On-the-job

What are the risk factors for these musculoskeletal disorders?
Upper-extremity problems are associated with engaging in repetitive movements or exerting high degree of force. Other physical risk factors include awkward postures sustained for prolonged periods,vibrations like those from using power tools,and inadequate strength. Women are more prone to developing symptoms than men.
Additional contributors may include psychosocial factors like high job demands,high job stress,inadequate breaks during work,low job security and little social support from colleagues.

What other medical conditions might explain my symptoms?
Your physician should determine if you have other illnesses that could be causing the injury,and treat them. For instance,diabetes,hypothyroidism and rheumatoid arthritis increase the risk of carpal tunnel syndrome and tendinitis. Carpal tunnel syndrome also can develop during pregnancy.

What is the plan for my treatment?
The doctor will try to figure out the potential causes of the injury from your work or nonwork environments,and suggest changes to mitigate them.
Standard care for controlling tendinitis and carpal tunnel syndrome includes resting the injured area,applying ice and taking painkillers for short-term pain relief,and physical therapy. The physical therapy can help ease pain; strategies typically include hot and cold treatments,electrical stimulation and ultrasound treatments. The therapist may recommend stretching and strengthening exercises and give important advice on ways to avoid making the pain worse,by limiting certain postures or activities for a time.
For wrist tendinitis and carpal tunnel syndrome,the doctor may recommend wearing a wrist splint at night to keep the joint in a neutral,non-aggravating position. If those strategies arent sufficient,other options,depending on the specific injury,may include corticosteroid injections or surgery.

How long will it take to recover from this injury?
Discussing this question will help establish realistic expectations for progress. The answer will depend on the location and severity of the injury,and on the measures you take on the job or outside work to avoid or modify the activities that aggravate the pain. Most cases of nagging tendon injuries or carpal tunnel syndrome do get better,especially if patients seek medical care early and stop or minimise the injury-inducing activities. But recovery can take months to a year.

What is the likelihood that my pain will recur?
At work,the patient should return to job activities that are safe,which could mean restricted work hours or a change in duties. For a subset of patients,severe repetitive strain problems can become a long-term challenge,leading to chronic pain and disability.

What results can I expect from surgery for carpal tunnel syndrome?
Carpal tunnel release surgery is highly effective at relieving pressure on the compressed median nerve. The operation involves cutting the overlying ligament that forms the top of the tunnel through which the nerve and tendons run. Most patients are able to return to work,although they may not be as effective and productive as they were before injury. Risks and complications from surgery include nerve damage in rare cases. Scar tenderness and some loss of hand strength can also occur.

Is surgery a good option for tendinitis?
It depends on the type of tendinitis. Clinicians recommend trying other conservative treatment measures first,for as long as 6-12 months,before considering surgery. The goal of surgery is to remove diseased tissue from the tendon or creating more space around it so it can slide properly through its sheath. For tendinitis from trigger finger,or De Quervains disease,surgery might be considered sooner,possibly after you have tried a corticosteroid injection without success.

What adjustments can I make to my computer workstation to reduce or prevent pain problems?
our employer or doctor should be able to refer you to an ergonomics consultant who can look at your computer setup and suggest changes that will put you in a safer posture. Be aware that despite a widespread view that ergonomic interventions can prevent repetitive strain injuries,results from studies have been mixed. It is unlikely that there is any one correct recommendation for posture or equipment. Computer users should try to vary their working posture throughout the day.

What else can I do to improve my recovery?
Walking,running and other regular aerobic exercise helps to improve spinal posture and puts the arms and shoulders through a healthy range of motion.

Do any alternative medicine therapies relieve repetitive strain injuries?
Some patients try acupuncture,massage therapy or chiropractic care for carpal tunnel syndrome,tennis elbow and shoulder or neck pain,but it is unclear whether these interventions are effective. There is generally a dearth of reliable,well-designed investigations of alternative therapies. Research has failed to find benefits from vitamin B6 supplements for carpal tunnel syndrome.
Ingfei Chen,NYT