Workers Risk Damage from Repetitive Motion
By Jay Sternickle
Article originally appeared in the Life & Times Magazine
Patriot Newspaper, Hinesville, Georgia
By Jay Sternickle
Article originally appeared in the Life & Times Magazine
Patriot Newspaper, Hinesville, Georgia
When Debra Naill first experienced pain in her hands, while working as a sewing machine operator, she did not think it was unusual. She thought the pain would go away; like the deep aches you get after a hard workout at the gym.
She was new at her job and thought her hands would get stronger as she learned to sew better; repeating the same motions day after day.
But the pain did not go away; it got worse, and Naill's hands got weaker and weaker. After nine months on the job, she was forced to quit—she no longer had the strength in her hands to grip objects. Naill was the victim of a repetitive stress injury.
She was new at her job and thought her hands would get stronger as she learned to sew better; repeating the same motions day after day.
But the pain did not go away; it got worse, and Naill's hands got weaker and weaker. After nine months on the job, she was forced to quit—she no longer had the strength in her hands to grip objects. Naill was the victim of a repetitive stress injury.
As we move into the next century, problems created a workplace that moves at the speed of light, and by high-tech equipment, and are often encountered. One of these “modern” problems is repetitive stress injuries which are the result of overusing muscles and tendons in the fingers, hands, arms, and shoulders. Many family members, like Naill, and soldiers are affected by these injuries.
Any stress to the body too soon, too hard, too long without the body having time to adapt, can cause damage, according to Capt. Steven D. Hunte, chief of Physical Therapy, Winn Army Community Hospital. Small movements can be as crippling as a single heavy exertion.
Anyone who uses their hands, or body, vigorously for prolonged periods of times, in the same motion, may be at risk.. In the past these injuries affected meatpackers and assembly workers, but today's victims more often are computer operators and highly skilled technicians who repeat the same tasks daily. Nearly half of the country's workers, some 45 million, use computers every day.
Any stress to the body too soon, too hard, too long without the body having time to adapt, can cause damage, according to Capt. Steven D. Hunte, chief of Physical Therapy, Winn Army Community Hospital. Small movements can be as crippling as a single heavy exertion.
Anyone who uses their hands, or body, vigorously for prolonged periods of times, in the same motion, may be at risk.. In the past these injuries affected meatpackers and assembly workers, but today's victims more often are computer operators and highly skilled technicians who repeat the same tasks daily. Nearly half of the country's workers, some 45 million, use computers every day.
“But the pain did not go away; it got worse, and Naill's hands got weaker and weaker. After nine months on the job, she was forced to quit—she no longer had the strength in her hands to grip objects.”
Computer operators, cashiers, dental hygienists, assembly-line workers, mechanics, musicians and journalists all share these same injuries.
“Any job with repetitive motion—from a gunner cocking a weapon, to a mechanic tightening the same bolts over and over again—can lead to these type of injuries,” explained Hunte.
The U.S. Department of Labor called repetitive stress injuries the chief occupational hazard of the 1990s. The number of cases reported to the federal government jumped from 23,000 in 1981 to more than 115,000 in 1988. The Occupational Safety and Health Administration called the disorders the occupational illness of the decade; and estimates are that these stress disorders strike more than 185,000 workers a year.
Repetitive injuries can develop whenever there is stress on the hands, arms, shoulders, back, and neck These include tendonitis, tenosynovitis, ulnar nerve syndrome and thoracic outlet syndrome. One of the most common of these injuries is carpal tunnel syndrome.
First Lt. Greg Wattron, chief of Occupational Therapy at Winn, said he sees four to five new cases of carpal tunnel syndrome each week. The injury occurs when nerves in the wrist are compressed.
The wrist is bounded on three sides by bones, and is enclosed by a strong ligament called the flexor retinaculum. The small opening they form is called the carpal tunnel, explained Wattron.
Carpal comes from the Latin word carpus, that means wrist. Through this tiny “wrist” tunnel run eight tendons and the median nerve which provides sensation to the entire hand The tendons are surrounded by thin, fluid filled sacks, called synovial sheaths.
When the finger tendons are overused, these sacks swell with extra fluid to protect tendons from irritation. Normally the carpal tunnel is just big enough to accommodate the finger tendons and the median nerve, but when swelling occurs the nerve can be pressed against the wrist bones or flexor retinaculum, causing pain. Constant swelling can lead to carpal tunnel syndrome.
Repetitive motion, as well as—rheumatoid arthritis, diabetes, thyroid problems, pregnancy, gout, or a injury to the wrist—can all cause swelling or pressure on the median nerve.
The main symptom of the syndrome is numbness and pain—usually in the thumb, index finger, long finger and half of the ring finger (The nerve that controls the pinky finger passes through a different channel in the hand). Pain often radiates up from the wrist to the shoulder.
