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Human Analysis Summer 2014 > Work-Related Musculoskeletal Disorders > Flashcards

Work-Related Musculoskeletal Disorders Flashcards

1
Q

where are Musculoskeletal disorders the predominant occupational health problem ?

A

industrialized countries

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2
Q

what are WRMD’s?

A

Painful disorder of muscles, tendons, nerves due to overuse, repetitive injury NOT traumatic

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3
Q

what do WRMD result in?

A

loss of productivity

on both the working and non-working lives

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4
Q

what are the body regions usually involved?

A

hands, wrists, elbows, shoulders & neck

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5
Q

what are the 2nd most injured body regions?

A

back, lower extremities

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6
Q

what are other names for WRMD?

A

Cumulative Trauma Disorders (CTD) (north america)
Repetitive Strain/Stress Injuries (RSI)
Occupational Cerviobrachial Disorder (OCD)
Overuse Syndrome
Repetitive Motion Disorders
Regional MS Disorders
Soft tissue disorders

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7
Q

are WRMD a diagnosis?

A

no just a general category

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8
Q

what % of WMSD represent registered occupational disease?

A

1/3 or more

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9
Q

what % of WMSD are UE symptoms?

A

20-30%

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10
Q

what do WMSD cause more of than any other group of diseases?

A

work absenteeism or disability

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11
Q

what are general high risk sectors?

A 
Nursing facilities
Air transportation
Mining
Food processing
Leather tanning
Heavy/light manufacturing
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12
Q

what are high risk UE sectors?

A 
Clerical work
Postal service
Cleaning
Industrial inspection
Packaging
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13
Q

what are high risk LE sectors?

A 
Truck drivers
Warehouse workers
Baggage handlers
Construction
Health care workers
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14
Q

what is the most common category of injury?

A

overexertion (25%)

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15
Q

how much do indirect costs affect cost?

A

Indirect costs are estimated to be from 2-5 times the direct costs

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16
Q

what are WMSD risk factors?

A 
Repetition
High force
Awkward postures
Direct pressure
Vibration
Prolonged static positioning
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17
Q

what does repetition cause?

A

tissue micro trauma & fatigue

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18
Q

what is fatigue proportional to?

A

the amount of force & duration of force application

i.e. hazardous movements hand & wrist

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19
Q

what does intr-muscular pressure cause?

A

decreased blood flow -> muscle energy crises & pain

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20
Q

what are the results of sufficient vs insufficient recovery?

A

sufficient recovery is permitted after trauma, results may be stronger tissue. If recovery in insufficient, muscle injury may occur

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21
Q

what are txs for repetition and force?

A

Rest
Splinting
Anti-inflammatory meds

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22
Q

what can awkward postures lead to?

A

muscle imbalance

pressure around, stretch of nerves

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23
Q

what are issues of muscle imbalance?

A

weakness, pain
overuse, underused
muscle lengthening, shortening

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24
Q

how do you tx awkward postures?

A

Ergonomic modification
breaks,
alternative postures,
fitness

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25
Q

what are psychological risk factors?

A

Job repetition, dissatisfaction
Anxiety
Depression
Pain

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26
Q

how do you tx psychological causes for WMSD?

A

Goal directed & educational gives people control and relief

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27
Q

What are characteristics of WMSD?

A 
Mechanical & physiological
Related to work intensity & duration
Develops/recovers over weeks, months, years
unreported
multifactorial
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28
Q

what are symptoms of WMSD like?

A

poorly localized, non-specific, episodic

29
Q

what are the 4 categories of WMSD?

A

nerve compression (entrapment) syndrome
tendinitis/tenosynovitis
pain syndromes
other

30
Q

what is nerve compression (entrapment) syndrome?

A

incompatibility between volume of PN structure & anatomical space available to nerve

31
Q

what is tendinitis/tenosynovitis?

A

inflammation of tendon & synovial membrane of tendon sheath

32
Q

what are nerve compression syndromes?

A 
Cervical radiculopathy
Thoracic Outlet Syndrome (TOS)
Cubital Tunnel Syndrome
Anterior Interosseous Syndrome
Pronator Teres Syndrome
Carpal Tunnel Syndrome
Guyon’s Canal Syndrome
33
Q

where does tendonitis of the shoulder occur?

A 
Rotator cuff muscles
Biceps Brachii (long head)
34
Q

how does tendonitis of the elbow occur?

A

Lateral (extensor) Epicondylitis

Medial (flexor) Epicondylitis

35
Q

how does tendonitis of the wrist occur?

