Chronic Pain and Numbness
Cumulative trauma disorders are conditions of upper extremity nerves, tendons and muscles caused by repetitive activity, often combined with unnatural postures. These conditions are usually the result of work-related activity, but can also be attributed to athletics or leisure pursuits.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is the standard bearer of nerve-related repetitive stress conditions.
Pain and numbness associated with CTS is directly attributable to repetitive wrist flexion-extension or consistently abnormal wrist postures. The disorder is seen in computer operators, assembly line workers and various other occupations. Careful consideration of conditions that can mimic CTS is critical to providing appropriate care.
Activity and work station modification are essential in attempting to avoid surgery or preventing recurrence after surgery. Endoscopic carpal tunnel surgery in selected patients has dramatically decreased postoperative recovery time.
Ulnar Neuritis
Numbness and tingling of the ring and little fingers can result from activity requiring chronic pressure on the inner elbow or repetitive flexion or extension of the elbow. Hand grip and dexterity can be significantly affected in longstanding cases.
Early diagnosis and activity modification can avert long-term disability.
Tendonitis of the Wrist, Elbow and Shoulder
"Trigger Finger" is the most common tendon impairment in the hand. It presents with the thumbs or fingers partially catching in a bent position or with restricted motion of fingers. It is often misdiagnosed as arthritis. This is unfortunate because unlike arthritis, it is completely curable.
DeQuervain's Tendonitis is representative of repetitive stress-induced tendonitis at the wrist. Precipitated by activities that require repetitive wrist position changes, it is seen in mothers and check-out clerks. Wrist and thumb discomfort of deQuervain's Tendonitis should be differentiated from the pain of arthritis at the base of the thumb.
Tool modifications to angled-handled tools have significantly decreased the incidence of this condition in the workplace.
Tennis elbow, or lateral epicondylitis, is the most common cause of elbow discomfort and is often seen in carpenters, painters and homemakers as well as tennis players. Surgery is rarely required and may be performed arthroscopically.
In addition to rest and medication, successful treatment frequently involves behavioral modification in both work and leisure activities.
Rotator cuff tendonitis epitomizes the impact of repetitive or forceful overuse of the shoulder. The condition typically affects people pursuing repetitive overhead activities, such as plasterers and throwing athletes. Prompt treatment is necessary to avoid disabling stiffness of the shoulder.
Arthroscopic surgery has revolutionized the surgical treatment of rotator cuff tendonitis when non-surgical treatment proves unsuccessful.