Work Related Musculoskeletal Disorders

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Work Related Musculoskeletal Disorders
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Upper Extremity Disorders

• Carpel tunnel syndrome
• Cubital tunnel syndrome
• Thoracic outlet syndrome
• Raynauds syndrome (white finger)
• Rotator cuff syndrome
• DeQuervains disease
• Tendinitis
• Tenosynovitis
• Trigger finger
• Ganglion cyst

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Neurovascular Disorders

• Carpal Tunnel Syndrome
• Impingement of the median nerve caused by
  irritation and swelling of the tendons in the
  carpal tunnel
  
• Cubital Tunnel Syndrome
• Pressure on the ulnar nerve when the elbows are
  exposed to hard surfaces

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Neurovascular Disorders

• Thoracic Outlet Syndrome
• Compression of the blood vessels between the neck
  and shoulder caused by reaching above shoulder
  level or carrying heavy objects
  
• Raynauds Syndrome
• Also known as Vibration White Finger Blood
  vessels of the hand are damaged (narrowed) from
  repeated exposure to vibration for long periods
  of time

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Tendon Disorders

• Rotator Cuff Syndrome
• DeQuervains Disease
• Combination of tendinitis and tenosynovitis
• Tendinitis
• Irritation of the tendon
• Tenosynovitis
• Irritation of the synovial sheath
• Ganglion Cyst
• Accumulation of fluid within the tendon sheaths

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Tendinitis
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Hand and Wrist
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Common Occupational CTDsof the Upper Extremities

• Carpal Tunnel Syndrome occurs from chronic
  swelling of the flexor tendons in the wrist.
  
• The median nerve, which feeds the first three
  fingers and the thumb, can become impaired from
  pressure in the carpal tunnel in the wrist.
  
• Symptoms include
• pain in the first three fingers and the thumb
• numbness in these areas
• tingling in these areas

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Carpal Tunnel Syndrome
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Carpal Tunnel Syndrome
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Common Occupational CTDsof the Upper Extremities
Raynauds Syndrome is when blood vessels of the
hand are damaged (narrowed) from repeated
exposure to vibration for long periods of time
This is connected with use of vibrating tools, s
uch as hair clippers and jack hammers.
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Raynauds Syndrome

• Symptoms
• Numbness and tingling in the fingers during
  vibration exposure may continue after exposure
  has been discontinued
  
• Blanching (whitening) of one fingertip because of
  a temporary constriction of blood flow
  
• Other fingers also blanch
• Intensity of pain frequency of attacks increase
  in time

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Common Occupational CTDsof the Upper Extremities

• Cubital Tunnel Syndrome is caused by resting the
  elbows on hard surfaces such as unpadded tables
  or armrests.
  
• The ulnar nerve, which feeds the ring and little
  fingers, can become impaired from pressure near
  the elbows.
  
• Symptoms include
• pain in the ring and little fingers
• tingling in these areas
• numbness in these areas

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Cubital Tunnel Syndrome
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Common Occupational CTDsof the Upper Extremities

• Thoracic Outlet Syndrome is caused by frequent
  reaching above shoulder level, by carrying heavy
  objects, or poor posture involving a forward head
  tilt.
• A Neurovascular bundle called the brachial
  plexus, which passes between the collar bone and
  the top rib, can become impaired from pressure
  associated with movements that causes these two
  bones to be positioned close together.
• Symptoms include
• the arms falling asleep
• weakened pulse
• numbness in the fingers

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Thoracic Outlet Syndrome
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Common Occupational CTDsof the Upper Extremities

• Rotator cuff syndrome is a disorder involving
  swelling and pain of tendons comprising the
  rotator cuff muscle group
  
• subscapularis, supraspinatus, infraspinatus,
  teres minor
  
• Symptoms include
• Pain when you bend the arm and rotate it
  outwards against resistance 
  
• Pain on the outside of the shoulder possibly
  radiating down into the arm 
  
• Pain in the shoulder, which is worse at night 
• Stiffness in the shoulder joint.

