Treatment

Work related upper limb disorder (WRULD) requires a multi-disciplinary approach involving a number of medical professionals and active participation by the individual affected over a period of time, often many months. The employer has a key role to play especially in prevention and lessening the impact of the condition.

When individuals have ill-defined upper limb pain, management is often more difficult. A referral to physiotherapy should be made; an exercise programme is important and should include stretching and postural exercises. Localised treatment with heat and/or with ice may also be helpful as may be massage of tender muscles.

If pain is a problem analgesics or other drug therapy may be indicated. Treatment with acupuncture and a more holistic approach may also be considered. Individuals with chronic pain should be considered for cognitive behavioural therapy (CBT) which will include advice on coping strategies and psychological support. Occasionally steroid injections can be considered but where diffuse pain occurs this is often unhelpful. Appropriate periods of rest are required.

Prevention of WRULD

This is best prevented in its early stages before it becomes difficult to control. A combination of several kinds of intervention is often needed to prevent WRULD. Intervention may need to be multidisciplinary.

The following are important in preventing symptoms from increasing.

• Stop movement when symptoms such as pain and fatigue appear (stop using the computer for example).
• Ergonomic measures such as adapted hand tools can reduce the workload on the upper limbs.
• Posture assessment is important and regular breaks are necessary to avoid fatigue.
• A fitness programme and exercise to improve muscle strength and tone is very helpful.

Amended November 2009