All you need to know about work related upper limb disorders

Dubai: According to the definition of the World Health Organization an occupational disease is any disease contracted primarily as a result of an exposure to risk factors arising from work activity while work-related diseases have multiple causes, among which factors in the work environment may play a role, together with other risk factors.

Upper limb disorders are a particular group of musculoskeletal ailments affecting the shoulder, neck, elbow, forearm, wrist, hand and fingers. It includes problems with soft tissue, muscles, tendons and ligaments as well as the blood circulation or nerve supply to the upper limb. If untreated, and continually aggravated, these aches can develop into upper limb disorders. In the past, these disorders have been widely known as repetitive strain injury, but it is now accepted that they can occur without a person having carried out repetitive activities. In fact, while some upper limb disorders have an exact diagnosis, the cause and treatment of some upper limb pains can be more difficult to identify.

There are various factors that lead to upper-limb disorders. Wrong postures, particularly of the arm can often lead to a person getting susceptible to such disorders.  For example, the wrist works best with the hand and arm are particularly in a straight line. If it is twisted, rotated or bent this will increase the strain on the tendons and nerves which pass through the wrist to the hand. Repetitive activities, like working on a factory production line, are well known causes of ULDs because unequal stress is put on different parts of the body. Another factor is the force or tension which is created in nerves and tendons. Directly applying a force, particularly in activities that rotate the arm or wrist (e.g. folding boxes or twisting wires) can also trigger ULD’s. Additionally, it also depends on how long a force is applied or how often the action is carried out.

Dr. Bhuvaneshwar Machani, Consultant Orthopedic Surgeon specialized in Upper Limb treatment at Burjeel Hospital for Advanced Surgery says “With sedentary lifestyles and maximum hours being spent at the workplace, there has been an increase in work-related musculoskeletal disorders of the upper limbs or ULD’s. Physical work factors, psychosocial and environmental factors and individual characteristics affect work-related upper limb disorders. These disorders are not confined to particular jobs or sectors and are found throughout most manufacturing and service industries. Upper limb disorders include aches and pains in any part of the body from the shoulder to the fingers and can include problems with soft tissue, muscles, tendons and ligaments as well as the blood circulation or nerve supply to the upper limb. Pain however is a common symptom of ULDs but the experience of pain in the upper limb is also common amongst the general population. Therefore, feeling pain in the upper limb is not in itself an indication of the presence of an ULD, and such symptoms may be difficult to attribute to work with any certainty.”

Common Types of work related upper limb disorders include enosynovitis in the wrist, hand or shoulder, carpal tunnel syndrome (pressure on the median nerve in the wrist), cubital tunnel syndrome (ulna nerve compression in the elbow) epicondylitis (tennis or golfers elbow), cervicalgia (neck pain) and some non-specific fore arm pain and restless hand.

“I sincerely believe that employers/management should actively be involved in minimizing the risks of upper limb disorders (ULDs) through a positive management approach. They must have an understanding of ULDs and should be committed towards its prevention. Organizations should educate their employees on the common ULD’s, their possible risks and how to combat them. Strong focus should be laid on introducing workplace training around ULDs, assessing the posture of employees as they work; encouraging early reporting of symptoms. Employees who have symptoms that suggest an upper limb disorder should seek medical advice and report any symptoms to their employer as soon as possible as an early intervention and treatment is the best way to avoid long-term problems”, he added.