Law Report: RSI is not a medical condition: Rafiq Mughal v Reuters Ltd - Queen's Bench Division (Judge Prosser QC, sitting as a High Court judge), 28 October 1993.

The term 'repetitive strain injury' (RSI), as used to describe a condition involving pain and swelling in the hands, arms and shoulders suffered by someone working long hours at a computer keyboard and screen, had no medical meaning in that it had no pathology, no clinical symptoms that could be pointed to as confirming a patient as having RSI.

Judge Prosser QC dismissed a claim by the plaintiff, Rafiq Mughal, for damages for personal injury and consequential loss, against his former employer, Reuters Ltd.

John Foy (Stephens Innocent) for the plaintiff; Andrew Collender QC and Christian DuCann (Davies Arnold Cooper) for Reuters.

JUDGE PROSSER QC, said the plaintiff, a 44-year-old journalist working as a sub-editor on Reuters' equities desk, alleged he had suffered pain in his fingers, hands, arms and shoulders due to the length of time he had to sit at his desk and the position he was obliged to sit in as he worked at his visual display units (VDUs). He claimed he had suffered permanent disability as a result of Reuters' failure to provide him with adequate advice and equipment to enable him to carry out his work in safety.

Three doctors gave evidence, one for the plaintiff and two for the defendant. Their evidence dealt specifically with the plaintiff's complaints as well as current learning on the question of upper-limb disorders brought about by the use of VDUs. While all recognised the existence of known pathological symptoms such as tenosynovitis and peritendonitis crepitans, caused by repetitive use and overworking, there were deeply divided opinions about the condition known as RSI.

The plaintiff alleged he was given no advice about working posture or keeping his wrists in the neutral position, his arms parallel to the keyboard, and his eyes at a proper angle to the screen, or of the need for breaks in keyboard work.

The equities desk was a busy one. The plaintiff had two screens and two keyboards. His wrists were away from the keyboard and raised at an angle. His typing speed was 60-80 wpm and his key rate 30-40 wpm. He took breaks but not at regular intervals. Within a month of moving to the equities desk in 1988, it was said, he experienced tingling and numbness in his fingers and hands, then in his forearms. These symptoms worsened. He was referred by his general practitioner to a number of different specialists, including Dr Pierson (who was called to give evidence), and was given drugs and physiotherapy.

His GP (who was not called to give evidence) had referred to RSI in his notes but his Lordship did not know which symptoms he was speaking of. The GP gave the plaintiff National Insurance certificates on the basis that he had RSI tenosynovitis. Tenosynovitis was a well-known inflammatory condition in the tendon sheaths of the wrist. When that condition was at the musculo-tendinous junction of the forearm muscles, it was more properly known as peritendonitis crepitans. Both conditions had clear clinical signs and symptoms; each had a definite pathology and a cause, namely trauma or the use of the wrist or forearm during reptitive operations, unaccustomed work, alterations in work tempo or persistent strain.

It was clear there was a wide spectrum of debate and division about RSI. His Lordship believed the mainstream view was that there was no pathology, no clinical symptoms that could be pointed to as confirming a patient having RSI. His Lordship agreed with the two consultants, Mr Campbell Semple and Mr Murray Mathewson, called by the defendants, that the term RSI was meaningless, and that its use by doctors could only confuse.

In any case, the plaintiff had failed to convince his Lordship that he had suffered any injury as had been alleged. Even if the plaintiff were suffering from something, 'condition X', the evidence did not show any failure or breach on his employers' part such as to establish causation. It was clear from the evidence that Reuters were careful and prudent employers. The plaintiff's action failed.