Skip to main content
SpringerLink
Log in

Les cervicobrachialgies occupationnelles chroniques (CBOC): éléments sémiologiques et mécanismes nociceptifs

  • Published:
Douleur et Analgésie

Résumé

Les cervico-brachialgies chroniques représentent une entité nosologique fort complexe. Fréquemment rapportées en association avec certaines contraintes mécaniques (bras, rachis cervical et ceinture scapulaire en particulier), elles se développent, plus communément, au cours d’activités professionnelles caractéristiques ce qui justifie le terme supplémentaire d’ «occupationnelles» (CBOC). Cette entité place le clinicien devant un difficile problème médical pour lequel il n’existe à l’heure actuelle aucune approche étiopathogénique et thérapeutique satisfaisante. Cependant, en faisant appel à des données neurophysiologiques complexes, dont les perturbations paraissent, jouer un rôle essentiel dans la genèse et la chronicité des symptômes, différents mécanismes nociceptifs peuvent être mis en évidence.

D’autre part il est nécessaire, impérativement, de prendre en compte la dimension psycho-affective ainsi que l’impact médicosocial qu’entourent les douleurs chroniques et, en particulier, les CBOC.

Summary

Chronic cervicobrachial pain disorders are a complex nosological entity. Frequently related to mechanical constraints involving the upper limbs, neck and shoulder girdle, they develop commonly during the performance of certain characteristic work tasks. Hence the use of the synonym «occupational cervicobrachial disorder».

This entity presents the clinician with a difficult medical problem for which there is at the present time neither a satisfactory aetiopathogenic basis nor therapeutic approach. In spite of this there are clues that disturbed nociceptive mechanisms may be playing an essential role in the genesis and chronicity of symptoms. These disturbances of nociceptive neurophysiology must be considered in conjunction with concepts of psychoaffective components and medicosocial problems which are commonly associated with all chronic pain disorders, in particular chronic occupational cervicobrachial pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Bibliographie

  1. Amadio P.C.: Pain dysfunction syndromes.J. Bone Joint Surg. 70/A (6) 944–949, 1988.

    Google Scholar 

  2. Aoyama H.: Occupational cervicobrachial disorder.In:Encyclopaedia of Occupational Health and Safety. Ed.: International Labour Office (Geneva). Vol. I, p. 440–442, 1985.

  3. Arner S. andMeyerson B.A.: Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain.Pain 33, 11–23, 1988.

    Article  PubMed  CAS  Google Scholar 

  4. Arroyo J.F., Cohen M.L. andChampion G.D.: Sensory assessment in diffuse cervicobrachial pain syndrome: evidence for neuropathic pain mechanisms.Abstracts of 33rd. Annual Scientific Meeting of the Australian Rheumatism Association, Brisbane, 1989.

  5. Arroyo J.F., Champion G.D. andCohen M.L.: Focal Dystonia in association with upper limb pain of presumed neuropathic aetiology.Abstracts of 33rd. Annual Scientific, Meeting of the Australian Rheumatism Association, Brisbane, 1989.

  6. Bengtsson A., Henriksson K.G. andLarsson J.: Muscle biopsy in primary fibromyalgia.Scand. J. Rheumatol. 15, 1–6, 1986.

    Article  PubMed  CAS  Google Scholar 

  7. Bogduk N.: The rationale for patterns of neck and back pain.Patient Management (August): 13–21, 1984.

    Google Scholar 

  8. Bogduk N. andMarsland A.: The cervical zygapophyseal joints as a source of neck pain.Spine 13 (6), 610–617, 1988.

    PubMed  CAS  Google Scholar 

  9. Brooks P.M.: Occupational pain syndromes.Med. J. Aust. 144, 170–171, 1986.

    PubMed  CAS  Google Scholar 

  10. Cervero F.: Visceral nociception: peripheral and central aspects of visceral nociceptive systemsIn:Nociception and Pain. Ed.: Iggo A., Iversen L.L. and Cervero F., The Royal Society (London), p. 16–23, 1985.