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Rotator Cuff Syndrome
Anterior View
Posterior View
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Common Occupational CTDsof the Upper Extremities

• Tendinitis is a common CTD for the wrist, elbow,
  and shoulder. It occurs when we continually
  stress the tendon cables, causing them to become
  irritable and sore.
• Lateral Epicondylitis - Tennis elbow
• Medial Epicondylitis - Golfers elbow
• Symptoms include
• point tenderness
• swelling
• tennis elbow, pain radiates down to back of
  hand
  
• golfers elbow, pain radiates down to back of
  hand
  

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Tendinitis
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Common Occupational CTDsof the Upper Extremities
Tenosynovitis is swelling of the sheath that
covers the tendon from constant rubbing against
the tendon. Symptoms include swelling p
ain loss of motion loss of strength
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Tenosynovitis
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Common Occupational CTDsof the Upper Extremities

• Trigger Finger is a tendon disorder that occurs
  when there is a groove in the flexing tendon of
  the finger
  
• If the tendon becomes locked in the sheath,
  attempts to move the finger cause snapping or
  jerking movements
  
• Usually associated with using tools that have
  handles with hard or sharp edges.
  

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Trigger Finger
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Common Occupational CTDsof the Upper Extremities

• Ganglion Cyst is a bump under the skin caused by
  an accumulation of fluid within the tendon
  sheath. It is commonly found at the hand and
  wrist.

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Ganglion Cyst
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Common Occupational CTDsof the Upper Extremities

• De Quervains Disease is an inflammation of the
  tendon sheath of the thumb attributed to
  excessive friction between two thumb tendons and
  their common sheath.
• Its a combination of Tendonitis and
  Tenosynovitis.
  
• May be caused by twisting and forceful gripping
• Symptoms include
• swelling
• pain at the base of the thumb.

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De Quervains Disease
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De Quervains Disease
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Prospective Study of Computer Users

• Fredric Gerr, et. al., 2002, A Prospective
  Study of Computer Users 1. Study Design and
  Incidence of Musculoskeletal Symptoms and
  Disorders.
• 632 individuals
• Newly hired into jobs requiring ? 15 hr/week of
  computer use
  
• Were followed for up to 3 years

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Primary Results

• Hand/Arm (H/A) Neck/Shoulder (N/S) MSS and MSD
  were common among computer users
  
• More than 50 of users reported MSS during the
  1st year after starting a new job
  
• Most common H/A disorder was DeQuervains
  tendonitis
  
• Most common N/S disorder was somatic pain
  syndrome
  

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Common Occupational Injuriesof the Back
Strains and sprains are damage to the tendons an
d ligaments caused by one time exertions such as
lifting or carrying heavy objects.
These can lead to very noticeable back pain, but
the pain usually begins to subside within a few
days
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Common Occupational CTDsof the Back

• Facet joint pain results from irritation of the
  area where the ribs meet the spinal column.
  
• Typically, there is muscle swelling in the
  affected area and it can become very painful to
  sit or stand up straight. In some cases it may
  also be difficult to breath deeply.

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Common Occupational CTDsof the Back

• Disk erosion occurs from prolonged pressure on
  the spinal disks, which causes them to become
  permanently compressed.
  
• The space between the vertebrae becomes smaller,
  which can lead to impingement of the nerve roots
  leading out from the spine.
  
• Sitting puts more pressure on the spinal disks
  than standing, and sitting with the back
  unsupported can lead to high levels of disk
  pressure.

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Disc Erosion
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Common Occupational CTDsof the Back

• Sciatic nerve impingement, also called sciatica,
  is common for people who sit for prolonged
  periods of time.
  
• The sciatic nerve runs from your lower back down
  the back of your leg and into to your feet.
  
• Swelling in certain muscles in the buttocks can
  put pressure on the sciatic nerve, causing pain
  down the leg.
  

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Common Occupational CTDsof the Back

• Herniated discs occur when the inner portion of
  the disc protrudes, putting pressure on the nerve
  roots leading from the spine.
  
• Pain or numbness in the legs is a common symptom
  of herniated discs in the lower back.
  

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Herniated/Bulging Disc
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