Housewives and professionals are the people
most affected by repetitive stress injuries
Sore muscles, cramps and body
aches are what some housewives
have to live with, after years of
doing various chores to keep their
homespick and span.
However, the persistent pain can
also be a symptom of repetitive
stress injury (RSI), a chronic condition
that affects the tendons and
joints of the body.
A 2013 study done by the Singapore
General Hospital (SGH) found
that about 75 per cent of 1,108
patients diagnosed with upper limb
repetitive stress injury were
women and, of these, nearly half
were between 51 and 60 years old.
Housewives (21.1 per cent)
formed the second most common
demographic, behind professionals
(30.6 per cent).
As the name suggests, repetitive
stress injuries are the result of
repeated stress sustained by tendons
from a particular activity.
Chronic inflammation develops
as patients continue with the
activity and do not give the injury
time to heal.
RSI typically affects the hand,
wrist, elbow, shoulders and neck
“Patients first notice a deep ache
in these joints, which might abate
or reduce if given time to rest,” said
Professor Denny Lie, a senior
consultant at the Singapore
General Hospital's (SGH's)
department of orthopaedics.
“This deep ache can worsen to
outright sharp pain over time, as
the trauma sustained by the tendon
accumulates. Persisting in the same
repetitive work could lead to
ruptures of the tendon.”
The SGH study did not collect
data on the most common type of
repetitive stress injury among
housewives, but common culprits
include tasks such as hand-washing
clothes and hanging clothes with
an awkward wrist posture.
“For example, carrying a pole of
wet clothes or heavy bags of
groceries exerts a tremendous
force across the shoulders,” said
“As it is done repeatedly every
day, it is not surprising many housewives
suffer from shoulder pain.”
Other types of RSI include trigger
finger, in which patients feel finger
aches and pain from activities such
as continuous typing on a keyboard,
and DeQuervain’s tenosynovitis,
which is pain in the wrist
when turning door knobs or carrying
Trigger finger is the most common
repetitive stress injury seen at
SGH, said Ms Yang Zixian, a principal
occupational therapist at SGH.
In Singapore, 5 to 10 per cent of
the population have repetitive
stress injuries. The condition is
sometimes described as a modern
malaise, a consequence of modern
jobs and lifestyles that involve
hours of sitting at desks or in front
According to the US Department
of Labour, Occupational Safety and
Health Administration in 2014, RSI
is the most common and costly
occupational health problem in the
United States, costing more than
US$20 billion (S$27 billion) a year
in worker compensation.
The reason for its prevalence
among housewives is, however,
Another SGH study done in 2010
among women with upper limb RSI
found that housewives were reluctant
to make adjustments in their
daily routine due to longstanding
perceptions about housework.
Older women, especially, were
less willing to make changes to
their routines. Those who took part
in the study had a mean age of 58.5
Ms Yang said: “These women
have a strong emotional attachment
to the way they do their
housework and require it to be of a
“This can become a barrier to
making any changes as more ergonomic
practices may not meet the
quality or efficiency these housewives
For example, some housewives
may opt to wash clothes by hand
instead of using a washing machine.
This can lead to RSI in the
hands and wrists.
Ways of doing housework and the
readiness to accept change also
vary among housewives.
Said Ms Yang: “Our therapists
have therefore had to adapt their
ways of communicating with
patients and educating them to
facilitate behavioural change.”
Occupational therapy and physiotherapy
are the main ways to treat
In more severe cases, steroid
injections to the affected tendon
may be needed to reduce inflammation.
Platelet-rich plasma injections
which promote the healing of
injured musculoskeletal tissue are
also an option.
However, Prof Lie stressed that
early recognition and treatment are
key for repetitive stress injuries.
“If your joint is in pain, stop the
activity or household chore immediately.
This will prevent continuous
strain on the tendons,” he said.
“Self-medication with ointments
can be useful but if the pain persists,
patients should seek medical
help sooner, rather than later.”
Simple measures can also help
prevent repetitive stress injuries.
Adjusting the height of the ironing
board can help reduce neck strain
and back pain.
Standing on a stool when doing
overhead work can reduce the
strain onthe arms as well.
Said Prof Lie: “Maintaining a
reasonable level of fitness and
doing regular stretches during rest
breaks can help reduce the severity
of repetitive stress injuries. This
applies across all fields of work.”