Public Health Physician - Epidemiologist
Background According to the United States Centres for Disease Control and Prevention (CDC), “Musculoskeletal disorders (MSDs) are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and supporting structures of the upper and lower limbs, neck, and lower back that are caused, precipitated or exacerbated by sudden exertion or prolonged exposure to physical factors such as repetition, force, vibration, or awkward posture”. It is basically a disease of the body’s “locomotor” apparatus, and can affect different parts of the body. It excludes conditions such as fractures, contusions, abrasions, and lacerations, which are basically physical injuries resulting from acute traumatic events like road traffic crashes or falls. Common examples of MSDs include: ligament sprain, muscle/tendon strain, carpal/radial tunnel syndrome, tendonitis, mechanical back syndrome, trigger finger, degenerative disc disease, ruptured/herniated disc, tension neck, among many others. MSDs are major contributors to global disease burden; rated as the second leading cause of disability globally. They are also regarded as the single largest category of workplace injuries, accounting for an estimated 9.5 million working days lost and almost 30% of all worker’s compensation costs. Risks and progression to MSDs Typically, persons exposed to MSDs risk factors complain of fatigue. As the fatigue progresses and outweighs the body’s response mechanisms, a musculosketelal imbalance ensues. With a musculoskeletal imbalance and rapidly progressing fatigue, MSD eventually develops. Basic risks of MSDs are classified into two categories: work-related (ergonomic) risk factors, and individual-related risk factors. Work-related (ergonomic) risk factors: Ergonomics refers to the scientific study of people and their workplace settings; primarily targeted at reducing stress and eliminating injuries/disorders associated with excessive use of muscles, bad posture, and/or repetitive tasks. Ergonomics ensures work spaces, controls, displays, tools, lighting, and equipment are designed to fit the employee´s physical capabilities and limitations. Examples of work related risk factors are: repetitive and/or heavy lifting, bending and twisting, repeating an action too frequently, uncomfortable working position, exerting too much force, working too long without break, adverse working environment, and some psychosocial factors (e.g. high job demands, and time pressures). Individual-related risk factors: These are risk factors occasioned by personal or individual lifestyles. Examples include: bad overall health habits, inadequate rest and recovery, and poor nutrition, fitness and hydration. Increasing age is another individual risk—MSDs are not common in adolescents and young adults, but the risk increases with ageing. Symptoms of MSD Symptoms of MSDs range from mild to severe, which can affect daily living and tasks. Affected persons have reported limited range of motion, and difficulties in accomplishing previous or favourite tasks. At the “early stage”, there may be aching and tiredness of the affected body parts, occurring more during the work shifts but disappear at night and during days off work. As this progresses to an “intermediate stage”, aching and tiredness may occur early at work shifts and persist at night. This may be accompanied with a reduced capacity for repetitive work. At an advanced “late stage”, aching, fatigue and weakness usually persist, even at rest. There is marked inability to sleep and perform light duties. Sometimes, affected persons may progress through these stages in different ways, making it difficult in such instances to determine exactly when one stage ends or the next begins. Staying healthy As noted, MSDs present with recurrent pains, stiff and painful joints, muscle swellings and dull aches. The first pain one experiences is usually a signal to rest the muscles and tendons, to allow for quick recovery. It is also important that you consult your doctor or physiotherapist if pain persists. This is required so that an expert can locate the exact causes of the pain and discomfort, as there may be other causes such as gout, osteoarthritis, or rheumatoid arthritis. The management of MSDs depends on the severity of the condition. Occasional pains may be addressed with exercises as well as pain relievers (please, don’t take these without doctor’s prescription!). Physiotherapy and special occupational therapies may help for advanced cases, as affected individuals can learn techniques to manage pain and discomfort during daily activities. There may also be need for medications (based on the doctor’s clinical assessment) to help reduce associated inflammation and pain. One of the best ways to prevent MSDs is to ensure there is relatively good assessment of our various workplace settings. If you notice the pains are frequently associated with workplace activities (e.g. sitting positions, use of computers, lifting objects, etc), please discuss this with your doctor and human resources, or you personally take extra care to adjust as you complete daily activities. I agree this may be difficult, though. Regular exercises and mild stretching can also help keep bones, joints, and muscles healthy. Back aches can be prevented with well-fitted office chairs and desks. We should also be careful when bending down (preferably, bend down straight to pick objects!). Sleeping on hard mattresses have been useful for many. Lastly, good nutrition, especially fresh fruits, vegetables, and plenty fluids are generally good for the body, and can facilitate quick recovery from MSDs. Conclusion Thank you for reading through this. It is important we fit well to our work environment, and importantly maintain healthy lifestyles.