Work-related upper limb disorders and repetitive strain injuries

What are work-related upper limb disorders?

Work-related upper limb disorders (WRULDS) is a term used to describe a variety of symptoms which may include pain, numbness, pins and needles, tingling and weakness in the neck, shoulders, arms and hands.

Sometimes the term repetitive strain injury or RSI is also used to describe a similar set of symptoms.

Work-related upper limb injuries are not associated with any accident/traumatic injury and the term is generally reserved for persistent symptoms which do not appear to be associated with any structural damage to the neck or upper limb. Therefore, the primary treatment for WRULDS is physiotherapy rather than injections or surgical procedures.

Prior to a diagnosis being given for Work-related upper limb disorders, you may have undergone tests including MRI scans and nerve conduction studies. Once these tests have eliminated any other diagnoses our physiotherapists will take a thorough history and perform a physical examination to establish the underlying cause for the problem.

Work-related upper limb injuries may develop due to a combination of reasons including:

  • Sudden increase in workload
  • Poor ergonomic setup
  • Little time for regular breaks from repetitive work
  • Psychological stress
  • Poor general physical fitness

Once this diagnosis is made it is important to start active treatment as soon as possible as long periods of physical inactivity and rest following the diagnosis has been found to prolong symptoms.

Once a comprehensive analysis of the underlying contributing factors has been done our physiotherapists will then be able to guide treatment appropriately. Where there are problems identified with desk setup your physiotherapist may raise chair, desk or screen heights to encourage a more appropriate posture.

Regular breaks may be encouraged to offload the painful muscles or nerve tissue further. Exercises may be prescribed to do at these times as evidence has demonstrated that small amounts of dynamic upper limb and cardiovascular activity can promote blood flow to the lower arms and reduce symptoms.

More specific exercises may include stretches to the chest, mobility exercises to the nerve tissues in the upper limb as well as strengthening exercises to promote more appropriate spinal and shoulder postures.

Due to the multitude of factors which may contribute to developing a Work-related upper limb disorder, symptoms may take several months to fully resolve. If neural symptoms including sensory symptoms and weakness are present this may prolong recovery.

However, if there are significant changes which need to be made to ergonomics, once these changes are put in to place symptoms may reduce much more rapidly.

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH