Repetitive Strain Injuries
Repetitive strain injury, as a condition or disease, does not exist. It is merely a descriptive term used for a mechanism of injury, which tends to encompass a number of different injuries and conditions.
Although strain and injury caused by repetitive movement has been a feature of the workplace for years, it did not become a matter of public knowledge or concern until the 1970s. Recently people have made successful compensation claims for repetitive strain injuries.
The following conditions can be caused by repetitive strain, however it is important to acknowledge that they can also incur in people who have not been engaged in repetitive work. Therefore although it is in most cases quite easy to prove that someone has been involved in a repetitive movement at work, it is more difficult to establish causation, i.e. prove beyond reasonable doubt that the condition itself has been caused by the repetitive movement and not as a matter of natural course.
TENOSYNOVITIS
This condition is the inflammation of the lubricate sheath known as the synovium which surrounds and protects the various tendons passing through the wrist and into the hand. A person suffers from true tenosynovitis only when there is inflammation of the synovium. The main cause of true tenosynovitis is secondary to rheumatoid arthritis or tuberculosis, though the condition may be aggravated by repetitive work. The link between repetitive work and true tenosynovitis is widely accepted.
PERI-TENINITIS
This is an inflammation of the junction between the muscle and the thumb extensor tendons on the inner side of the wrist. It is accepted that this condition is directly caused by rapid repeat movements and thus may be caused by repetitive work.
DE QUERVAIN’S SYNDROME
This condition is caused by the thickening of the fibrous sheath of the tendons. It causes constriction of the tendons and occasionally results in actual inflammation of the tenosynovium. It is known to be cause by repeated pinching or gripping with the thumb or repeated ulnar deviation of the wrist. It can also develop spontaneously and it is more prevalent among women than men. Causation will always be an issue and a court is more likely to find repetitive strain as a mechanism of injury if the repetitive strain involved was repeated pinching, gripping or ulnar deviation of the wrist.
TENDONITIS
This is inflammation of the tendons themselves leading to pain and swelling. The tendons can become locked into the sheaths so that the finger may become locked in flexion. This is commonly known as trigger finger. The relation between the condition and repetitive work is controversial. Where a claimant suffers from tendonitis the nature of the repetitive work must be analysed. If it reveals that the material tendon is being repeatedly used to its extremes of movements, again the chances of establishing a link is more likely.
CARPAL TUNNEL SYNDROME
This is a common condition in which the median nerve is compressed in the carpal tunnel. The carpal tunnel is a form of protective covering in the vicinity of the wrist through which all the nerves and tendons pass. Most usually the condition effects women between 45-55 years of age, strongly suggesting as hormonal cause. This is particularly common among data input workers. There is a body of medical literature which demonstrates that repeated use of the hand and wrist is associated with the onset of the condition. However the majority opinion seems to be against the view that carpal tunnel syndrome can be caused by repetitive strain injury.
EPICONDYLITIS (TENNIS ELBOW)
This occurs when the muscle joins the bone at the elbow, causing pain and swelling. It frequently arises spontaneously, without any precipitating factor such as sport or stressful work. However the relationship between repetitive strain and this condition is firmly established. It may be caused by such jobs as repeated hammering, bricklaying and lifting with outstretched fingers under pressure. Undoubtedly, repetition alone is not sufficient to bring on this condition. The work must be relatively heavy, placing strain upon the elbow.
BURSITIS
Inflammation of the saclike cavity situated in places in tissues where friction would otherwise occur. The most common type is prepatellar bursitis which is situated in the front of the patella in the knee area. Commonly know as housemaids knee. The link between repetitive kneeling and this condition is well established.
I cannot emphasise the importance of understanding the importance of a proper diagnosis in repetitive strain injury cases. The vast majority of clients that come and see me seeking leagal advice for compensation claims are already convinced that they have a repetitive strain injury. They were not in pain, they went to work, had a pain ergo, work causes pain, simple! Often the client has been diagnosed by his GP or occupational health as having “RSI”. Often they are on long term sick leave and have little confidence that they will be able to return to their employment. Many of them will have applied for and successfully obtained Industrial Injuries Disablement Benefit as a result of an injury caused at work. There are many other causes of pain that can cause similar symptoms but are not work related. Carpal tunnel syndrome I have already touched upon but we must also discount acute cervical sprain, osteo arthritis, cervical spondylosis, cervical rib, Raynaud’s phenonomen, vibration white finger and fractures of the wrist, scaphoid etc.
