Work Related

Musculoskeletal Disorders
Upper Extremity
Disorders
 Carpel tunnel syndrome
 Cubital tunnel syndrome
 Thoracic outlet syndrome
 Raynaud’s syndrome (white
finger)
 Rotator cuff syndrome
 DeQuervain’s disease
 Tendinitis
 Tenosynovitis
 Trigger finger
 Ganglion cyst
 Neurovascular Disorders

 Carpal Tunnel Syndrome

 Impingement of the median nerve caused by
irritation and swelling of the tendons in the carpal
tunnel

 Cubital Tunnel Syndrome

 Pressure on the ulnar nerve when the elbows are
exposed to hard surfaces
 Neurovascular Disorders

 Thoracic Outlet Syndrome

 Compression of the blood vessels between the neck
and shoulder caused by reaching above shoulder
level or carrying heavy objects

 Raynaud’s Syndrome
 Also known as Vibration White Finger ; Blood
vessels of the hand are damaged (narrowed) from
repeated exposure to vibration for long periods of
time
 Tendon Disorders

 Rotator Cuff Syndrome

 DeQuervain’s Disease
 Combination of tendinitis and tenosynovitis
 Tendinitis
 Irritation of the tendon
 Tenosynovitis
 Irritation of the synovial sheath
 Ganglion Cyst
 Accumulation of fluid within the tendon sheaths
Tendinitis
Hand and Wrist
 Common Occupational CTDs
of the Upper Extremities

Carpal Tunnel Syndrome occurs from chronic

swelling of the flexor tendons in the wrist.

The median nerve, which feeds the first three fingers

and the thumb, can become impaired from pressure in
the carpal tunnel in the wrist.

Symptoms include:
· pain in the first three fingers and the thumb

· numbness in these areas

· tingling in these areas

Carpal Tunnel Syndrome

CARPAL
LIGAMENT

BONES TENDONS MEDIAN

NERVE
Carpal Tunnel Syndrome
 Common Occupational CTDs
of the Upper Extremities

Raynaud’s Syndrome is when blood vessels of the

hand are damaged (narrowed) from repeated exposure
to vibration for long periods of time

This is connected with use of vibrating tools, such as

hair clippers and jack hammers.
 Raynaud’s Syndrome

Symptoms
 Numbness and tingling in the fingers during vibration exposure;
may continue after exposure has been discontinued
 Blanching (whitening) of one fingertip because of a temporary
constriction of blood flow
 Other fingers also blanch
 Intensity of pain & frequency of attacks increase in time
Common Occupational CTDs
of the Upper Extremities
Cubital Tunnel Syndrome is caused by resting
the elbows on hard surfaces such as unpadded
tables or armrests.

The ulnar nerve, which feeds the ring and little

fingers, can become impaired from pressure near the
elbows.

Symptoms include:
· pain in the ring and little fingers

· tingling in these areas

· numbness in these areas

Cubital Tunnel Syndrome
 Common Occupational CTDs
of the Upper Extremities
Thoracic Outlet Syndrome is caused by frequent reaching
above shoulder level, by carrying heavy objects, or poor posture
involving a forward head tilt.

A Neurovascular bundle called the brachial plexus, which passes

between the collar bone and the top rib, can become impaired from
pressure associated with movements that causes these two bones to
be positioned close together.

Symptoms include:
· the arms “falling asleep”
· weakened pulse
· numbness in the fingers
Thoracic Outlet Syndrome
 Common Occupational CTDs
of the Upper Extremities

Rotator cuff syndrome is a disorder involving swelling and pain

of tendons comprising the rotator cuff muscle group:
subscapularis, supraspinatus, infraspinatus, & teres minor

Symptoms include:
• Pain when you bend the arm and rotate it outwards against resistance 
• Pain on the outside of the shoulder possibly radiating down into the arm 
• Pain in the shoulder, which is worse at night 
• Stiffness in the shoulder joint.
Rotator Cuff Syndrome

Anterior View Posterior View

Common Occupational CTDs
of the Upper Extremities

Tendinitis is a common CTD for the wrist, elbow, and

shoulder. It occurs when we continually stress the
tendon cables, causing them to become irritable and
sore.

