What are the medications for Repetitive Strain Injury (RSI)?

From the Guidelines

For repetitive strain injury (RSI), I recommend a combination of over-the-counter pain relievers and anti-inflammatory medications, such as oral NSAIDs or acetaminophen, to reduce or relieve symptoms, including pain, and to improve physical function, as suggested by the American College of Physicians and American Academy of Family Physicians 1.

Key Recommendations

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours or naproxen sodium (Aleve) at 220-440mg every 12 hours can help reduce inflammation and pain.
• Acetaminophen (Tylenol) at 500-1000mg every 6 hours is an alternative if you cannot take NSAIDs.
• These medications should be used for short periods (7-10 days) while implementing rest, proper ergonomics, and stretching exercises.

Additional Considerations

• For topical relief, consider diclofenac gel (Voltaren) applied to the affected area 3-4 times daily or menthol-based creams like Biofreeze, as they have been shown to reduce pain at less than 2 hours compared with placebo 1.
• Nonpharmacologic treatments, such as massage therapy, specific acupressure, joint manipulation therapy, and transcutaneous electrical nerve stimulation (TENS), may also be beneficial in reducing pain at less than 2 hours 1.
• If symptoms persist beyond 2 weeks despite these measures, consult a healthcare provider as prescription medications like muscle relaxants or corticosteroid injections might be necessary.

Rationale

The American College of Physicians and American Academy of Family Physicians suggest that clinicians treat patients with acute pain from non–low back, musculoskeletal injuries with oral NSAIDs or acetaminophen to reduce or relieve symptoms, including pain, and to improve physical function 1. Additionally, the evidence suggests that topical NSAIDs and nonpharmacologic treatments may also be effective in reducing pain at less than 2 hours 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Medications for Repetitive Strain Injury (RSI)

• Medications used to treat RSI include:
  • NSAIDs (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation 2
  • Topical pain-relief agents to alleviate discomfort 2
  • Local anesthetic-corticosteroid mixture injections for temporary pain relief 2
• These medications can help manage symptoms, but it's essential to address the underlying causes of RSI, such as improper posture, inadequate ergonomic factors, and contributory habits 2, 3, 4

Treatment Approaches

• Treatment for RSI often involves a combination of:
  • Elimination of aggravating factors 2
  • Simple joint-protection measures 2
  • Self-help strategies, such as exercise and education, to restore flexibility and strength 2, 5, 4
  • Physiotherapy and bracing for conservative management 6
• Surgery may be reserved for cases that do not respond to conservative treatment, particularly for nerve-related disorders 4, 6

Prevention and Management

• Prevention of RSI involves adopting measures to promote recovery, such as:
  • Improving workplace conditions and ergonomic factors 3, 4
  • Educating workers about the causes of RSI and proper equipment use 4
  • Encouraging regular breaks and exercise to reduce repetitive strain 5
• Primary care physicians play a crucial role in establishing a diagnosis and treating RSI, with referral to specialists for cases refractory to conservative management 6