However without an appropriate understanding of the cause of their pain and suffering it is very difficult to seek either compensation or rehabilitation.
Another real difficulty in diagnoses is that pain caused by repetitive strain is often defuse. Not all the conditions will be caused by the work but may be naturally occurring and aggravated by the work. Not everyone may develop the symptoms. Many people can work in precisely the same conditions and at the same speed but only one of two will develop such symptoms. Symptoms do tend to develop gradually and often people imagine that it is simply a question of getting used to the job or changes that have been made in the job. The employees approach to repetitive strain injury will vary. Some employees will assume it is repetitive strain and instigate a reporting procedure to their employers. Other employees will ignore the pain for years, in the hope that it will go away naturally.
It is important to emphasise the importance of proper diagnosis in repetitive strain injury compensation cases. Often an individual has been diagnosed by a GP or Occupational Health person as having “repetitive strain injury”. However not all conditions will be caused by the workplace, in some instances they may occur naturally and be aggravated by work. It is also important to emphasise that not everyone in for instance a factory production line may develop problems/symptoms, many people can work in precisely the same conditions and at the same speed, but only one or two will develop symptoms. Symptoms do tend to develop slowly, and people’s reactions to the develop can greatly vary.
There is clearly a wide variety of repetitive strains that employees are faced with at work. In most instances in considering a claim there are three major factors that require to be considered.
1. Force
2. Frequency and duration of movement
3. The awkward posture that may be adopted with the hand, wrist, arm, shoulder or even back.
Occasionally one of the above factors may be responsible for a problem developing, but more often a combination of two or sometimes three. It is when a repetitive effort is repeated throughout a working day, and for a lengthy period of employment, that most instances of repetitive strain injury occur.
The above list of conditions is not exhaustive, and should a person feel that a condition or injury has been caused by a repetitive movement at work, they should look to obtain advice regarding the potential for claiming compensation due to industrial injury.
Although strain and injury caused by repetitive movement has been a feature of the workplace for years, it did not become a matter of public knowledge or concern until the 1970s. Recently people have made successful compensation claims for repetitive strain injuries.
The following conditions can be caused by repetitive strain, however it is important to acknowledge that they can also incur in people who have not been engaged in repetitive work. Therefore although it is in most cases quite easy to prove that someone has been involved in a repetitive movement at work, it is more difficult to establish causation, i.e. prove beyond reasonable doubt that the condition itself has been caused by the repetitive movement and not as a matter of natural course.
TENOSYNOVITIS
This condition is the inflammation of the lubricate sheath known as the synovium which surrounds and protects the various tendons passing through the wrist and into the hand. A person suffers from true tenosynovitis only when there is inflammation of the synovium. The main cause of true tenosynovitis is secondary to rheumatoid arthritis or tuberculosis, though the condition may be aggravated by repetitive work. The link between repetitive work and true tenosynovitis is widely accepted.
PERI-TENINITIS
This is an inflammation of the junction between the muscle and the thumb extensor tendons on the inner side of the wrist. It is accepted that this condition is directly caused by rapid repeat movements and thus may be caused by repetitive work.
DE QUERVAIN’S SYNDROME
This condition is caused by the thickening of the fibrous sheath of the tendons. It causes constriction of the tendons and occasionally results in actual inflammation of the tenosynovium. It is known to be cause by repeated pinching or gripping with the thumb or repeated ulnar deviation of the wrist. It can also develop spontaneously and it is more prevalent among women than men. Causation will always be an issue and a court is more likely to find repetitive strain as a mechanism of injury if the repetitive strain involved was repeated pinching, gripping or ulnar deviation of the wrist.
TENDONITIS
This is inflammation of the tendons themselves leading to pain and swelling. The tendons can become locked into the sheaths so that the finger may become locked in flexion. This is commonly known as trigger finger. The relation between the condition and repetitive work is controversial. Where a claimant suffers from tendonitis the nature of the repetitive work must be analysed. If it reveals that the material tendon is being repeatedly used to its extremes of movements, again the chances of establishing a link is more likely.
