CHRONIC ( WORK RELATED ) UPPER LIMB PAIN SYNDROME
This name is preferred to repetitive strain injury (RSI) .The predominant symptoms are pain in all or part of one or both arms.A specific lesions,such as tennis elbow or carpal tunnel syndrome ,or muscular -pattern neck pain often develop first ,and early recognition and treatment may prevent chronicity.After a variable period ,the pain becomes more diffuse and no longer simply work related ,and there is often severe distress.It is seen in keyboard workers and others who perform the same task without breaks for prolonged periods, and in musicians.When it arises at work ,it is often at a time of changing work practices ,shortage of staff or disharmony .Middle managers find it difficult to deal with and this compounds the stress.
It is seen throughout the developed world .It peaked in incidence in Australia in the 1970s and 1980s but has largely disappeared there ,apparently because of changes in work practices ,improvements in early medical management ,changes in workers compensation legislation ,and reduced media discussion of the problem.
Work related upper limb disorder (WRULD) is a general term that covers a variety of of musculoskeletal disorders which affect the shoulder, elbow, forearm, wrist or hand. This is not a specific condition, but a group of diseases. Previously the terms repetitive strain or stress injury (RSI) were frequently used.
There are also some specific conditions affecting the upper limbs which may be work-related if it can be shown they are due to occupational overuse. These conditions usually occur in working adults.
Some conditions are well defined with accepted diagnostic criteria, well defined risk factors and well established medical treatment.Some Other conditions, in which there is non-specific forearm or upper limb pain, are less well defined.
A large number of individuals with upper limb pain and dysfunction do not exhibit signs which are easily identifiable or in a good condition with a definitive diagnosis. these people may experience pain that is not localized to one region and the pain can go from one area to another and be of a very indefinite in nature. The Examination can often identify very little in the way of objective abnormality. The diagnosis is made after other specific conditions have been excluded.Forearm pain is Non-specific has been defined for purposes of research as ‘pain in the forearm in the absence of a specific diagnosis or pathology . It is one of the common complain of work related upper limb pain syndrome but estimates of its distribution vary widely. Other features which may be present include loss of function, weakness, cramp, muscle tenderness, burning and non-specific paraesthesia, and often a feeling of swelling.
Individuals who regularly use the computer is in danger, but professional sports is also aware of the risk of upper limb. Who spends time writing reports record is also aware of the risk of chronic( work related )upper limb pain syndrome . Even the usually pleasant to work in libraries can lead to shoulder pain. Small business owners, who may often have a tendency to do different activities, including lifting, moving and packing material can also they are at risk . Those who spend hours on the telephone all day can suffer, that's why call centers are now using headphones and microphones so there is no risk to human health cradling phone between shoulder and head for long periods. So there are many professions where Work Related Upper Limb pain syndrome are a risk. In fact, there are very few jobs and professions where there is very little risk or no risk of upper limb work related pain syndrome.
TREATMENT
If possible there should be a brief off work and a gradual return to activity once the pain has setteled .Cautious use of analgesia and NSAIDs ,with physiotherapy is helpful during the initial phase to prevent a vicious circle developing .
A review of working practices and the positioning of screen ,keyboard and chair essential ,as is support of the patient by their manager .Musicians are helped by expert advice on playing technique and should reduce playing times temporarily ,but not stop completely.