People suffering from this syndrome experience pain when driving, reading or gripping most objects. Any task that bends the wrist, cutting off the carpel tunnel, and increases swelling, causes pain. The job, or motion, that is at the root of the problem usually causes the most pain.
Patients often awaken in the middle of the night with shooting pain in their wrists. While sleeping, people curl their wrists, closing the carpel tunnel and pinching the median nerve.
The U.S. Department of
Labor called repetitive
stress injuries a major
occupational hazard.
As this “pinching” worsens the hand loses sensation and grip strength is lost. There can be permanent nerve damage. A victim may lose the sense of feeling in their fingertips; more than 25 percent of the body's pressure-sensitive nerve endings are in the fingertips.
In the worst cases the pain becomes so bad victims cannot button a shirt, or even remove a wallet from a pocket.
The worst case Wattron saw was a soldier who had dropped a car battery on their finger. The injury split his fingernail wide open, but it didn't hurt, and he didn't experience any pain for three days after the accident. The soldier had carpal tunnel so bad he couldn't even feel his fingertip. Within a week the soldier had to have surgery.
Cures depend on how advanced the condition has become. Treatments vary from heat packs, anti-inflammatory drugs and ultrasound treatments, to a special surgery that removes part of the ligament compressing the median nerve.
A large number of patients are prescribed wrist splints that limit wrist motions that cause pinching of the median nerve. The splints are worn during work activities and at night to keep the carpal tunnel open.
“We see a lot of the mechanical related MOSs here,” said Wattron. “The most frequent carpal tunnel sufferers we see are not active-duty soldiers, but are pregnant females naturally retain water and the tendon sheaths get inflamed because of that. After they deliver their child the problem usually goes away.”
Some studies have shown that women are two to five times more likely to suffer from these disorders. Many of the patients seen at the clinic are spouses.
“We see four to five new carpal tunnel cases a week, and more often they are female than male,” said Wattron. “The reason I believe that, is because males don't always understand the injury process. They think pain's a normal part of aging, and the injury gets bad before they are seen. I feel there are just as many males with the problem; they are just not a body conscious a females.”
Awareness and education are the keys to solving the problem. Once someone is made aware of the problem, they are more conscious of how they hold their hands and body and that alone can prevent further injury, said Wattron.
“If a computer operator works for six hours
a day, allowing for lunch and other breaks, they can move their fingers in the same motion about 72,000 times during
an average workday.”
“I think public awareness is why we're seeing more of these cases,” explained Wattron. “People have lived with these problems and the pain for years.
“The more 'Oprah Winfrey' talks about it, and the more the subject is in the media the more people come into the clinic for help. They say, 'I've had this problem for years but didn’t realize it until I read an article about it, or saw a tv show about it.”
There are usually simple solutions to these problems, said Wattron, but until the injuries are explained to a patient and they learn how the anatomy works, the pain will continue. Once you understand why these injuries occur, the solutions become common sense, he said. Education is very important.
Awareness of the work environment is another key to preventing the problem. In the days of the manual and electric typewriter, these stress injuries were uncommon. This is because while working at normal typewriters, people took built-in “mini-breaks” to change paper, correct errors and wait for a carriage to return. Any break in a job's motion allows over-worked muscles and tendons a chance to relax.
A worker may type at a rate of 40 words per minute, and perform 12,000 keystrokes per hour. Using modern word processors, this now can be done without ever taking a break.
If a computer operator works for six hours a day, allowing for lunch and other breaks, they can move their fingers in the same motion about 72,000 times during an average workday. Without some kind of change in routine this can cause great stress on fingers and hands.
Studies show that regular breaks trips to the water foundation, taking a break to stretch, or changing tasks periodically—can all reduce the chances of injuries developing. One study of repetitive injuries showed that smokers rarely have these problems. “Smoke breaks” taken throughout the day can create changes in an otherwise repetitive routine. This, however, is no rationalization to smoke; smoking has clearly been shown to be a serious health hazard.
Today's workplace also tends to be more specialized so workers repeat the same types of movements day in and out. In the future we will see more computer use in the military and in the civilian sector, but equipment in the future must also be better designed to be compatible with human use.
Anytime you have a piece of equipment that is not made to “fit” a person, it can put stress on the body, said Hunte. And since people come in all shapes and sizes, it is difficult to find a piece of equipment or work environment that truly “fits” the way a particular person's body works.
“The best thing to do is to modify your work space. Make sure your desk is at the proper work level and you have an adjustable seat,” said Hunte. “Adjustable is the key word, because all of us are a different size, but out chairs and desk are the same size. That is the key to preventing these injuries.”
Family members and soldiers who suspect they have a repetitive motion injury should see their doctor or go to their troop medical clinic for possible referral to the Physical Therapy or Occupational Therapy Clinics.