Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors.
OBJECTIVE
To review the epidemiologic literature concerning the occurrence of and the risk factors for pain and specific soft-tissue rheumatic conditions that affect the neck and upper limbs.


METHODS
An extensive search of the literature, including a search of Medline and EMBASE, authoritative recent reviews, and relevant textbooks, was performed. Studies that furnished data about the occurrence of or risk factors for regional pain or specific soft-tissue entities were extracted.


RESULTS
Numerous epidemiologic studies among different populations suggest a high prevalence of pain in the neck (10% to 19%), shoulder (18% to 26%), elbow (8% to 12%), and wrist/hand (9% to 17%) at any point in time. Less clear is the proportion of pain caused by specific upper-limb disorders as compared with nonspecific pain; however, as many as 6% of adults may have carpal tunnel syndrome. Significant risk factors for these disorders include age, female gender, obesity, and association with mechanical exposures (eg, posture, force, repetition, vibration) in the workplace. Also implicated are psychologic well-being and psychosocial workplace factors such as high levels of demand, poor control, and poor support.


CONCLUSIONS
Pain and soft-tissue rheumatic disorders of the neck and upper limb are common. It appears that individual, mechanical, and psychosocial factors all contribute to upper-limb disorders, suggesting that future strategies for prevention will need to address each of these factors if they are to be successful.
Walker-Bone
Karen E
KE
Medical Research Council Environmental Epidemiology Unit, University of Southampton, England.
Palmer
Keith T
KT
Reading
Isabel
I
Cooper
Cyrus
C
D006801:Humans; D009333:Neck; D009784:Occupational Diseases / Q000453:epidemiology*; D015995:Prevalence; D012216:Rheumatic Diseases / Q000453:epidemiology*; D012307:Risk Factors; D034941:Upper Extremity