CARPAL TUNNEL SYNDROME
This is a common condition in which the median nerve is compressed in the carpal tunnel. The carpal tunnel is a form of protective covering in the vicinity of the wrist through which all the nerves and tendons pass. Most usually the condition effects women between 45-55 years of age, strongly suggesting as hormonal cause. This is particularly common among data input workers. There is a body of medical literature which demonstrates that repeated use of the hand and wrist is associated with the onset of the condition. However the majority opinion seems to be against the view that carpal tunnel syndrome can be caused by repetitive strain injury.
EPICONDYLITIS (TENNIS ELBOW)
This occurs when the muscle joins the bone at the elbow, causing pain and swelling. It frequently arises spontaneously, without any precipitating factor such as sport or stressful work. However the relationship between repetitive strain and this condition is firmly established. It may be caused by such jobs as repeated hammering, bricklaying and lifting with outstretched fingers under pressure. Undoubtedly, repetition alone is not sufficient to bring on this condition. The work must be relatively heavy, placing strain upon the elbow.
BURSITIS
Inflammation of the saclike cavity situated in places in tissues where friction would otherwise occur. The most common type is prepatellar bursitis which is situated in the front of the patella in the knee area. Commonly know as housemaids knee. The link between repetitive kneeling and this condition is well established.
I cannot emphasise the importance of understanding the importance of a proper diagnosis in repetitive strain injury cases. The vast majority of clients that come and see me seeking leagal advice for compensation claims are already convinced that they have a repetitive strain injury. They were not in pain, they went to work, had a pain ergo, work causes pain, simple! Often the client has been diagnosed by his GP or occupational health as having “RSI”. Often they are on long term sick leave and have little confidence that they will be able to return to their employment. Many of them will have applied for and successfully obtained Industrial Injuries Disablement Benefit as a result of an injury caused at work. There are many other causes of pain that can cause similar symptoms but are not work related. Carpal tunnel syndrome I have already touched upon but we must also discount acute cervical sprain, osteo arthritis, cervical spondylosis, cervical rib, Raynaud’s phenonomen, vibration white finger and fractures of the wrist, scaphoid etc.
However without an appropriate understanding of the cause of their pain and suffering it is very difficult to seek either compensation or rehabilitation.
Another real difficulty in diagnoses is that pain caused by repetitive strain is often defuse. Not all the conditions will be caused by the work but may be naturally occurring and aggravated by the work. Not everyone may develop the symptoms. Many people can work in precisely the same conditions and at the same speed but only one of two will develop such symptoms. Symptoms do tend to develop gradually and often people imagine that it is simply a question of getting used to the job or changes that have been made in the job. The employees approach to repetitive strain injury will vary. Some employees will assume it is repetitive strain and instigate a reporting procedure to their employers. Other employees will ignore the pain for years, in the hope that it will go away naturally.
It is important to emphasise the importance of proper diagnosis in repetitive strain injury compensation cases. Often an individual has been diagnosed by a GP or Occupational Health person as having “repetitive strain injury”. However not all conditions will be caused by the workplace, in some instances they may occur naturally and be aggravated by work. It is also important to emphasise that not everyone in for instance a factory production line may develop problems/symptoms, many people can work in precisely the same conditions and at the same speed, but only one or two will develop symptoms. Symptoms do tend to develop slowly, and people’s reactions to the develop can greatly vary.
There is clearly a wide variety of repetitive strains that employees are faced with at work. In most instances in considering a claim there are three major factors that require to be considered.
1. Force
2. Frequency and duration of movement
3. The awkward posture that may be adopted with the hand, wrist, arm, shoulder or even back.
Occasionally one of the above factors may be responsible for a problem developing, but more often a combination of two or sometimes three. It is when a repetitive effort is repeated throughout a working day, and for a lengthy period of employment, that most instances of repetitive strain injury occur.
The above list of conditions is not exhaustive, and should a person feel that a condition or injury has been caused by a repetitive movement at work, they should look to obtain advice regarding the potential for claiming compensation due to industrial injury.
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