Many occupations involve repetitive movements, which put workers at risk of repetitive motion injuries. Repetitive motion injuries account for many work-related injuries. Tasks that require repetitive movements include typing at a computer, scanning groceries, hammering nails, working on an assembly line, and using a jackhammer.
Because many jobs involve repetitive motion, work-related repetitive motion injuries are common.
Work-related repetitive motion injuries are treated as needed with pain relievers and physical therapy.
Most work-related repetitive motion injuries resolve with rest over a period of weeks, but sometimes injections of a corticosteroid or hyaluronic acid or surgery is needed.
Other treatments may be used: Corticosteroid or hyaluronic acid injections for tendinitis, drainage with or without corticosteroid injections for bursitis, and a splint or brace for a compressed nerve.
Repetitive motion injuries include tendinitis, bursitis, and compression of a nerve.
Tendinitis Tendinitis and Tenosynovitis Tendinitis is inflammation of a tendon. Tenosynovitis is tendinitis accompanied by inflammation of the protective covering around the tendon (tendon sheath). The cause is not always known. Tendons... read more occurs when straining or overworking a muscle causes small tears in a tendon. Tendinitis results when a tendon tears faster than the body can repair it and the tendon becomes inflamed. Work-related tendinitis commonly develops in the biceps, elbow, and rotator cuff.
Bursitis Bursitis Bursitis is painful inflammation of a bursa (a flat, fluid-filled sac that provides cushioning where skin, muscles, tendons, and ligaments rub over bones). Movement is usually painful, and bursae... read more is caused by repeated pressure on the surface of a joint, which results in inflammation of a bursa. Bursae are fluid-filled sacs that enable muscles or tendons to smoothly slide over bone during movement. Work-related bursitis commonly affects the elbow, shoulder, hip joint, and knee. Causes of bursitis include
Elbow: Resting the elbow on hard surface
Shoulder: Working with the arms overhead
Hip joint: Sitting on a hard surface for a long time
Compression of a nerve Mononeuropathy Mononeuropathy is damage to a single peripheral nerve. Pressure on a nerve for a long time is the most common cause of mononeuropathy. The affected area may tingle, feel prickly, or be numb... read more can occur when a nerve passes through a narrow space (tunnel). As a result, the nerve malfunctions. Work-related injuries commonly occur in the wrist and elbow. Examples are carpal tunnel syndrome Carpal Tunnel Syndrome Carpal tunnel syndrome is a painful compression (pinching) of the median nerve as it passes through the carpal tunnel in the wrist. The cause of most cases of carpal tunnel syndrome is unknown... read more (wrist) and cubital tunnel syndrome Cubital Tunnel Syndrome Cubital tunnel syndrome is a disorder caused by compression (pinching) of the ulnar nerve at the elbow. Repetitive use of the elbow can cause cubital tunnel syndrome. Symptoms include numbness... read more (elbow).
Symptoms of Repetitive Motion Injuries
Tendinitis usually causes pain when the inflamed tendons are moved or touched. In severe cases, the skin over the tendons may be warm and red. The tendon may swell.
Bursitis also causes pain. Moving the joint makes the pain worse. Fluid accumulates in the bursa, causing it to swell and become painful. The skin cover the bursa may be warm or red.
Compression of a nerve most commonly causes pain, tingling, numbness, and burning.
Diagnosis of Repetitive Motion Injuries
A doctor's evaluation
Sometimes nerve conduction studies or magnetic resonance imaging
Doctors base the diagnosis of repetitive motion injury mainly on the location of the pain and the movement that causes pain. They suspect a specific disorder as follows:
Tendinitis: When movement of a tendon causes pain and when the tender feels tender when it is pressed (palpated)
Bursitis: When the area over the bursa is swollen, red, or warm or when people have unexplained pain worsened by movements that involve a bursa
Compression of a nerve: When a worker has abnormal sensations in areas supplied by certain nerves
Doctors also ask detailed question about the person's work history to confirm that the injury is work-related and to identify what type of repetitive movement caused the person's symptoms. However, testing is sometimes needed.
Sometimes nerve conduction studies Electromyography and Nerve Conduction Studies Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more are done to help confirm that a nerve is compressed. If doctors suspect that a tumor or an abnormal bone growth is compressing the nerve, magnetic resonance imaging (MRI) may be done.
Prevention of Repetitive Motion Injuries
The following strategies can help prevent work-related repetitive motion injuries:
Maintaining good posture
Taking breaks and stretching periodically
Reducing or eliminating overtime
Using chairs that support the back
Using headsets for phone calls
Using footrests if needed
Using adjustable desks and computer monitors
To reduce stress on hands and wrists, replacing hand tools with power tools and providing tools with handles that absorb vibrations
Employers should provide training about these preventive measures for workers and provide the equipment needed to reduce repetitive motion injuries. An ergonomic analysis for jobs that could result in these injuries should be done, and work stations should be adjusted as recommended. Workers should be encouraged to promptly report symptoms of a problem to a manager.
Treatment of Repetitive Motion Injuries
For tendinitis, corticosteroid or hyaluronic acid injections
For bursitis, drainage
For a compressed nerve, a splint or brace and possibly corticosteroid injections or surgery
Treatment of work-related repetitive motion injury includes resting the affected area. Workers may need to be placed on transitional duty (also known as light duty or modified duty) if their normal job duties cannot be done without the repetitive motion that caused the injury. Depending on the type and severity of the injury, transitional duty may last for weeks to months. If job duties that include the repetitive motion are resumed too early, the injury may recur. Then the worker must return to transitional duty, thus increasing the total time spent in transitional duty. Workers should avoid activities outside of work that worsen their injury.
Pain relievers (analgesics) and anti-inflammatory drugs are used as needed. Nonsteroidal anti-inflammatory drugs Nonsteroidal Anti-Inflammatory Drugs Pain relievers (analgesics) are the main drugs used to treat pain. Doctors choose a pain reliever based on the type and duration of pain and on the drug's likely benefits and risks. Most pain... read more (NSAIDs) are typically effective for short-term relief of pain caused by repetitive motion injuries, and they speed the resolution of tendinitis and bursitis.
Physical therapy Physical Therapy (PT) Physical therapy, a component of rehabilitation, involves exercising and manipulating the body with an emphasis on the back, upper arms, and legs. It can improve joint and muscle function, helping... read more may benefit workers with repetitive motion injuries and may speed recovery and help workers regain function.
For tendinitis, injection of a corticosteroid near the affected tendon, although it can relieve pain in the short term, is not usually recommended because it does not seem to help in the long term and could possibly result in harm.
For bursitis, drainage of excess fluid in the affected bursa is sometimes done, with or without corticosteroid injections. The drainage relieves pain and may speed recovery. After drainage, a dressing (such as an elastic bandage) that puts pressure on the bursa may help keep fluid from reaccumulating.
For compression of a nerve, using a splint or brace may relieve symptoms. If symptoms are severe or persistent, workers are referred to an orthopedic surgeon for corticosteroid injections and sometimes surgery.
Most work-related repetitive motion injuries resolve with rest over a period of weeks. However, compression of a nerve may result in chronic pain.