), manual work (eg: lifting and carrying heavy items), and process work (eg: working on an assembly line or a supermarket checkout).
Overuse injuries can also result from recreational activities that involve repetitive and/or high-intensity movements, such as practicing a musical instrument or training for a particular sport or other type of physical activity.Various other terms are commonly used to describe overuse injuries, including repetitive strain injury (RSI), gradual process injury (GPI), or cumulative trauma disorder (CTD).
Symptoms of workplace overuse injuries tend to develop gradually and worsen over time if left untreated. Overuse injury can affect the tendons, nerves, and/or muscles of the fingers, hands, wrists, elbows, shoulders, back and neck. Early symptoms of overuse injury include:
- Muscle discomfort or weakness
- Aches and pains
- Hot or cold feelings
- Muscles tightness and spasms
- Numbness or tingling.
- Restricted range of movement.
There may be associated symptoms of tiredness, headaches, anxiety, and loss of concentration. As the condition progresses the pain and discomfort may become constant, there may be a loss of muscle strength, burning sensations in the tissues, and sleep disturbances.
Occupational overuse syndrome, and other overuse injuries (such as tennis elbow and golfer's elbow), are caused by a repetitive task or activity causing soft tissue injury without sufficient recovery time. In other words, the rate of injury exceeds the rate of healing in the tissue.
The greater and/or the more sustained the forces involved in a repetitive activity, the greater the chance of developing an overuse injury.
Specific factors or conditions that can lead to overuse injuries developing include:
- Awkward or constricted postures
- Repetitive movement
- Prolonged muscle tension
- Forceful holding or movement
- Vibration, especially over long periods.
- Poor design or arrangement of equipment and furniture (ergonomics)
- Poor work practices eg: poor time management, poor work techniques, lack of training
- Psychosocial factors eg: excessive workload, tight deadlines, an uninspiring social and work environment.
Starting a new physical activity or intensifying a current training routine can increase the risk of an overuse injury. This is usually due to training errors (eg: too much activity too quickly) and/or technique errors (eg: poor form when doing strength training exercise or swinging a tennis racket).
Diagnosis and Treatment
Diagnosis of overuse injury will normally involve discussion of your medical history, symptoms, and a physical examination. The diagnosis of most overuse injuries does not usually require use of x-rays or MRI, but these tests may be used to rule out other causes for the symptoms (eg: osteoarthritis).
Once a diagnosis of overuse injury has been made, and the specific 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 of overuse injury 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.
Cold or hot packs and an elastic support or a splint may also help to relieve discomfort.
Injections of corticosteroids and local anaesthetics to reduce inflammation and pain in the affected area are commonly used in the treatment of overuse injuries, although repeated corticosteroid injections are not recommended.
Surgery is only used if other treatments have not helped and if the type of overuse injury is likely to respond to the surgery. Carpal tunnel syndrome and loose tendons or ligaments commonly lead to surgery.
A number of steps can be taken to prevent overuse injury in the workplace:
- Design equipment, workspaces, and tasks with people in mind eg: ergonomic workstations
- Organise reasonable workloads/deadlines, and schedule frequent rest breaks
- Pay attention to work environment eg: good lighting
- Train and educate all staff
- Use safe work methods.
The following approaches play an important role in the prevention of overuse injuries in general:
- Stop activity when you feel discomfort
- Maintain correct posture
- Use proper equipment
- Gradually increase activity levels
- Cross-train to avoid overloading a particular muscle group
- 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 overuse injury prevention.
If occupational overuse syndrome, or any other type of overuse injury, is suspected, is it important to seek early treatment to prevent the condition progressing.
Support and information
The Government's workplace health and safety agency, Worksafe provides general information and research on work-related health and safety, including overuse injuries.
WorkSafe New Zealand
Freephone: 0800 030 040
For specific advice or support, verified workplace health and safety advisors can be sourced through the Health and Safety Association of New Zealand (HASANZ):
Better Health Channel (2020). Workplace safety – overuse injuries (Web Page). Melbourne: VIC: Department of Health & Human Services, State Government of Victoria. https://www.betterhealth.vic.gov.au/health/healthyliving/workplace-safety-overuse-injuries [Accessed: 22/01/20]
Larker, S.R. (2018). Overuse injury (Web Page). Medscape Drugs and Diseases. New York, NY: WebMD LLC. https://emedicine.medscape.com/article/313121-overview#a6 [Accessed: 22/01/20]
Mayo Clinic (2018). Overuse injury: How to prevent training injuries (Web Page). Rochester, MN: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/overuse-injury/art-20045875 [Accessed: 22/01/20
NHS (2018). Repetitive strain injury (RSI) [Web Page]. London: National Health Service. https://www.nhs.uk/conditions/repetitive-strain-injury-rsi/ [Date accessed: 22/01/20]
Worksafe (2017). Lifting and carrying – what’s the problem? (Web Page). Wellington: WorkSafe – New Zealand Government. https://worksafe.govt.nz/topic-and-industry/manual-handling/lifting-and-carrying/ [Accessed: 22/01/20]
Worksafe (2017). Preventing manual handling injuries on farms ¬– guidelines (Web Page). Wellington: WorkSafe – New Zealand Government. https://worksafe.govt.nz/topic-and-industry/manual-handling/preventing-manual-handling-injuries-on-farms-guidelines/ [Accessed: 23/01/20]
Last Reviewed – January 2020