RSI at Work: 8 Things Employers Should Know
Repetitive strain injury is one of the few health and safety topics people search for because it is happening to them. Somebody's wrist aches after a long stretch at a keyboard, and they want to know what it is.
This is written for the other side of that: the employer. Because by the time somebody is searching, there is usually a work arrangement that contributed, and there is almost always something the organisation could have done earlier and more cheaply.
Eight things.
1. RSI is an umbrella term, not a diagnosis
Useful to know before the conversation with occupational health.
Repetitive strain injury is a general term covering a range of conditions affecting the muscles, tendons and nerves, mostly in the hands, wrists, arms, shoulders and neck.
The term used in health and safety is work-related upper limb disorder, and HSE's material on upper limb disorders covers it. The broader category is musculoskeletal disorders, which also takes in back problems and lower limb conditions.
Specific named conditions within it include carpal tunnel syndrome and tendonitis of the hand or forearm.
2. Some cases are legally reportable
The point most employers do not know, and it changes how a case should be handled.
Regulation 8 of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 makes certain diagnosed occupational diseases reportable where the work is likely to have caused or made them worse.
The list includes carpal tunnel syndrome, cramp of the hand or forearm, and tendonitis or tenosynovitis of the hand or forearm, where the work involves the relevant activity.
The trigger is receiving a written diagnosis from a doctor, not somebody reporting discomfort. This is the category office-based organisations miss most often, because it arrives through HR or occupational health rather than through the safety process.
3. Office work causes it, despite the reputation
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The conditions are associated with manufacturing and assembly work, and office environments produce them routinely.
The contributing factors in an office are recognisable: sustained keyboard and mouse use, a poorly positioned mouse requiring the arm to be extended, screens at the wrong height producing neck and shoulder load, a laptop used without a riser, long periods without changing posture, and periods of intense work with no break.
Two aggravating factors specific to how people work now. Laptops used as primary machines, where the keyboard and screen cannot both be right. And hybrid working, where the home setup is frequently worse than the office one and is used for half the week.
4. The DSE Regulations are the main legal route
For office work, this is where the duty lives.
Regulation 2 of the Health and Safety (Display Screen Equipment) Regulations 1992 requires a suitable and sufficient analysis of workstations to assess the health and safety risks to users.
Regulation 4 requires work to be planned so that daily screen work is periodically interrupted by breaks or changes of activity.
Those two together are the prevention. The assessment addresses the physical setup; the work planning addresses duration, which is the factor most often ignored.
5. Early signs are cheap to act on and easy to miss
The economics here are unusually clear.
Early symptoms are discomfort, aching and fatigue that settle after rest. At that stage the interventions are trivial: move the mouse, raise the screen, change the chair, adjust the schedule.
Left alone, symptoms can persist, and the interventions become occupational health referrals, adjustments, absence, and sometimes a claim. The condition also becomes harder to resolve.
So the practical objective is to hear about the aching wrist in week one rather than month six, which is a reporting culture question as much as an ergonomic one. People report early discomfort when they believe something will be done and nothing bad will follow.
6. What an employer should actually do
Five things, in order of effectiveness.
Assess workstations properly, including home setups for hybrid staff, and actually provide what the assessment identifies. An assessment recording a needed riser, followed by no riser, is a documented unmet need.
Issue equipment to the person, not the desk, so that hot deskers and hybrid workers have the same setup wherever they are.
Plan the work, not just the furniture. Periods of intensive input without variation are the underlying factor, and no amount of ergonomic equipment fixes an eight-hour stretch without a break.
Make it easy to report discomfort early, and act visibly when somebody does.
Train people on their own setup, because an adjustable chair nobody has adjusted is a fixed chair.
7. Handling an individual case
Where somebody reports symptoms, the response has two halves.
For the person: look at their setup and their work pattern, make the adjustments, and where symptoms persist, involve occupational health. Ask about the work rather than the diagnosis, and let the person describe what is difficult.
For the organisation: ask whether anybody else doing that work is likely to be affected. Upper limb disorders cluster, because the cause is usually the task rather than the individual.
If a written diagnosis of a listed condition follows, the reporting question in point two arises.
8. Record what you did, and when
The evidential half, and it matters here more than in most areas.
These conditions develop over time, and claims can follow long after. The relevant evidence is what you assessed, what you provided, when you were told, and what you did about it.
An organisation that can show it assessed the workstation, provided what was identified, and acted when somebody reported discomfort is in a completely different position from one that can show only a completed questionnaire.
The eight, in short
| Point | Position |
|---|---|
| The term | Umbrella; the precise term is upper limb disorder |
| Reportability | Certain diagnosed conditions are RIDDOR reportable |
| Office work | A common cause, not just industrial |
| Legal route | DSE Regulations: assessment plus work planning |
| Early signs | Cheap to fix early, expensive later |
| What to do | Assess, equip the person, plan the work, enable reporting, train |
| Individual cases | Treat the person and check for clustering |
| Records | What you assessed, provided, were told and did |
Row four is the one organisations act on and row three is the one they forget. Most have done a workstation assessment and never considered the duration of the work.
For international groups
Two considerations.
The assessment duty is widely shared, and the mechanism is not. Screen work obligations derive from a European directive across the European Union, and several jurisdictions covered in this series route them through occupational health rather than employer self-assessment. Estonia triggers mandatory health checks for display screen work and sustained sitting. Lithuania requires checks where the risk assessment indicates. Finland delivers the equivalent through compulsory occupational health care with a workplace survey that can examine ergonomics.
Reportability differs. Which occupational diseases are reportable, and on what trigger, is national. A group process built on the British list will miss categories elsewhere.
Holding assessments, provision and reported symptoms across every entity in one register is where health and safety consultants and software are worth more together than either alone, and periodic health and safety audits find assessments that identified equipment nobody ever bought.
Where Arinite fits
Arinite's DSE assessment work covers both halves: the workstation and the work pattern that uses it. We support 1,500+ businesses across 50+ countries and protect 100,000+ employees, with 95%+ client retention over 15+ years.
Our health and safety consultants work extensively with legal, finance and banking and IT and software organisations, where effectively the whole workforce meets the display screen user definition and multi-screen setups are normal.
Where offices span several countries, our global health and safety consultants establish what each jurisdiction requires of assessment and health surveillance, and our international health and safety consultants keep that current. HSE's musculoskeletal disorders pages cover the wider subject.
If somebody has mentioned wrist or shoulder discomfort in the last month and nobody has looked at their setup, a free gap analysis is the right place to start.
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Written by
Arinite Health & Safety Consultants
Health & Safety Expert at Arinite
