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Diagnosis |
CUMULATIVE TRAUMA DISORDER (Repetitive Strain Injury)
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| Definition | Cumulative Trauma Disorder (CTD) is a disease of the musculoskeletal system caused by repetitive or forceful motions. It may also be related to sustained or abnormal postures, and poor behavioral health. |
| Details | CTD is also known by a variety of names including repetitive strain injury, repetitive motion injury, and overuse syndrome. The US Bureau of Labor Statistics (BLS) reports that 60% of recordable occupational illnesses since 1991 fall under the heading of "repeated trauma disorders". The BLS also reports that the number of such work related injuries more that doubled in five ears, from 140,000 cases in 1989 to 281,000 cases in 1993. The highest percentage of repetitive motion injuries occurs in the manufacturing sector, where assembly-line work is common. Of 90,000 work injuries from repetitive motion, 12% were attributed to the repetitive motion of "typing of key entry." |
| Causes | Repetitive work such as keyboarding or cashiering may contribute to CTD. Exposure to excessive vibration (jackhammer), extreme prolonged hand positioning (dental hygienist, mouse work), cold work environments, and direct pressure on the nerves may worsen or cause CTD. Poor ergonomic positioning of computers or workstations may also be responsible for the some forms of CTD. Cervical nerve root compression and pain from cervical joints, ligaments, muscles and intervertebral discs can cause symptoms in the upper extremities with or without neck symptoms. Clinical examples include those patients whose pain starts in their arm or whose neck pain disappears and is replaced by arm and or hand symptoms. The pathology underneath the disorder may involve the musculoskeletal or neurovascular system. The specific processes may include microtrauma, inflammation, scar formation, and low blood flow in response to biomechanical forces. |
| Diagnosis | Symptoms of CTD may include numbness, tingling, and or pain in any part of the upper extremity, neck, or back. People with CTD also complain or aching, discomfort, muscle weakness, swelling, and tenderness. Symptoms may vary and move from area to area as well. A thorough cervical evaluation must be done initially to determine the cervical spine's involvement. The most common link between the cervical spine and CTD is called the double crush syndrome, where a compression of the nerve in the neck or shoulder girdle leads to an injury in the arm, forearm, or hand. CTD is not a diagnosis but a term used to broadly describe a number of upper quarter disorders including include muscle strains, myofascial trigger points, thoracic outlet syndrome, carpal tunnel syndrome, tendinitis, arthritis, neuritis, nerve compression, tenosynovitis, and ganglions. Often these terms will be seen in conjunction with a cervical or shoulder diagnosis. |
| Treatment | Nonoperative: If indicated, treatment of the cervical spine may be necessary, possibly including posture education, correction or muscles imbalance, joint or soft tissue mobilization, and neural mobilization. Some of these techniques can be done independently and some should be done under a physical or occupational therapist with experience treating CTD injuries. Correcting workstation set-ups and learning multiple "proper" postures to use throughout the day is often effective in eliminating some of the symptoms. Operative: Surgery is rarely indicated for CTD. It should be considered only for specific anatomic problems that have resisted conservative care. Typically, the results from surgery or less that optimal in CTD. |
| Prevention |
People at risk for CTD or with minor symptoms can prevent or copyright www.emedx.com |