Overuse syndrome of the upper limb in musicians.

A series of 379 musicians with painful overuse syndrome ("RSI") were examined and studied. The commonly used diagnosis for the condition of "tenosynovitis" or "tendinitis" could not be substantiated as it appeared to be a distinct clinical entity rather than a collection of unrelated disorders. The patients in this series showed muscular and joint capsule overuse. Those with painful hands and wrists showed persisting tenderness in the intrinsic muscles and joint ligaments, notable in the carpometacarpal joints of the thumb and the radial side of the wrist. Tenderness of more proximal muscle groups was also usually present. Pain generally started in a particular area, then spread both proximally and distally. The patients felt depressed. The treatment that evolved from the study was radical rest of the tender structures by the total avoidance of pain-inducing activities. The condition did not appear to be inflammatory in nature. The prevention of overuse lies in the control of use.