Fiona Evard Physiotherapist Moving and Handling Coordinator Harrogate and District NHS Foundation Trust

The Physiology of Upper Limb Disorder and Back Pain

People are at their best when They do a wide range of variable motions and tasks. BUT They are limited, wear out, and lose accuracy quickly. Have a fixed physical design. Are highly affected by the environment

Physical Stress Excessive loads and repetitive motions can cause problems

The Formula REPETITION X FORCE X POSTURE

pain and discomfort

Muscle weakness

Numbness and tingling sensations

Limited range of motion

Common Work Related Musculoskeletal Disorders Carpal Tunnel Syndrome Epicondylitis and Bicipital Tendonitis Rotator Cuff Tendonitis Shoulder Capsulitis Impingement Syndrome Tenosynovitis Cervical Spondylosis Tension Neck

The Painful Shoulder Sternoclavicular joint Acromioclavicular joint Subacromial space Glenohumeral joint Scapulothoracic joint Rotator cuff muscles: supraspinatus, infraspinatus, teres minor, subscapularis.

Causes of pain Impingement pain between 60 and 120 degrees of abduction. Normal x rays Rotator cuff tears, the result of chronic impingement. A scan will show the extent of the tear. Possible arthroscopic repair. Frozen shoulder chronic inflammation with loss of range of movement. Recovery prolonged. Physio and medication Calcific tendonitis. calcium salts deposited in tendons. Pain aggravated by movement. Injection or decompression

Hands and Wrists Tendonitis: Tendons connect the powerful forearm muscles to your fingers. When using the hand the tendons slide back and forth through a sleeve within the Carpal Tunnel Repetition creates friction and pain

Carpal Tunnel Syndrome The tunnel is small and creates a ‘bottleneck’ Excessive wrist movement creates a ‘kink’ in tunnel Pain and inflammation result. A major nerve running through the tunnel becomes compressed. Numbness, pain, pins and needles etc.

Epicondilitis or tennis elbow

Neck Pain Wear and Tear Static Postures Inability to adjust heights No Breaks equals Muscle Spasm, Fatigue, Pressure on intervertebral discs and pain

Adverse Neural Tension The position of the head creates pressure on the nerve root. This can cause headache The nerve ‘tethers’ at the elbow. Its smooth movement is impinged. This results in a constant aching.

Summary Poor work stations lead to: Musculoskeletal Disorders which are: INFLAMMATION Prevention is better than the cure Risk Assessment and ACTION