Musculoskeletal disorders (MSDs) are injuries or pain in the human musculoskeletal system, including joints, ligaments, muscles, nerves, tendons, and structures that support the limbs, neck and back. MSD can arise from sudden deployment (eg, lifting heavy objects), or they can arise from making the same movement over repetitive stretching, or from repeated exposure to awkward force, vibration, or posture. Injuries and pain in the musculoskeletal system caused by acute traumatic events such as car accidents or falls are not considered musculoskeletal disorders. MSD can affect many parts of the body including the upper back, the lower, the neck, the shoulders and the extremities (arms, legs, feet, and hands). Examples of MSDS include carpal tunnel syndrome, epicondylitis, tendinitis, back pain, tense neck syndrome, and hand-arm vibration syndrome.
Video Musculoskeletal disorder
Cause
MSDS can arise from the interaction of physical factors with ergonomics, psychological, social, and occupational factors.
Biomechanics
MSDS is caused by a biomechanical load which is a force that must be applied to perform the task, the duration of force applied, and the frequency of execution of the task. Activities involving heavy loads can result in acute injuries, but most work-related MSDS come from repetitive motion, or from maintaining a static position. Even activities that do not require much strength can result in muscle damage if these activities repeat quite often at short intervals. MSD risk factors involve performing tasks with heavy strength, repetition, or maintaining a nonneutral posture. Of particular concern is the combination of heavy loads with repetition. Although awkward posture is often blamed for lower back pain, a systematic review of the literature fails to find a consistent relationship.
Individual differences
People vary in their tendency to get MSDS. Gender is a factor with a higher rate in women than men. Obesity is also a factor, with overweight individuals having a higher risk of some MSD, especially the lower back.
There is a growing consensus that psychosocial factors are another cause of some MSDS. Some theories for this causal relationship are found by many researchers including increased muscle tension, increased blood and fluid pressure, reduced growth function, pain reduction of sensitivity, pupil dilatation, remaining body in high sensitivity state. Although the study findings are inconsistent at this stage, some workplace stressors found to be associated with MSDS in the workplace include high job demands, low social support, and overall job stress. Researchers have consistently identified a causal relationship between job dissatisfaction and MSDS. For example, increasing job satisfaction can reduce 17-69 percent of work-related backs and improve job control can reduce 37-84 percent of work-related wrist disorders.
Jobs
Because workers maintain the same postures during long and frequent work days, even natural postures such as standing can cause MSDs such as lower back pain, but less natural postures such as twisting or upper body tension usually contribute to the development of MSDS due to biomechanical loads which are not natural from these postures. There is evidence that posture contributes to MSD of the neck, shoulders, and back. Repetitive motion is another risk factor for workplace MSD because workers can repeat the same movement over a long period of time (eg typing leads to carpal tunnel syndrome), which can be used on the joints and muscles involved in the movement. Workers perform repetitive movements with high working speed with little recovery time and workers with little or no control over the timing of the movement (eg workers on the assembly line) are also vulnerable to MSD due to their work movements. The power required to perform action on the job can also be attributed to a higher risk of MSD in the worker, since movements that require more strength can weaken muscles more quickly that can cause injury and/or pain. In addition, vibration exposure (such as to truck drivers or construction workers, for example) and extreme heat or cold temperatures can affect a worker's ability to assess strength and strength, which can lead to MSDS development. Vibration exposure is also associated with hand-arm vibration syndrome, which has symptoms of lack of blood circulation to the fingers, nerve compression, tingling, and/or numbness.
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Diagnosis
The assessment of MSDS is based on self-reports of symptoms and pain and physical examination by the physician. Doctors rely on medical history, recreation and occupational hazards, pain intensity, physical examination to find the source of pain, and sometimes laboratory tests, X-rays or MRI doctors look for specific criteria to diagnose any different musculoskeletal disorders, based on location, type, and intensity of pain, as well as the kind of limited or painful movement that the patient experiences. The popular MSDS measure is the Nordic Questionnaire which has body drawings of various fields labeled and asks individuals to show in areas where they are experiencing pain, and in areas where there is pain that disrupts normal activity.
Prevention
The prevention of MSD depends on the identification of risk factors, either with self-report, occupational observation, or posture measurements that can lead to MSDS. Once the risk factor is determined, there are several intervention methods that can be used to prevent MSDS development. Target prevention efforts MSDs are often the workplace to identify the incidence rates of both disorders and exposure to unsafe conditions.