    Google Scholar 

  11. Champion G.D., Cornell J., Browne C.D., Garrick R., Herbert T.J.: Clinical observations in patients with the syndrome «repetition strain injury».J. Occup. Health Safety Aust. N. 2, 107–113, 1986.

    Google Scholar 

  12. Champion G.D., Cairns D., Spence S. andArroyo J.F.: Correspondence analysis of the adjective of the McGill Pain Questionnaire.Abstracts of the Eleventh Annual Scientific Meeting. Australian Pain Society, Sydney, March 1989.

  13. Champion D., Cohen M.L. andArroyo J.F.: Reflex sympathetic dystrophy syndrome (RSDS) in occupational cervicobrachial disorders.Abstracts of the Eleventh Annual Scientific Meeting. Australian Pain Society, Sydney, March 1989.

  14. Chatterjee D.S.: Repetition Strain Injury: a recent review.J. Soc. Occup. Med. 37, 100–105, 1987.

    Article  PubMed  CAS  Google Scholar 

  15. Chernetski K.E.: Sympathetic enhancement of peripheral sensory input in the frog.J. Neurophysiol 27, 493–515, 1964.

    PubMed  CAS  Google Scholar 

  16. Cleland L.G.: RSI: a model of social iatrogenesis.Med. J. Aust. 147, 236–239, 1987.

    PubMed  CAS  Google Scholar 

  17. Cline M.A., Ochoa J.L., Torebjork E.: Chronic hyperalgesia and skin warming causwed by sensitized C nociceptors.Brain 112, 621–647, 1989.

    Article  PubMed  Google Scholar 

  18. Coggeshall R.E., Hong K.A.P., Langford L.A., Shaible H.G. andScmidt R.F.: Discharge characteristics of fine medial articular afferents at rest and during passive movements of inflamed knee joints.Brain Res. 272, 185–188, 1983.

    Article  PubMed  CAS  Google Scholar 

  19. Cohen M.L.: Is diffuse regional upper limb pain syndrome sympathetically maintained?Abstracts of the Eleventh Annual Scientific Meeting. Australian Pain Society, Sydney, March 1989.

  20. Cohen M.L., Champion G.D. andArroyo J.F.: Clinical evidence for the neuropathic nature of diffuse upper limb (cervicobrachial) pain syndrome.Abstracts of 33rd. Annual Scientific Meeting of the Australian Rheumatism Association, Brisbane, 1989.

  21. Cohen M.L. andArroyo J.F.: (letter) Re: Hopkins & Charters: An unusual case of causalgia. Relevance to recent hypothesis on mechanism of causalgia.Pain (accepted for publication).

  22. Cook A.L., Woolf C.J., Wall P.D. andMcMahon S.B.: Dynamic receptive field plasticity in rat spinal cord dorsal horn following C-primary afferant input.Nature 325, 151–153, 1987.

    Article  PubMed  CAS  Google Scholar 

  23. Dennet X. andFry H.J.H.: Overuse syndrome: a muscle biopsy study.Lancet April 23, 905–908, 1988.

    Article  Google Scholar 

  24. Dubner R. andBennett G.J.: Spinal and trigeminal mechanisms of nociception.Annu. Rev. Neurosci 6, 381–418, 1983.

    Article  PubMed  CAS  Google Scholar 

  25. Ellis N.: Occupational overuse syndrome.Patient Management, June, 133–143, 1988.

    Google Scholar 

  26. Fairbank J.C.T., Park W.M., McCall I.W. andO'Brien J.P.: Apophyseal injection of local anesthetic as a diagnostic aid in primary low-back pain syndromes.Spine 6, 598–605, 1981.

    Article  PubMed  CAS  Google Scholar 

  27. Fields H.L.: Painful dysfunction of the nervous system.In:Pain. Ed.: McGraw-Hill, Inc. (New York), p. 133–169, 1987.

    Google Scholar 

  28. Fields H.L.: The peripheral pain sensory system.In:Pain. Ed.: McGraw-Hill, Inc. (New York), p. 13–40, 1987.

    Google Scholar 

  29. Fields H.L.: Pain from deep tissues and referred pain.In:Pain. Ed.: McGraw-Hill, Inc. (New York), p. 79–97, 1987.

    Google Scholar 

  30. Foreman R.D., Schmidt R.F. andWillis W.D. Effects of mechanical and chemical stimulation of line muscle afferents upon primate spinothalamic tract cells.J. Physiol. 286, 215–231, 1979.

