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Work Related Upper Limb Disorders (WRULD)

What is WRULD?

Upper limb pain – ie. pain in the shoulder, arm, elbow, forearm, wrist and/or hand is common in the workplace. It can also involve the neck and/or mid-spine.

Why does it occur?

WRULD can be caused by a variety of activities:

  •  heavy repetitive manual work or heavy work in awkward postures
  • repetitive tasks such as keyboard/mouse use, and assembly line work
  • poor, sustained postures such as sitting hunched over a desk; having the computer screen or keyboard to one side; tucking the phone between ear and shoulder in order to free the hands for further tasks; standing on an assembly line twisting in order to accomplish the task.

What are the symptoms?

 There is a wide range of symptoms which can occur individually or in any combination.

  • Pain – may be a dull ache or a sharp, electric pain anywhere in the arm/hand
  • Stiffness – of one or more joints, causing loss of movement and function
  •  Numbness and/or tingling in the arm/hand
  •  Cramp – most commonly in the hand
  • Swelling – most commonly in the hand, although a sensation of swelling or a tight band can occur in the upper arm or forearm as well.

These symptoms are usually aggravated by the above tasks initially, but become more frequent and consistent as the condition continues.

Common causes

  • Tendinitis – inflammation of a tendon – usually an overuse or fatigue injury affecting, most                        commonly, the tendons of the elbow, wrist or fingers. This is the condition that gave rise to the term RSI – Repetitive Strain Injury. Unfortunately, this term has now become more widely used to    incorporate all WRULDs, which is not strictly correct.
  • Neck or mid-spine dysfunction – this is commonly a result of poor, sustained postures. It can lead to abnormal muscle tension in the head, neck, shoulders and back, which in turn can cause joint stiffness and tension on the nerves and blood vessels in the arm. Hence the wide range of symptoms.

How to prevent WRULD

  • Last month’s topic was on posture and back care. This had some useful tips on how to sit correctly at a computer.
  • Reduce repetition – try and vary tasks regularly in order to change postures and actions
  • Reduce speed of action
  • Mouse work – try and use either hand and swap regularly. Position the mouse within easy reach to avoid unnecessary stretching. Keep your forearm supported on the desk while using the mouse, and do not press or grip it too firmly.
  • Posture – ensure that you are facing your task, be it an assembly line or computer. You should be working at your height without having to stoop or reach up.
  • Lifting – see last month’s advice on correct lifting techniques. Use levers, hoists and colleagues where available.
  • Headsets – if you are desk and phone-based, wear a headset to avoid the ear to shoulder scenario in order to free the hands up for another task!
  • Working environment – good lighting and temperature will prevent adopting awkward postures such as leaning forward to see better, or hunching over to stay warm! Try and avoid reflections and glare on screens – put a blind on the window, or move the screen slightly if necessary.
  • Vibrations – constant vibrations affect the spine and joints. Using machinery that vibrates should be done in short bursts – vary it with other tasks.

If symptoms develop, early treatment is important to prevent them worsening and spreading to other parts of the arm, which is common when left. Physiotherapy  for symptom relief and advice on prevention of recurrences is the most popular method of treatment.

For further advice or to book an appointment, please contact Radlett Physiotherapy on 01923 857338

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