Written by Annie Duong
The increase in technological advances in the workforce and our everyday lives over the past century have had numerous economic benefits, expediting the growth of agricultural, technological, and secretarial work. However, many of those who work in factories or in office settings face an important health concern that can hinder their work: repetitive strain injury. Due to the same continuous hand, shoulder, and back movements workers perform in their jobs, nerves and tendons within the upper body become especially prone to damage [1].
The term “repetitive strain injury” encompasses a wide variety of disorders that come from not only repetitive movements, but also unnatural postures and continuous force. Some common disorders include those affecting tendons, muscle, peripheral-nerves, joint-capsules, and neurovascular or vascular systems. The hands and wrist are prone to disorders such as De Quervain’s tenosynovitis, which may be caused by overuse of the thumb and awkward wrist strain, and carpal tunnel syndrome, where the wrist is strained due to prolonged force and mechanical stress. The shoulders and neck are particularly prone to cervical syndrome and thoracic outlet syndrome, the risks of which are increased by repeated overhead reaches at or above the shoulder level. Unfortunately, those who work in factory farms and other agricultural industries must place severe pressure on their bodies when processing carcasses and lifting heavy loads, which can lead to additional lower body strain in the hips and knees [2]. The list of syndromes and disorders goes on with different occupations and lifestyles, but they share a common theme. In order to prevent workplace injury and improve safety, the physiological aspects of the upper body joints and ways to prevent common injuries must be understood and applied.
The hand is linked to the arm by the wrist, which is composed of a mechanical system consisted of eight carpal bones situated into two rows. Between the carpal bones and the wrist are synovial joints help facilitate movement. The wrist and hand are stabilized and kept in a neutral position by the muscles in the wrist and the palms. Tendons, flexible cords made of polyfibers attach the muscles to the carpal bones and other bones in the hand. These tendons are stabilized by a series of ligaments arranged in a tunnel and a coating called tenosynovium in order to connect them on the bones. The sensations of pain and soreness from overuse and overstretching the ligaments are indicated by the three major hand nerves that run through the arm to the wrist [3]. Damage to muscular tissue, ligaments, tendons, or bones from excessive force or repeated movement all require an integrative approach at therapy and rehabilitation through a variety of different treatments in order to alleviate symptoms.
A review of several clinical trials have determined that there is no one form of treatment that best treats patients suffering from repetitive strain injuries. Those suffering from non-specific work related injuries can undergo exercise, physical, occupational and manual therapy, including osteopathy and chiropractic treatment, can be used to improve everyday activities or relieve pain and symptoms. The lack of low sample size studies of clinical studies can not empirically support the use of multi-disciplinary treatment, it is highly recommended [2]. Patients may also choose corticosteroid injections, but it only provides short term relief, and is a not a solution to the disorder.
Preventing these injuries requires reformation in the workplace and constant awareness of our surroundings. It is obvious that tighter regulations in the workplace where heavy manpower is prominent should be implemented. However, office workers, students, and even avid phone users should take steps toward preventative treatment to keep these injuries from developing in the first place. Regular breaks and persistent stretching can help reduce the risk of these syndromes and also help contribute to a generally healthier lifestyle.
References:
1. Yassi, Annalee. Repetitive strain injuries. 1997. The Lancet. 349: 943-947
2. Van Tulder, Maurits. Malmivaara, Antti. Koes, Bart. 2007. Repetitive Strain Injury. The Lancet. 369(9575): 1815 – 1822.
3. Schmidler, Cindy. “Anatomy of the Hand and Wrist.” HealthPages.org | Anatomy, Surgery, Pregnancy, Nutrition, Fitness. HealthPages.org, 20 Nov. 2016. Web. 25 Feb. 2017.