RSI: Integrating the major theories

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Abstract
The dimensions of the RSI problem (incidence, cost, and affected groups) are described. Psychiatric, medical, and psychological explanations of causation are examined. The psychiatric explanation that RSI is a conversion disorder is not supported in the literature. There is research support for the medical/ergonomic explanation that pain and fatigue result from poor operating posture and, to a lesser extent, from excessive force and repeated movement. However, the existence of a distinct clinical entity apart from accepted disorders (tenosynovitis and the like) is not supported. The association of RSI with psychological factors has received research support and, although a causal relationship cannot yet be assumed, a psychological explanation cannot be discounted. A “best” theory is proposed on the basis of Littlejohn and Miller's 1986 classification of RSI into: (a) well‐known clinical entities (Type I); (b) chronic pain syndromes without identifiable degeneration or inflammation (Type II); and (c) chronic pain syndromes in which pain becomes the dominant symptom of a Type I disorder (Type III).

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