    PubMed  CAS  Google Scholar 

  31. Foreman R.D., Schmidt R.F. andWillis W.D.: Convergence of muscle and cutaneous input onto primate spinothalamic tract neurons.Brain Res. 124, 555–560, 1977.

    Article  PubMed  CAS  Google Scholar 

  32. Fry H.J.H.: Overuse syndrome of the upper limb of musiciens.Med. J. Aust. 144 (4), 182–183, 1986.

    PubMed  CAS  Google Scholar 

  33. Furey P.: (letter) Understanding needed of Tenosynvitis.Occup. Health 24, 29, 1982.

    Google Scholar 

  34. Graff-Radford S.B., Reeves J.L., Baker R.L. andChiu D.: Effects of transcutaneous electrical nerve stimulation, on myofascial pain and trigger point sensitivity.Pain 37, 1–5, 1989.

    Article  PubMed  CAS  Google Scholar 

  35. Harris G. andRollman G.B.: The validity of experimental pain measures.Pain 17, 369–376, 1983.

    Article  PubMed  CAS  Google Scholar 

  36. Hoffert M.J., Greenberg R.P., Wolskee P.J., Gracely R.H., Wirdzek P.R., Vinayakom K. andDubner R.: Abnormal and collateral innervations of sympathetic and peripheral sensory fields associated with a case of causalgia.Pain 20, 1–12, 1984.

    Article  PubMed  CAS  Google Scholar 

  37. Hopkins C.S. andCharters P.: An unusual case of causalgia. Relevance to recent hypothesis on mechanism of causalgia.Pain 37, 93–95, 1989.

    Article  PubMed  CAS  Google Scholar 

  38. Hosokawa M.: The study on occupational, cervicobrachial disorders (OCD).Academic Reports of Kyoto Prefectural University (Kyoto)37, November, 1985.

  39. Kavanagh J.: Keyboard cripples: the avalanche looms.Business Rev. Weekly 17–23, 37–52, 1984.

    Google Scholar 

  40. Kellgren J.H.: On the distribution of pain arising from somatic, structures with charts of segmental pain areas.Clin. Sci 4, 35–46, 1942.

    Google Scholar 

  41. Kozin F., Ryan L.M., Carrera G.F., Soin J.S. andWortmann R.L.: The reflex sympathetic dystrophy (RSDS). Part III.Am. J. Med. 70, 23–30, 1981.

    Article  PubMed  CAS  Google Scholar 

  42. Kumazawa T. andMizumura K.: Thin-fibre receptors responding to mechanical, chemical and thermal stimulation in the skeletal muscle of the dog.J. Physiol. 273, 179–194, 1977.

    PubMed  CAS  Google Scholar 

  43. Laitinen L.V.: Electrical sensimetry: assessment of cutaneous sensibility with electrical stimulation.Clin. Neurol. Neurosurg. 89-1, 5–8, 1987.

    Article  Google Scholar 

  44. Lockwood A.H.: Medical problems of musiciens.N. Engl. J. Med. 320, 221–227, 1989.

    PubMed  CAS  Google Scholar 

  45. Lucire Y.: Neurosis in the work place.Med. J. Aust. 145, 323–327, 1986.

    PubMed  CAS  Google Scholar 

  46. Maeda K., Hunting W. andGrandjean E.: Localized fatigue in accounting-machine operators.J. Occup. Med. (Chicago)22–12, 810–816, 1980.

    Google Scholar 

  47. Mandel S.: Neurologic syndromes from repetitive trauma at work.Postgrad. Med. 82 (6), 87–92, 1987.

    PubMed  CAS  Google Scholar 

  48. McCall I.W., Park W.M. andO'Brien J.P.: Induced pain referral from posterior lumbar elements in normal subjects.Spine 4, 441–446, 1979.

