Repetitive Motion Injuries

Steven R. Kirkhorn and Guilia Earle-Richardson

Key words: repetitive stress disorders, cumulative trauma disorders, carpal tunnel syndrome, tendonitis

The terminology of repetitive motion injuries has changed over the last several years. The term now used by the United States Department of Labor and the National Institute of Occupational Safety and Health (NIOSH) to describe adverse health effects of repetitive motion to the musculoskeletal system is musculoskeletal disorders (MSDs). When these injuries or disorders are considered to be work related, they are identified as work-related musculoskeletal disorders (WMSDs). Other common names used interchangeably over the years have included repetitive stress injuries (RSIs), repetitive stress disorders, cumulative trauma disorders (CTDs), and overuse syndrome. Mus-culoskeletal disorders refer to conditions that involve nerves, tendons, muscles, and supporting structures of the body. They do not include injuries resulting from slips, trips, falls, motor vehicle crashes, or similar causes (1,2).

A definition of WMSDs by the State of Washington Bureau of Labor and Industry that captures the full spectrum is as follows:

Non-traumatic disorders of the soft tissues of the musculoskeletal system that can be caused or aggravated by work activities such as repetitive forceful motions, awkward postures, use of vibrating tolls or equipment, or by manual handling of heavy awkward loads. Examples include carpal tunnel syndrome, tendonitis, epicondylitis, hand-arm vibration syndrome, rotator cuff syndrome, cubital tunnel syndrome, and sciatica. Work-related disorders are primarily, but not exclusively, associated with the upper extremity and back (2).

Musculoskeletal disorders may affect soft tissue (muscle, tendon, ligament, bursa, cartilage, nerve, blood vessel, disk) or bone. Generally the symptoms do not arise from one acute episode of significant trauma but are the result of continual exposure to repetitive force and microtrauma that exceeds the ability of the body to recover and adequately repair structural damage. The terms RSI, MSD, and CTD are not a specific diagnosis but include both clinical entities and symptoms of pain.

The identification and prevention of repetitive motion injuries is a priority area in agricultural medicine. Upper-extremity MSDs are a priority area of the National Occupational Research Agenda for Musculoskeletal Disorders. Additionally, the U.S. Department of Health and Human Services Healthy People 2010 project has set a goal (Goal 20-3) to reduce the rate of injury and illness cases involving days away from work due to overexertion or repetitive motion (3-5).

For the purposes of consistency, MSDs will be used to refer to repetitive motion injuries arising from occupational exposures. The focus of this chapter is on diagnosis and treatment of common MSDs affecting the upper and lower extremities, based on available evidence-based medicine, determination of work-relatedness, ergonomic issues in agriculture leading to MSDs, and prevention through engineering and work practices that are applicable to agriculture. Although the neck and back are the body parts most commonly affected by repetitive motion injuries and are mentioned in this chapter, a detailed discussion of spinal injuries and conditions were addressed in Chapter 17.

0 0

Post a comment