Occupational Health

by Anna Harrington

Musculoskeletal disorders

‘Musculoskeletal disorders’ is an umbrella term used to identify an injury to soft or bony tissue.

The most recent survey of self-reported work-related illness estimated that in 2001/02 some 1.1 million people in Great Britain suffered from musculoskeletal disorders caused or made worse by their current or past work. An estimated 12.3 million working days were lost due to these work-related MSDs. On average, each sufferer took about 20 days off in that 12-month period.

Types of musculoskeletal disorders (MSDs)

Back pain

The majority of us will, at sometime, experience back pain, most commonly of the lower back. It is unlikely that there will be a serious underlying cause to the pain; however, that does not reduce its significance. Back pain causes anxiety and can affect an individual’s ability to carry out normal tasks, including work. Once a serious problem has been ruled out, this reduction in activity can delay recovery.

The back pain may appear to have been caused by a one-off event, such as lifting an object or moving awkwardly, but usually it is the result of long-term exposure to one or more of the risk factors:

  • Lack of exercise
  • Excess weight
  • Poor posture
  • Whole body vibration
  • Repetitive actions
  • Overexertion
  • Stress/anxiety and depression
  • Twisting, stretching and reaching
  • Pushing, pulling and dragging.

Shoulder pain

This is common in one in three of us. Aggravating factors include

  • Poor posture – slouching
  • Lack of movement
  • Poor work station set-up and use.

Neck pain

This is also said to be common in the population. Research has suggested that causes/aggravating factors are

  • Neck flexion
  • Arm force
  • Arm posture
  • Duration of sitting, twisting
  • Workplace design
  • Hand arm vibration
  • Repetition of arm and hand movements
  • Static loading of neck and shoulder muscles.

However the research is variable both in quality and results.

Carpal tunnel syndrome

Affecting approximately five per cent of the population, its symptoms are

  • Numbness
  • Tingling
  • Variable pain, worse at night and in the mornings.

Causative factors are

  • Repetitive work
  • Forceful work
  • Posture
  • Vibration
  • Flexion and extension of the wrist.

As their manager, you should remove the person from aggravating work roles until symptoms have disappeared; conduct a workplace assessment with emphasis on posture; trial different keyboards, and remove or reduce vibration exposure.

Non-specific arm pain (WRULD, RSI)

The individual experiences pain in forearm, possible loss of function, weakness, cramp, slowing of fine motor movement and muscle tenderness. Causative factors:

Repetitive work

  • Forceful work
  • Poor posture
  • Vibration
  • Flexion and extension of the wrist
  • Stress/anxiety.

Workplace management: after a four-week absence, use the flag system; take a Stepped approach and offer multi-disciplinary vocational rehabilitation. Assess the person’s workstation and temporarily modify their duties.

Tenosynovitis

Symptoms include pain in the forearm, tenderness and possible swelling. This can be caused by

  • Excessive flexion and/or extension of the wrist
  • Repetitive and forceful movements.

Temporarily modify their duties to avoid aggravating aspects; assess the workstation with particular reference to posture.

Lower limb disorders

Causes are said to be

  • Kneeling/squatting
  • Climbing stairs or ladders
  • Heavy lifting
  • Walking/standing
  • Slips and trips.

Research is recommended on causes and subsequent management.