A work injury is not always caused by a sudden or immediate accident. In many cases, the work-related injury occurs over time. These cases are generally called “cumulative trauma disorder”, “occupational overuse syndrome”, or “repetitive strain injuries.”
The most “well-known” repetitive motion injury manifests itself as carpal tunnel syndrome (CTS). This condition occurs when the median nerve is compressed at the wrist level. This compression causes pain, numbness, and muscle weakness in the hands. There is a global debate as to whether CTS is actually caused by repetitive motion stress. According to some doctors, the current medical research does not support a causal relationship between repetitive work activities and the manifestation of CTS.
However, according to the Occupational Safety and Health Administration (OSHA), it has adopted regulations regarding the occupational risk factors of repetitive force, posture, and tasks. CTS has been noted in factory workers, construction workers, and office/clerical workers. Common symptoms include waking up at night with tingling or numbness and general weakness in the hands. Most treatment plans include corticosteroid injections, medication, and surgery.
Gunyon Syndrome is also a common diagnosis of workers complaining of hand and wrist pain. The injured workers report pain, numbness, and tingling in their ring finger and “pinky finger.” The injured employee will have weakness and pain along the wrist as well. Gunyon Syndrome is noted to be caused by an entrapment of the ulnar nerve on the inside portion of the wrist.
Another common repetitive work injury may be epicondylitis. With this diagnosis, the tendons around the elbow become inflamed causing significant pain and loss of use. Medial epicondylitis is also known as “golfer elbow”, while lateral epicondylitis is regarded as “tennis elbow.” With “golfer elbow”, the employee has overused the flexor muscles. If the worker is suffering with “tennis elbow”, this employee has injured his extensor muscles. Unlike CTS, there is little debate that both of these conditions are caused by repetitive use of the wrist extensors or continuous “power” gripping.
Employees who have jobs where repetitive overhead reaching is required may develop rotator cuff syndrome. This condition affects the employee’s shoulders. The rotator cuff consists of a collection of tendons that support the shoulders. The tearing of these tendons causes a great amount of pain, weakness, and loss of range of motion. In fact, it is often difficult, if not impossible, to lift the arm over a 90 degree angle. Steroid injections, physical therapy, and surgery are common methods to treat the repetitive shoulder condition.
These repetitive motion injuries are serious and should not be taken lightly. An upper extremity orthopedic specialist should be consulted. Generally diagnostic films, studies, and scans will be used to assist in the diagnosis. With carpal tunnel syndrome, an electromyography (EMG) will be used to determine any nerve latency. With the rotator cuff syndrome, a Magnetic Resonance Imaging (MRI) scan will be used. In addition to these diagnostic tools, the doctor may perform clinical evaluations such as Tinels testing to detect evidence of irritated nerves.
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