Musculoskeletal Disorders - Case Study Example

 Musculoskeletal Disorders Musculoskeletal disorders (MSDs) denote various forms of disorders, injuries or damages that occur to tissues or joints in the back or lower and upper limbs. The commonly affected tissues include tendons, muscles, cartilage, spinal discs, nerves and joints. Commonly affected parts of the human anatomy include the upper and lower limbs as well as the neck, back and shoulders. MSDs are commonly caused by incidences that lead to overworking of the tissues involved. Overworking in this case implies engagement of muscles or supportive tissues in bearing loads and forces that they are originally not designed to bear (CDC, 2012). Musculoskeletal disorders may be caused by multiple factors, but most of them are work-related. Engagement in other non-work related activities such as extreme sporting could also cause MSDs. This assignment focuses specifically on highlighting work-related musculoskeletal disorders and their differential diagnosis. The task uses the review of a case study as a means to build knowledge around MSDs. The case study involves an employee, who has presented chronic, lower back pain, and it is presumed that it is work-related. The worker often does menial jobs involving the lifting of heavy boxes. Diagnosis and deliberation of such cases is essential in improving workplace environments through instituting measures that would improve ergonomics or aid in processing claims for injury. Ergonomics involves scientific studies aimed at studying people and their interaction with work-related environments (CDC, 2012). The main objective of ergonomics is to minimize injuries and stress linked to repetitive body movements, bad posture or muscle overuse. The assessment phase of ergonomics is often followed by the design phase, which seeks to develop tasks, controls, work areas, lighting and tools so as to fit the requirements of employees’ limitations and abilities (CDC, 2012). MSDs are work-related when they result from work-related activities and conditions. Work-related tasks and poor ergonomic conditions may primarily cause MSDs, contribute to their development or exacerbate MSDs. However, these are not always the only causes of MSDs (Noonan & Wagner, 2010). As such, standardized diagnosis and classification is necessary in the case highlighted. The warehouse supervising, health manager should therefore, make a critical evaluation of various factors that are pertinent in determining whether the worker’s MSD is indeed work-related. Firstly, s/he should make a comprehensive evaluation of the present and past work and working conditions. The current work environment and organizational factors may be the primary cause. Factors such as perception, organization, weight, work-related behavior, experience and repetitive rhythms of the patient’s work could possibly affect the development of MSDs (Darragh, Huddleston & King, 2009). The presence of identifiable risk factors at the current workplace could be a strong indicator that the MSD is perhaps work-related (Mehlum et al., 2009). However, it will be prudent to analyze the onset of the problem by objectively interviewing the worker to determine exactly when the problem begun. Temporal relations with periods of exposure prior to the onset are important in determining causal inference. Therefore, the first significant step would be the analysis of the workplace, for presence of potential risk factors and thereafter determining possible exposure times in relation to the onset of the problem (Mehlum et al., 2009). Lack of risk factors and potentially minimal or no exposure could be indicators of the MSD being non-work-related. However, this does not totally rule out the fact that the MSD could be work-related because it may be a result of past work. This is why the review of past work history and working conditions is necessary as part of the assessment (Mehlum et al., 2009). It may not be possible for the health manager to visit past workplaces, but the use of a comprehensive questionnaire structured to elicit responses on past work history can be essential in determining the possibility of an MSD having arisen from past workplaces. The past working environment may have been deficient in terms of ergonomic considerations and thus a possible cause of the problem. If found to be a result of such past workplaces, then, such an MSD may be declared non-work-related with respect to the current workplace (Mehlum et al., 2009). Sufficiency of recovery time between tasks and sessions of work is also an essential determinant of MSDs. Less recovery time, which could be assessed by checking work schedules and tasks involved, can help in revealing whether the MSD is indeed work-related (Mehlum et al., 2009). Short recovery time/breaks between sessions and tasks are probable indicators of potential MSD origins. Therefore, if