Occupational Health

 Occupational Health

KM Woods Physiotherapy works closely with public sector and corporate businesses to keep their employees in work, or to reduce the time period for which they are signed off work, when experiencing occupational musculoskeletal injuries.

Musculoskeletal injuries, relating directly or indirectly to occupation, can manifest as a huge spectrum of signs and symptoms, largely dictated by the tasks an employee performs, and the positions which they assume, on a daily basis. Such patterns have led to the clinical identification of two primary causes of occupational injuries which we see in clinic; postural syndromes, and repetitive strain injuries.

Postural Syndrome
Postural Syndrome is a clinical presentation which is usually present when a patient works in a static, sedentary position on a daily basis. Professions which typically induce such a syndrome may include call handlers, drivers, office workers, receptionists etc.

Postural syndrome may present with any number of symptoms, but most commonly seen clinically are the following;

  • Neck stiffness, pain, “creaking” sensation on movement
  • Upper or lower back pain and/or stiffness
  • Pain radiating from the neck, through the shoulder, into the arm
  • Symptoms of pins & needles, tingling, or numbness in the arm or hand
  • Poor alignment of the spine, with a protruding head position, rounded shoulders, and/or an increased curve of the upper back

Treatment of a postural syndrome encompasses several facets. Treatment of the acute symptoms of pain, stiffness etc. is primary, as these are the main reasons for the patient attending initially. Holistic attention is paramount however. Postural education, and instilling a greater postural awareness in the patient, is key, for if the underlying postural issues are not addressed, clinical treatment will be limited with regard to its effectiveness. Ergonomic habits are also addressed, and a work routine discussed with the patient to lead to a healthier lifestyle while at work. Simple changes can exert huge influence; 30-45 minute “micro-break” from ones desk, improved desk layout, altered postural positioning etc all combine to reduce symptom irritation.

Treatment includes clinical intervention, a home exercise programme, and the development of an improved postural awareness of the patient’s behalf. Clinical intervention typically includes the reduction of muscle spasm, the mobilisation of hypomobile spinal segments, and correction of muscular imbalances.

The undertaking of a workstation assessment is often required to address a postural syndrome also, to ensure that the layout of one’s desk and office furniture is not contributing to poor postural habits.

Repetitive Strain Injuries
Repetitive strain injuries typically result from the consistent, repeated performance certain tasks. Such repetition leads to micro-trauma and gradual overload of soft tissues and neural tissue. Constant use of a keyboard or mouse, the undertaking of regular typing, or constant use of the hands for fine movements tend to lead to repetitive strain. While not solely reserved for diagnosis of sportspersons, the entities of “tennis elbow” and “golfers elbow” are both types of repetitive strain, overuse injuries. Professionals who tend to attend our clinic with such a condition include typists, graphic designers, dentists, print workers etc.

Postural syndrome may present with any number of symptoms, but most commonly seen clinically are the following;

  • Pain radiating from the neck, through the shoulder, and into the arm
  • Loss of grip strength
  • Loss of fine control of the hand and fingers
  • Pain in the arm, forearm, or hand
  • Pin induced by prolonged use of the hand for gripping, fine motor activities etc.
  • Pins & needles, tingling, or numbness in the arm or hand
  • Pain at the lateral (outer) on medial (inner aspect) of the elbow

Treatment of repetitive strain injuries will also encompasses several facets. Treatment of the acute symptoms of pain, pins & needles etc. is again primary. Holistic attention is important again however. Postural education, and instilling a greater postural awareness in the patient, is again important, as such issues may be contributing to symptoms. The identification and rectification of poor ergonomic habits are also vital. Simple 30-45 minute micro breaks from repetitive tasks will give the implicated tissues some respite from irritation, will allow for the recommencement of stagnated circulation, and will allow for the resetting of postural positioning upon recommencement of task. Simply, the patient must achieve regular breaks from the aggravating activity, or clinical treatment will be limited in its effectiveness.

Treatment includes clinical intervention, a home exercise programme, adherence to a routine of regular “micro-breaks” from the aggravating task, and the development of an improved postural awareness of the patient’s behalf.

Clinical intervention typically includes the reduction of muscular inflammation, the mobilisation of hypomobile spinal segments, desensitisation of inflamed neural tissue, and the mobilisation of scar tissue in implicated tissues.

The undertaking of a workstation assessment is often required to address a postural syndrome also, to ensure that the layout of one’s desk and office furniture is not contributing to the causative repetitive strain.

In Conclusion…
Patients often comment on how work-related musculoskeletal injuries are an accepted consequence of certain jobs, especially those involving prolonged sitting at a desk etc. Such is inaccurate. Any occupational role can be undertaken, without exerting any ill effects on the employees health, so long as good ergonomic habits and postural awareness are maintained.

Occupational health & safety legislation states that all employees have a right to leave their place of work in the same state of health in which they enter it. Such a statement is not any guarantee however, and the onus is on the employee to ensure this scenario is achieved. Occasionally, they may require some assistance from a physiotherapist along the way however.