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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.
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