Advice for workers suffering from repetitive strain injury (RSI)

Introduction

RSIs are a set of painful conditions caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward position. They include the specific conditions of edema, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, De Quervain syndrome, thoracic outlet syndrome, intersection syndrome, golfer's elbow, tennis elbow, trigger finger, radial tunnel syndrome, and others.

In this blog post is my advice to employees who find themselves suffering from RSI at work, based on my knowledge and personal experience of developing RSI and my experience in supporting and representing many union members with the condition. I live in the UK, so this is based on the UK legal framework, however many aspects will be applicable elsewhere, particularly in countries where there are laws prohibiting disability discrimination.

Most RSI conditions nowadays are caused by use of a computer keyboard and mouse, so I will focus on these here, however the same general principles apply whatever the cause (i.e. use of a pneumatic drill or piece of factory machinery etc).

Some of my advice will be slightly different depending on whether people count legally as "employees" or "workers". Basically, employees will normally be directly employed workers on permanent or fixed term contracts. Workers will usually be those engaged on a casual basis or by an employment agency, and have fewer rights. In some cases workers can challenge their legal status and argue they should be treated as employees. People who are unsure should seek advice (you can Google more information or speak to a union representative if available).

Don't delay

The first and main thing I would say is if you think you may be suffering from RSI, do not wait around. In many cases, with early intervention RSI can be completely cured and not recur.

However, if you leave it you can end up seriously and permanently disabled. Some sufferers are left unable to perform everyday tasks like eating without pain. I have learned this the hard way, as despite advocating very strongly on behalf of others, unfortunately with myself I did not want to "cause trouble" or "rock the boat" with my manager. So I continued to work while my pain increased, and now my condition is permanent and irreversible. And of course I had to bring it up with my manager eventually as I was no longer physically able to keep working.

Some people may also fear victimisation if they asked to support. However, at least in large employers victimisation is unlikely and even if it is a possibility if you let yourself get permanently disabled you will be in a much worse situation, where you risk being victimised not just in your current employment but you risk not being able to even get another job.

So if you do believe you may be experiencing RSI symptoms seek immediate medical advice from your doctor. If you experience pain, numbness or pins and needles which worsens throughout the working day as you perform repetitive tasks like using a computer, but these get better in the evenings and at weekends when you don't, then you may well be experiencing RSI.

If you start experiencing pain, note it in the workplace accident book (or other accident reporting system) and go to your doctor right away and demand a referral to a specialist, as many GPs have little or no understanding of RSI. Your GP may also be rude, dismissive, unhelpful or even try to suggest that you are making it up (as mine did) so prepare yourself for this and be ready to challenge them.

In addition, let your manager know that you have been experiencing pain and are going to the doctor. If you don't let your employer know about the problem then they are under no obligation to support you with it.

When communicating with management, make sure you keep a record of everything. If you cannot prove you have kept your employer informed, they can claim they were not aware and so could not have done anything to support you.

If possible, conduct all correspondence over e-mail or in writing. If this is not possible, make notes of any conversations which take place including times and dates, and where possible follow-up verbal conversations with an e-mail saying something like: "Just to confirm our conversation just now where I informed you that… and we agreed that… etc".

If there is a recognised union at your workplace, it could well be worth joining. Then your union representative can engage in correspondence on your behalf. They can then phrase any requests for support in terms of them implementing union policy rather than you being a difficult employee. They may also know what adjustments have been made to support colleagues elsewhere.

When diagnosed

If you get a medical diagnosis that you do have RSI, act as quickly as possible. The best way to treat RSI is to immediately cease the activity which is causing it. In many cases ceasing the repetitive task and resting for some weeks can cause the RSI to cease permanently. However in some cases you may need to avoid the repetitive task for good.

Inform your manager or your HR department that you have the condition and that you have a disability (even if you are uncomfortable with considering yourself disabled, as this is a legal term with concomitant legal protections).

Don't just get yourself signed off sick at this point. As this can mean your employer can stop your pay, or can begin down a punitive route towards dismissal on the basis of sickness or incapability.

Instead, go to your GP and ask for a fit note stating that you are able to work but without performing the repetitive task (e.g. using a computer keyboard or mouse). (It is also worth pointing out that at this stage you should also cease the activity which causes pain outside of work as well. So stop personal computer use/texting/playing Candy Crush etc. You can download voice-activated software like Dragon NaturallySpeaking from torrent sites and install it on your home computer if you want to continue doing this.)

Contact Access to Work, part of the Department for Work and Pensions (DWP), which provides funding for employers to make adjustments for disabled employees. Ask them for an assessment as quickly as possible.

Inform your employer of the fit note either personally or through your union rep. And ask for a referral to occupational health if available (if your employer does not have their own occupational health service they should have an outside contractor to whom they can make referrals).

At this point your manager may just ask you to sign yourself off sick. You should not agree to this for the reasons outlined.

Instead you should ask either to be moved to alternate duties, to be provided with supportive equipment (like voice-activated software so you won't have to use a keyboard or mouse) or if neither of these options are immediately applicable, employees can request to be placed on medical suspension.

Medical suspension is an option open to many employers for workers who are not signed off sick by a GP, but the employer does not believe can be allowed to work safely for the time being. For example if reasonable adjustments cannot yet be made as there are no alternative duties and supportive equipment cannot be provided immediately. Medical suspension should be on full pay, and not counted as sick leave. Check your employer' s sickness absence policies for more details. Even if the policy does not make mention of medical suspension, it can still be requested as you can make the argument that any reduction in pay due to a disability which the employer has not made reasonable adjustments for is discriminatory and a breach of the Equality Act.

Workers for whom medical suspension would not apply may need to take some sick leave if there are no alternative duties available and other adjustments cannot be made immediately.

With the much weaker legal protections, workers are in a much more difficult situation than employees as apart from anything else they have no protection from unfair dismissal. However I would still advise trying to stand as firm as possible, because even if you are dismissed, or not given any more hours, this is better than becoming permanently physically impaired and being unable to get any job.

Both employees and workers should inform your employer that you have requested an Access to Work assessment, which will recommend adjustments to help you stay in work and will mean that the DWP will pay 80% of the cost of most adjustments (and 100% for some), so your employer should not have to worry about the cost.

In the case of employees your manager may try to pressure you into performing the repetitive task. It may be difficult but you need to stand firm and refuse (or get your union rep to do so on your behalf. They can say that the union legal advice is that you should refuse, so it looks like you personally are not being problematic, you are just doing what the union tells you). Try talking to colleagues to get their support, and explain that it could happen to any of them. And explain to your manager that you are not trying to be difficult, you are trying to remain in work and if you continue the repetitive task you will end up going off sick.

Reasonable adjustments

If/when you see your Access to Work and/or occupational health assessors, make sure you have preprepared an idea of the adjustment/s which you would find helpful.

For example, if you have RSI caused by use of computer keyboard and/or mouse you should request voice-activated software (like Dragon NaturallySpeaking) and the necessary training and hardware upgrades (like additional RAM) to be able to use it effectively. If you get pain taking notes, you could request a voice recorder. If your pain is caused by using a pneumatic drill you could ask for altered duties, or for a transfer to a different job.

Best of luck to anyone who does unfortunately suffer from any of these symptoms, and please feel free to ask any additional questions or point out any omissions in the comments below. And if you have any experiences suffering from RSI at work please share them in the comments below.