A

deQuervain’s (APL, EPB)

FCU, FCR, EIP

36
Q

what are examples of pain syndromes?

A

Complex Regional Pain Syndrome
Myofascial Pain syndrome
Fibrositis
Fibromyalgia

37
Q

what are examples of other syndromes?

A

Vibration white fingers
Osteoarthritis
vascular syndromes

38
Q

what does nerve compression cause?

A

Inflammation/thickening of tendon = compression of nerve & vascular supply

39
Q

what is more involved in nerve compression?

A

sensory>motor

40
Q

what is an indication of nerve compression?

A

hormone changes

41
Q

what are symptoms of nerve compression?

A

vague but include pain, tingling, numbness, weakness

42
Q

what is compressed in carpal tunnel syndrome?

A

median nerve

43
Q

what are early symptoms of WMSD?

A

aching & tiredness of limb during work but disappears at night/days off. No reduction of work

44
Q

what are intermediate symptoms of WMSD?

A

aching and tiredness occurs early in work day, persists at night, reduced capacity for repetitive work

45
Q

what are late symptoms of WMSD?

A

all symptoms persist at rest, inability to sleep perform even light duties

46
Q

what occurs during the tendonitis cycle?

A

overuse = micro trauma = swelling, pain, less motion followed by rest, disuse, and weakness

47
Q

what is the presentation of tendonitis?

A

localized pain, swelling, pain on resisted motion, movement limitation, weakness, and crepitation of tendon

48
Q

what are the symptoms of tendonitis?

A

pain and limited ROM reproduced with work

49
Q

what does myofascial pain cause?

A

Muscle overuse causes hyperirritability with a focal point = “trigger point”

50
Q

how does muscle overuse present itself?

A

local inflammatory response, muscular hardness, local ischemia & connective tissue irritation

51
Q

how do overused muscles palpate?

A

muscles feel “ropey”

52
Q

what are symptoms of muscle overuse?

A

generalized, diffuse pain & weakness, traditional treatment for tendinitis has failed

53
Q

what are indicators of grade 1 cumulative trauma disorders (CTD)?

A

pain after activity, resolves with rest
no decrease in amount or speed of work
no objective findings

54
Q

what are indicators of grade 2 CTDs?

A

pain while working, resolves with rest
productivity mildly affected
may have objective findings

55
Q

what are indicators of grade 3 CTDs?

A

pain in 1 or more sites while working
pain after activity stops
productivity affected, many breaks needed
affect activity outside of work
weakness, loss of dexterity, tingling, numbness
active or latent trigger points

56
Q

what are indicators of grade 4 CTDs?

A

all common uses of hand & UE cause pain 50% - 75% of time
can work/works in limited capacity
objective findings: weakness, loss of control & dexterity, tingling, numbness, trigger points

57
Q

what are indicators of grade 5 CTDs?

A

loss of ability to use hand/UE due to chronic unrelenting pain
usually unable to work
symptoms may persist indefinitely

58
Q

how do you tx CTDs?

A

OT must take active role in investigating relationship between injury (pathology) and activity

59
Q

what do OT’s do in tx for CTDs?

A 
Restriction of movement
Application of heat/cold/modalities
Exercise
Medication
Surgery
60
Q

what occurs during phase 1 of tx?

A

Symptom Control: reduce symptoms while teaching self-management

Strengthening: only when symptoms begin to subside

61
Q

what are some modalities used in tx?

A

Hot packs, Neuromuscular Electrical Stimulation (NMES), Ultra Sound, Splinting

62
Q

what occurs during phase 2 of tx?

A

Conditioning: when acceptable strength has returned but endurance is needed, all symptoms resolved
Ergonomic Assessment: in acute phase
Return to work (job analysis)

63
Q

what is the vocational model of tx?

A

person as client
OT works with rehab professionals to find employment for injured worker
as job options are developed, OT reviews for physical appropriateness, suggests supports and adjustments

64
Q

what occurs in case management model of tx?

A

OT works as consultant to insurance co

65
Q

what does OT do as a case manager?

A

follows injured worker through medical & rehab process

coordinates services, stays in communication with worker

facilitates worker through WC system so time isnt wasted and person returns to work

66
Q

what occurs in the industrial model of tx?

A

ergonomic training of employees and supervisors, on site evaluations, prevention of injury

screening of new employees to comply with ADA

67
Q

how can job design prevent WMSD?

A

Mechanization
Rotation
Enlargement/enrichment
Teamwork

68
Q

how can WMSD be prevented?

A

job design
Workplace Design
Tools & Equipment Design
Work practices

Human Analysis Summer 2014 (6 decks)

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