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Work-Related Repetitive Motion Injuries

By

Michael I. Greenberg

, MD, Drexel University College of Medicine;


David Vearrier

, MD, MPH, University of Mississippi Medical Center

Last full review/revision Aug 2022| Content last modified Sep 2022
CLICK HERE FOR THE PROFESSIONAL VERSION

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 Bursitis 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

  • Knee: Kneeling

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 Electromyography and Nerve Conduction Studies 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

  • Rest

  • Pain relievers

  • Physical therapy

  • 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.

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.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSIONAL VERSION
CLICK HERE FOR THE PROFESSIONAL VERSION
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