Workplace control
Groups with special risks can be identified, and modifications to the physical and psychosocial environment can be made. Approaches to prevention in workplace settings include matching a person's physical capabilities with tasks, improving one's ability, changing the way a task is performed, or changing a task. Employers can also use engineering controls and administrative controls to prevent injuries that occur while working. Implementation of engineering control is the process of designing or redesigning the workplace to take into account the strengths, weaknesses, and needs of the working population - an example would be to change the layout of the workstation to be more efficient or to reduce bending, or to move the necessary tools within a shorter range of the worker station. Employers may also use administrative controls such as reducing the number of hours in certain positions, limiting overtime, or including more rest during shifts to reduce the amount of time at risk for each worker.
Ergonomics
Encouraging the proper use of ergonomics not only matches the worker's physical ability with the right job, but also deals with designing the correct equipment for the task. Limiting weight lifting, training, and reporting of early signs of injury are examples that may prevent MSD. Employers can provide support for employees to prevent MSD in the workplace by engaging employees in planning, assessing, and developing standard procedures that will support appropriate ergonomics and prevent injuries.
One focus of the ergonomic principle is to maintain neutral posture, which is a posture in which the muscles are at normal length and are capable of producing the greatest strength, while reducing stress and possible injury to muscles, tendons, nerves, and bones-hence, work or in everyday life, is ideal for muscles and joints to maintain a neutral position. In addition, to prevent hand, wrist, and finger injuries, to understand when to use pinch grips (best for fine motor control and proper movement with low strength) and grip (best for repetitive high power movements) employees and general duties outside the workplace. The choice of the instrument must be in accordance with the proper grip and conducive to neutral posture, which is important for the entrepreneur to consider when purchasing equipment. To reduce injury to the lower back and spine, it is recommended to reduce the weight and frequency of lifting cycles as well as reduce the distance between the body and the load to reduce the torque force in the back for workers and individuals who make recurring appointments to avoid spinal cord failure. The shape of the raised object must also be considered, especially by the employer, since objects that are easier to grasp, lift, and access present less pressure on the spine and back muscles than objects that are awkward and difficult to access.
The National Institute of Occupational Safety and Health (NIOSH) has issued ergonomic recommendations for several industries, including construction, mining, agriculture, healthcare and retail, among others.
Epidemiology
The general population
MSD is a growing health problem globally, being the second cause of disability. For example, in the US there were more than 16 million strains and sprains treated in 2004, and the total cost of treating MSD was estimated at more than $ 125 billion per year. In 2006 about 14.3% of Canadians lived with disabilities, with almost half due to MSDS. Neck pain is one of the most common complaints, with about a fifth of adults worldwide reporting pain every year.
Workplace
Most MSD episodes in the workplace involve many parts of the body. MSD is the most frequent health complaint by European, US and Asia Pacific workers. and the third major reason for disability and early retirement in the US. The incidence rate for MSDS among residents working in 2014 was 31.9 MSDS newly diagnosed per 10,000 full-time workers. By 2014, median days away from work because the MSDS is 13, and there are 10.4 cases per 10,000 full-time workers where MSD causes a worker not to work for 31 days or more. MSDS is widespread in many jobs, including those with heavy biomechanical loads such as construction and factory work, and those with light loads such as office work. The transportation and warehousing industry has the highest incidence rate of musculoskeletal disorders, with an incidence rate of 89.9 cases per 10,000 full-time workers. The health care, manufacturing, agriculture, wholesale, retail, and leisure industries all have an incidence rate of over 35 per 10,000 full-time workers. For example, a national survey of US nurses found that 38% reported MSD in the previous year, especially lower back injury. The neck and back are the most common sites of MSDS in workers, followed by the upper extremities and lower extremities. The Bureau of Labor Statistics reports that 31.8 new MSDS cases per 10,000 full-time workers per year are due to fatigue, bodily reactions, or repetitive motion.
See also
- Carpal Tunnel
- Human factors and ergonomics
- The human musculoskeletal system
- Lower back pain
- Sprain
- Ischemia-repurfusion injury to the appendicular musculoskeletal system
References
External links
- Musculoskeletal disorder Single Entry Point European Agency for Safety and Health at Work (OSHA)
- Good Practices to Prevent Musculoskeletal Disorders of the European Agency for Occupational Safety and Health (OSHA)
- Musculoskeletal disorder homepage Health and Safety Executive (HSE)
- Dangers and risks associated with manual handling of loads at the Office of the European Agency for Occupational Safety and Health (OSHA)
- National Institute for Occupational Health and Health Musculoskeletal Programs [1]
Source of the article : Wikipedia
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