    Article  PubMed  CAS  Google Scholar 

  49. Melzack R. andWall P.D.: Pain mechanisms: a new theory.Science 150, 971–978, 1965.

    Article  PubMed  CAS  Google Scholar 

  50. Melzack R.: The McGill Pain Questionnaire: major properties and scoring methods.Pain 1, 277–299, 1975.

    Article  PubMed  CAS  Google Scholar 

  51. Mense S. andSchmidt R.F.: Muscle pain: which receptors are responsible for the transmission of noxious stimuli?In:Physiological aspects of Clinical Neurology. Ed.: Rose J.S., Blackwell (Oxford), p. 265–278, 1977.

    Google Scholar 

  52. Meyer R.A. andCampbell J.N.: Myelinated nociceptive afferents account for the hyperalgesia that follows a burn to the hand.Science 213, 1527–1529, 1981.

    Article  PubMed  CAS  Google Scholar 

  53. Miller M.H. andTopliss D.J.: Chronic upper limb pain syndrome (Repetitive Strain Injury) in the Australian workforce: A systematic cross sectional rheumatologic study of 229 patients.J. Rheumatol. 15–11, 1705–1712, 1988.

    Google Scholar 

  54. Mills K.R., Newhan D.J. andEdwards R.H.T.: Muscle pain.In:Textbook of Pain. Ed.: Wall P.D. and Melzack R. Churchill Livingstone (New York), p. 319–330, 1984.

    Google Scholar 

  55. National Occupational Health, and Safety Commission: Repetitive Strain Injury (RSI): a report and model code of practice.Worksafe Australia, p. 1, 1986.

  56. Ochoa J.L., Torebjork E., Marchettini P. andSivak M.: Mechanisms of neuropathic pain: Cumulative observations, new experiments and further speculation.In:Advances in Pain Research and Therapy. Ed.: Fields H.L.et al., Raven Press (New York) Vol. 9, 431–450, 1985.

    Google Scholar 

  57. Onischi N., Nornura H., Sakai K., Yamamoto T., Hirayama K. andItani T: Shoulder muscle tenderness and physical features of female industrial workers.J. Hum. Ergol. (Tokyo)Dec. 5–2, 87–102, 1976.

    Google Scholar 

  58. Payne R.: Neuropathic pain syndromes, with special reference to causalgia and reflex sympathetic dystrophy.Clin. J. Pain 2, 59–73, 1986.

    Article  Google Scholar 

  59. Price D.D.: Primary afferents subserving Pain.In:Psychological and Neural Mechanisms of Pain. Ed.: Raven Press (New York), p. 76–99, 1988.

    Google Scholar 

  60. Price D.D., Hayes R.L., Ruda M.A. andDubner R.: Spatial and temporal transformations of input to spino-thalamic tract neurons and their relation to somatic sensation.J. Neurophysiol. 41, 933–947, 1978.

    PubMed  CAS  Google Scholar 

  61. Price D.D.: Spinal cord mechanisms subserving pain.In:Psychological and Neural Mechanisms of Pain. Ed.: Raven Press (New York), p. 100–149, 1988.

    Google Scholar 

  62. Raja S.N., Meyer R.A. andCampbell J.N.: Peripheral mechanisms of somatic Pain.Anesthesiology 68, 571–590, 1988.

    Article  PubMed  CAS  Google Scholar 

  63. Ramazzini B.:Disease of workers (English translation, by W.C. Wright). Ed. Hafner (New York), 1940.

    Google Scholar 

  64. Revak J.M.: Incidence of upper extremity discomfort among piano students.Am. J. Occup. Ther 43 (3), 149–154, 1989.

    PubMed  CAS  Google Scholar 

  65. Roberts W.J. andElardo S.M.: Sympathetic activation of A-delta nociceptors.Somatosensory Res. 3, 33–44, 1985.

    Article  CAS  Google Scholar 

  66. Roberts W.J. andFoglesong M.E.: Identification of afferents contributing to sympathetically evoked activity in wide-dynamic-range neurons.Pain 34, 305–314, 1988.

    Article  PubMed  CAS  Google Scholar 

  67. Roberts W.J. andFoglesong M.E.: Spinal recordings suggest that wide-dynamic-range neurons mediate sympathetically maintained pain.Pain 34, 289–304, 1988.

    Article  PubMed  CAS  Google Scholar 

  68. Royal Australasian College of Physicians (R.A.C.P.): Repetitive strain injury/Occupational overuse syndrome. R.A.C.P. Fellowship Affairs. December 1988.

  69. Rudge S.R.: Repetitive strain injuryBr. J. Rheumatol. 27 477–478, 1988.

    Article  Google Scholar 

  70. Schaible H.G. andSchmidt R.F.: Responses of fine medial articular nerve afferents to passive movements of knee joint.J. Neurophysiol 49, 1118–1126, 1983.

    PubMed  CAS  Google Scholar 

  71. Simons D.G. andTravell J.G.: Myofascial pain syndromes.In:Textbook of Pain. Ed.: Wall P.D. and Melzack R., Churchill Livingstone (New York), p. 263–276, 1984.

    Google Scholar 

  72. Sinclair D.S. Repetitive Strain Syndrome: An Australian Experience.J. Rheumatol. 15–11, 1729–1730, 1988.

    Google Scholar 

  73. Smythe H.: The “repetitive strain injury syndrome” is referred pain from the neck.J. Rheumatol. 15–11, 1604–1608, 1988.

    Google Scholar 

  74. Souquet R.:Syndromes canalaires du membre, supérieur. Ed.: Expansion Scientifique Française (Paris), 1983.

    Google Scholar 

  75. Sternbach R.A. andTimmermans G.: Personality changes associated with reduction of pain.Pain 1, 177–181, 1975.

    Article  PubMed  CAS  Google Scholar 

  76. Sternbach R.A., Wolf S.R., Murphy R.W. andAkeson W.H.: Traits of pain patients: the low-back «loser».Psychosornatics 14, 226–22?, 1973.

    CAS  Google Scholar 

  77. Vecchiet L., Giamberardino M.A., Dragani L. andAlbe-Fressard D.: Pain from renal/ureteral calculosis: evaluation of sensory thresolds in the lumbar area.Pain 36, 289–295, 1989.

    Article  PubMed  CAS  Google Scholar 

  78. Wall P.D.: Causes of intractable Pain. Hospital Update, December 969–974, 1986.

  79. Willis E.:RSI as a Social Process.Community Health Studies, Vol. X, 2, 1986.

    Google Scholar 

  80. Waris P.: Occupational cervicobrachial syndromes. A review.Scand. J. Work Environ. Health (Helsinki),Suppl. 3, 3–14, 1979.

    Google Scholar 

  81. Wofle F., Hawley D.J. andCathey M.A.: Fibrositis: symptoms frequency and criteria for diagnosis. An evaluation of 291 rheumatic disease patients and 58 normals individuals.J. Rheumatol 12, 1159–1163, 1985.

    Google Scholar 

  82. Woodyard J.E.: Diagnosis and prognosis in compensation claims.Ann. Roy. Coll. Surg 64, 191–194, 1982.

    CAS  Google Scholar 

  83. Yaksh T.L.: Behavioral and autonomic correlates of the tactile evoked allodynia produced by spinal Glycine inhibition: effects of modulatory receptor systems and excitatory amino acid antagonists.Pain 37, 11–23, 1989.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Rheumatology Department, St. Vincent’s Hospital, Darlinghurst, Sydney

    M. L. Cohen MD & G. D. Champion MD

  2. Clinique Médicale, Hôpital Cantonal Universitaire, CH-1211, Genève 4

    J. F. Arroyo MD

Authors
  1. J. F. Arroyo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. L. Cohen MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. D. Champion MD
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Arroyo, J.F., Cohen, M.L. & Champion, G.D. Les cervicobrachialgies occupationnelles chroniques (CBOC): éléments sémiologiques et mécanismes nociceptifs. Doul. et Analg. 2, 137–146 (1989). https://doi.org/10.1007/BF03013670

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03013670

Key words

Search

Navigation