I attended an interesting lecture from Dr Ian Winspur, a Consultant Hand surgeon at an OH study day, who works a lot with the symphony orchestra (nothing more repetitive than a violinist practising 10 hours a day)
Hi mantra for management or what he called Industrial Arm Pain (not a fan of the RSI movment)
Was, first ensure causation:
* By strength of association with activity
* Consistency of activity - the activity always causes the pain
* Specificity - what else can cause the pain
* temporality - I have no idea what this bit was and can't remember back to 2009 sorry
* Biological gradient - the more activity the worse the pain
Management
* Early recognition
* Early job modification - rotation of activities etc.
* Precise diagnosis - he suggested a private consult may be worthwhile
* Precise treatment
* Gradual return to work - can take 18 months to get back to normal doing 20 min of the activity 4 times a day and building up. Doing nothing is counterproductive to recovery as it's like being in training, if you don’t use it you lose it and have to keep starting from scratch
* Job security - if they worry they will lose their job the psychological factors will outrun the recovery
Apparently De quervains is common in mothers who carry babies/toddlers pressing on sensitive areas of their arm and doing all those poppers up the front of their jump suits
If the company would have to compensate her it may be worthwhile to get a second and independent opinion but I'd defintely be writing for some answers to your questions.
Sue
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Tracy Turner
Sent: 10 January 2012 08:56
To: [log in to unmask]
Subject: [OCC-HEALTH] quervains tenosynovitis
Good morning
Please can you help with this case which I am finding quite challenging. 32 yr lady working in sausage factory - repetative tasks required. Long history of pain in both wrsits and shoulder. Given restricted role for almost 3 motnhs - no improvement. Given splints to wear at work but I advised she would be best refraining from work as even a light duty role was not allowing full recovery.
S/B rheumatology - diagnosed with quervains tenosynovitis most likely brought on by her repetative work. off work for 6 weeks - light ache in wrists but wants to RTW. discharged by physio. It has been recommended that she RTW with altered duties so that she does not have to make repetative movements for whole shift and to lift less weights. The specialist has said that she is likely to continue to have the symptoms if she keeps injuring her wrists. Has anyone every dealt with an employee with this diagnosis who has sucessfully returned to their original role or would you recommend a permanent transfer to an alternatve role. I dont think there is such a role available in the factory. In my opinion she is unlikely to come under the DDA as every day activities are not affected. Is it RIDDOR reportable?? Please also note that she is clearly not telling her specialist of the support which she has recived just that her Occupational Health Nurse does not want her to work with splints! Do you think it is appropriate to work in a repetative role if she required splints ?? Or do you think that now the injury is improving splints would prevent further exacerbation. Sorry to aks so many questions but I know you are all a knowledgable lot and will help. Thank you.
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