Cummulative Trauma Disorder exp ined ppt

Cummulative Trauma Disorder exp ined ppt

• 1.
  Cumulative Trauma Disorders Recognitionand Prevention in the Workplace
• 2.
  Objectives By the endof this class final year should able to know:  What is cumulative trauma disorder?  Causes of cumulative trauma disorders  Common WMSD’s
• 3.
  Cumulative Trauma Disorders Cumulative = occurring gradually over a period of weeks, months, or years  Trauma = bodily injury to nerves, tissues, tendons, or joints  Disorders = physical ailments or abnormal conditions
• 4.
  Cumulative Trauma Disorders Bodily injuries or physical ailments that have developed gradually over periods of weeks, months, or even years as the result of repeated stresses on a particular body part
• 5.
  What are aliasesfor WMSDs?  Work-related MSDs go by many other names: – Repetitive Strain or Stress Injury (RSI) – Repetitive Motion Injury (RMI) – Cumulative Trauma Disorder (CTD) – Overuse Syndrome – Activity-related Pain Syndrome
• 6.
  Causes of CTD’s Usuallycaused by a combination of following risk factors:  Repetitive motions  Forceful exertions - pulling, pushing, lifting, and gripping  Awkward postures  Static postures - body positions held without moving
• 7.
  Causes of CTD’s Mechanical compression of soft tissues in the hand against edges or ridges  Fast movement of body parts  Vibration especially in the presence of cold conditions  Mental stress  Lack of sufficient recovery time (rest breaks, days off)
• 8.
  Common CTD’s Upper Body –Tension Neck Syndrome – Rotator Cuff Syndrome – Lateral Epicondylitis (Tennis Elbow) – Medial Epicondylitis (Golfer’s Elbow) – Tendinitis – Carpal Tunnel Syndrome – DeQuervain’s Tenosynovitis – Trigger Finger – Hand-Arm Vibration Syndrome
• 9.
  Common CTD’s Lower Body –Low Back Pain – Back Strain – Disc Disorder – Degenerative Disc Disorders – Sciatica – Knee Disorders – Foot Disorders
• 10.
  Clinical symptoms ofMSDs • Continuous general weakness • Restrictions of movements • Sleep disturbances • Other physical & psychological problems • Discomfort continues • Sleep disturbances • Limitation of work • Pain • Tiredness • Numbness • Tingling • Discomfort • Stiffness in joints • Weakness • Swelling • Burning • Loss of functions
• 11.
  A FEW SOLUTIONS... Reduce manual material handling – Pre-Plan material drops – Utilize material handling equipment – Keep materials in “neutral zone”  Equipment – Use the right tool for the job – Evaluate new tools for ergonomics – Keep sharp & in good repair – Use vibration dampening tools / gloves  Reduce Duration – Mini-breaks – Multi-task – Employee rotation/job share
• 12.
  Common CTD’s  CarpalTunnel Syndrome-Injury to the median nerve.  Tendonitis-Swelling of the tendons.  Tenosynovitis-Swelling in tendon sheath.
• 13.
  Carpal Tunnel Syndrome Definition – Compression neuropathy of the median nerve at the wrist Palmar aponeurosis Median nerve
• 14.
  Carpal Tunnel Syndrome Pain and Paresthesias on palmar-radial aspect of hand  Often worse at night  Risk factors – Intrinsic – extrinsic
• 15.
  Carpal Tunnel Syndrome Intrinsic risk factors – Anatomic variants » Either decreased dimension of carpal tunnel or increased volume of its contents – Physiologic variants » Diabetes , alcoholism , smoking , pregnancy , rheumatoid arthritis , myxedema » All associated with edema
• 16.
  Carpal Tunnel Syndrome Extrinsic factors – Hand position – Forceful use of hand – Repetitive motion – Vibration
• 17.
  Carpal Tunnel Syndrome MRI has shown that wrist flexion compresses the median nerve between flexor retinaculum and tendons  Minimizing wrist flexion/extension by redesign of tools helps reduce CTS
• 18.
  Carpal Tunnel Syndrome Forceful use of hand  Repetitive motion is a risk factor for hand pain BUT not specifically for CTS  No correlation between hours of keyboard work and CTS
• 19.
  Carpal Tunnel Syndrome andVibration  Hand-arm vibration syndrome – Raynaud’s , sensory changes – Digital nerves mainly – Often misdiagnosed as CTS  Definite dose-response relationship – >50% incidence with >8000 hrs.  Carpal tunnel release does not help
• 20.
  Dequervain’s Tendonitis  Tendonentrapment not tenosynovitis  Analogous to trigger finger  APL & EPB tendons  Peritendinous fibrosis not inflammation
• 21.
  Dequervain’s Tendonitis
• 22.
  Dequervain’s Tendonitis  Noreports that relate incidence of Dequervain’s to frequency or intensity of repetitive work  Tender over radial styloid  Finklestein’s test
• 23.
  Finklestein’s test
• 24.
  Dequervain’s Tendonitis Treatment  Splinting Rest  NSAIDS ?  Steroid injection - 80% success  Surgery
• 25.
  Tennis elbow Lateral epicondylitis Angiofibroblastic tendinosis – Not inflammatory – ?avascular or degenerative etiology – ECRB origin
• 26.
  Tennis elbow Lateral epicondylitis
• 27.
  Tennis elbow Lateral epicondylitis Associated with repetitive use – Occupational – Sports – Musicians  Tender over lateral epicondyle  Pain on resisted wrist extension
• 28.
  Tennis elbow Treatment  “comfortand cure”  NSAIDS  Steroid injection  Rehab program – 4 months !!  Rest
• 29.
  Impingement Syndromes • Subacromialbursitis • Rotator cuff tendonitis • Bicipital tendonitis • AC arthritis • Rotator cuff tear
• 30.
  Impingement Syndrome
• 31.
  Impingement syndrome • Repetitiveoverhead use of arm • Swimmers,pitchers • painful arc • impingement signs • decreased ROM active vs. passive • pain with resisted motion
• 32.
  Impingement : treatment •Avoidance of offending activity • Physiotherapy • NSAIDS • Corticosteroid injection • Surgery : Subacromial decompression
• 33.
  Recognize The WarningSigns
• 34.
  Warning Signs  Numbnessand tingling in first three fingers  Clumsy feeling in your hand  Pain going up into the elbow or shoulder  Pain is worse at night
• 35.
  SEE A DOCTOR IMMEDIATELYand use….
• 36.
  Alternative Work Methods Evaluate Work Area  Take Periodic rests and Stretch  Awkward positions caused by certain items and work practices in can be prevented.  Trying to do too much at one time can cause muscles to tire and cause injury
• 37.
  Environment Adjustment  ReplaceExisting Equipment-The desks should have rounded edges to reduce possible pressure points. The chairs need the arm height and chair height to be adjustable, and give back support by having a tilt adjustment.
• 38.
  Environment Adjustment Add Accessoriesto Existing Equipment-  Wrist rests- help to promote a neutral wrist position  An adjustable document holder - promote the proper head angle  A seat cushion- helps to support the back  A footrest- helps to keep thighs parallel to the ground and promote good posture
• 39.
  Education, New Equipmentand Preventative Measures All Add Up To A Safer and Ergonomically Correct Work Environment