the worker’s present work schedule has no risk factors, no significant exposure and there is sufficient recovery time, then, the MSD in such a case may not be work-related. Apart from reviewing work-related factors so as to determine causation, it would also be important to consider non-work related factors that may point to causation beyond the workplace. The presence of non-occupational risk factors such as engagement in extreme sporting may be a pointer to the possibility of the MSD being non-work related (Mehlum et al., 2009). This is especially the case if the non-occupational activity bears same rhythmic body moves and engagement of similar muscles and strength levels in a manner akin to the working set up or on an extreme level. Therefore, it would also be very important to check the employee’s engagement in past-time activity. The assessment of the intensity of activities and engagement periods and patterns can help in determining whether the MSD could possibly have been a result of non-occupational engagements. Additionally, there will be a need to assess whether the problem is a result of medical conditions that present signs similar to MSDs. In this regard it will be important to also assess the worker’s past medical history and recommend medical tests. The fact that there is a financial element attached to MSDs, could also lead to falsification of information and non-disclosure of non-occupational activities so as make claims for compensation. As such, it would be prudent to also assess the possibility of such an occurrence in the claims made when conducting the assessment. The comprehensive assessment of all these factors should be sufficient in determining whether the MSD is work-related (Mehlum et al., 2009). 1b. Distinguishing between work-related MSDs and non-work-related MSDs is quite challenging because the two are caused by similar engagements both within the occupational and non-occupational set ups. Workers are often active in their past-times just as they are during their working hours. As such, it is often hard to determine whether the cause of the injury is a result of occupational activities or non-occupational activities. This is often the case because both activities occur interchangeably within the same day as part of the daily routine of activities. These activities involve the use of common muscles and connective tissues and joints. The challenge is often worsened by the fact that there are medical conditions that manifest with signs and symptoms similar to MSDs. These conditions may manifest in a manner that makes them seem like genuine MSDs. For example, lower back pain (LBP), which is a form of musculoskeletal disorder, is common within the workplace set up, just as it is in non-workplace environments. As such, it would be difficult to determine whether and LBP is a genuine MSD or not (Piedrahita, 2006). The fact that occupational and non-occupational activities rely on the same structures within the human anatomy, makes it difficult to determine which activity is to blame. The resultant MSDs are at times a result of a contributory relation of occupational activities and non-occupational activities, which share the use of common structures within the body. In such, cases it would be inappropriate to delineate the specific cause of the problem unless either the occupational or non-occupational activity is stopped. In addition to these challenges, MSDs are often associated with financial claims for injury. As such, most employees may often present MSDs as work-related yet they may be aware of the fact that the MSD is not work-related. This incentive to claim for compensation often leads to non-disclosure of pertinent information that could help reveal the actual cause of an MSD. This is thus part of the reason why it becomes more challenging to determine the actual causes of an MSD in a work-related environment (Noonan & Wagner, 2010). References Centres for Disease Control and Prevention (CDC) (2012). Ergonomics and musculoskeletal disorders, retrieved from http://www.cdc.gov/niosh/topics/ergonomics/ Darragh, A., Huddleston, W., & King, P. (2009). Work-Related Musculoskeletal Injuries and Disorders among Occupational and Physical Therapists. The American Journal of Occupational Therapy, 63(3), 351-62 Mehlum, S. I., Veiersted, K., Wærsted, M., Wergeland, E., & Kjuus, H. (2009). Self-reported versus expert-assessed work-relatedness of pain in the neck, shoulder and arm. Scandinavian Journal of Work, Environment & Health, 35(3), 222-32 Noonan, J., & Wagner, S. (2010). A Bio-psychosocial perspective on the management of work-related musculoskeletal disorders. AAOHcNN Journal, 58(3), 105-14 Piedrahita, H. (2006). Costs of Work-Related Musculoskeletal Disorders (MSDs) in Developing Countries: Colombia Case. International Journal of Occupational Safety and Ergonomics (JOSE), 12 (4), 379–386 Read More