[The most common overuse injury syndromes of the upper extremity associated with work activity].
Repetitive use of upper extremities, non-physiological body posture, especially of cervical spine, shoulders, lower arms, and fists are still present in modern technological processes. Innate deformities, weakness of connective tissue, accompanying morbidity (radicular symptoms, neuropathies, superior thoracic aperture syndrome, vasopathies and neuroses) are significant pathogenic overuse syndromes. Other causes of overuse syndromes are non-ergonomic tools, musical instruments, furniture, or keyboards. Lack of training for jobs involving repetitive movements, as well as job dissatisfaction are additional aggravating factors of the overuse syndrome. Polypragmasy with drug and physical therapy, insufficient rehabilitation, and questionable medical prognosis of working capacity are challenges to public health of even in richer societies. This paper describes the most common overuse syndromes of upper extremities. The aetiology of reflex dystrophy syndrome, carpal tunnel, and myofascial painful syndrome are still insufficiently explained. The paper also presents data collected in a group of 40 metal workers exposed to significant shoulder strain. They more often reported pain in the cervical spine than the control group of workers under moderate strain (45% v. 7.5%; P < 0.01), as well as pain in the shoulders (12.5% v. 5.0%) and stiffened hand (22.5%:7.5%). Symptoms were significantly more frequent in the dominant hand. A common diagnosis in a sample of 110 musicians was a change in the shoulder joint, which was more distinct in the right shoulder (10%) than in the left (7%) and comparable in the elbows (8%). The paper proceeds with cases of advanced overuse syndrome in a textile worker and cases of dissimulation in a physician and a guitarist. The paper stresses the importance of quantification of morphological and functional changes in overuse syndromes and discusses the necessity of prevention, education, early diagnosis, pharmacological and physical therapy, and rehabilitation of overuse syndromes.
Krapac
L
L
Odjel za fizikalnu medicinu i rehabilitaciju, KB Dubrava, Zagreb. lkrapac@kbd.hr
D000328:Adult; D001134:Arm Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012090:Cumulative Trauma Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000628:therapy; D010146:Pain / Q000209:etiology; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000070599:Shoulder Injuries