Lateral Epicondylitis - “Tennis elbow”

Medial Epicondylitis - “Golfer’s elbow”
Symptoms include:
· point tenderness
· swelling
· tennis elbow, pain radiates down to back of hand
· golfer’s elbow, pain radiates down to back of hand
Tendinitis
Common Occupational CTDs
of the Upper Extremities

Tenosynovitis is swelling of the sheath

that covers the tendon from constant
rubbing against the tendon.

Symptoms include:
swelling
pain
loss of motion
loss of strength
Tenosynovitis
 Common Occupational CTDs
of the Upper Extremities

Trigger Finger is a tendon

disorder that occurs when there is
a groove in the flexing tendon of
the finger

If the tendon becomes locked in

the sheath, attempts to move the
finger cause snapping or jerking
movements

Usually associated with using

tools that have handles with hard
or sharp edges.
Trigger Finger
Common Occupational CTDs
of the Upper Extremities

Ganglion Cyst is a bump under the skin

caused by an accumulation of fluid within the
tendon sheath. It is commonly found at the
hand and wrist.
Ganglion Cyst
Common Occupational CTDs
of the Upper Extremities
De Quervain’s Disease is an inflammation of the
tendon sheath of the thumb attributed to excessive friction
between two thumb tendons and their common sheath.

It’s a combination of Tendonitis and Tenosynovitis.

May be caused by twisting and forceful gripping

Symptoms include:
• swelling
• pain at the base of the thumb.
De Quervain’s Disease
De Quervain’s Disease
 Prospective Study of
Computer Users
Fredric Gerr, et. al., 2002, “A Prospective
Study of Computer Users: 1. Study Design
and Incidence of Musculoskeletal Symptoms
and Disorders”.

 632 individuals
 Newly hired into jobs requiring  15
hr/week of computer use
 Were followed for up to 3 years
 Primary Results
 Hand/Arm (H/A) & Neck/Shoulder (N/S) MSS and
MSD were common among computer users

 More than 50% of users reported MSS during the 1st

year after starting a new job

 Most common H/A disorder was DeQuervain’s

tendonitis

 Most common N/S disorder was somatic pain

syndrome
Common Occupational Injuries
of the Back

Strains and sprains are damage to the tendons and

ligaments caused by one time exertions such as lifting or
carrying heavy objects.

These can lead to very noticeable back pain, but the pain
usually begins to subside within a few days
Common Occupational CTDs
of the Back

Facet joint pain results from irritation of the area

where the ribs meet the spinal column.

Typically, there is muscle swelling in the affected area

and it can become very painful to sit or stand up
straight. In some cases it may also be difficult to breath
deeply.
 Common Occupational CTDs
of the Back

Disk erosion occurs from prolonged pressure on the

spinal disks, which causes them to become permanently
compressed.

The space between the vertebrae becomes smaller, which

can lead to impingement of the nerve roots leading out
from the spine.

Sitting puts more pressure on the spinal disks than

standing, and sitting with the back unsupported can lead
to high levels of disk pressure.
Disc Erosion
 Common Occupational CTDs
of the Back

Sciatic nerve impingement, also called sciatica, is

common for people who sit for prolonged periods of time.

The sciatic nerve runs from your lower back down the
back of your leg and into to your feet.

Swelling in certain muscles in the buttocks can put

pressure on the sciatic nerve, causing pain down the leg.
Common Occupational CTDs
of the Back

Herniated discs occur when the inner portion of the

disc protrudes, putting pressure on the nerve roots
leading from the spine.

Pain or numbness in the legs is a common symptom

of herniated discs in the lower back.
Herniated/Bulging Disc
QUESTIONS?