Upper Extremity Pain

Abstract

Work-related upper extremity disorders (WRUEDs) are a major problem in modern society, and they represent the primary cause of absenteeism in North America and Western Europe (Health and Safety Executive (HSE), 2002; Punnett & Wegman, 2004). The impact of WRUEDs on workers themselves in terms of pain and disability is important, but these conditions, often chronic, also incur significant loss of quality of life and impact the workers’ families, co-workers, and employers (Huang, Feuerstein, & Sauter, 2002; Punnett & Wegman, 2004). The productivity loss and economic costs of WRUEDs for society are substantial, and the economic burden of WRUEDs is increasing, despite efforts in prevention and implementation of novel intervention strategies for sustainable return to work (RTW) (Fabrizio, 2002; Feuerstein et al., 1993; Katz et al., 2000). At the outset, it should also be noted that WRUED is an “umbrella term” used to describe a wide range of disorders of the muscles, tendons, bursae, nerves, or blood vessels, potentially caused or aggravated by work, that may affect the neck/shoulder region, the shoulder itself, the elbow, the wrist, or the hand (Burton, Kendall, Pearce, Birrell, & Bainbridge, 2009; Zakaria, Robertson, MacDermid, Hartford, & Koval, 2002). These disorders range from those that are relatively well defined and specific (disorders with a well-defined set of diagnostic criteria established from evidence-based approaches) to those that are considered nonspecific (ill-defined disorders for which signs and symptoms may be present without a clear pattern allowing for a specific diagnosis) (Van Eerd et al., 2003). Numerous other terms have also been used to describe WRUED, such as cumulative trauma disorders, repetitive physical overuse, or repetitive strain injuries, but this lack of consensus on the definition of WRUED has led to confusion (Burton et al., 2009; Katz et al., 2000).