RISK FACTORS, CLINICAL FEATURES AND OUTCOME OF TREATMENT OF WORK RELATED MUSCULOSKELETAL DISORDERS IN ON-SITE CLINICS IN INDIAN IT COMPANIES

摘要

BACKGROUND: Work related musculoskeletal disorders (WRMSD's) is a constellation of disorders common in (but not exclusive to) computer users which involves muscle, fascia, tendon and/or neurovascular structures of neck and upper limb; but any part of the body may be affected. The treatment involves physical therapy, workstation assessment and modifications, postural correction and periodic follow-up. METHOD: The prospective study covered 3000 consecutive IT Professionals who attended on-site clinics in various companies in Bangalore and Hyderabad over a 3 year period. Risk factors based on assessment by a Rehabilitation Physician, Physical Therapist and Ergonomist, clinical features, diagnosis, treatment and eventual outcome of WRMSD's were recorded. RESULT: The median age of patients was 26 years and males outnumbered females 4:1.The commonest ergonomic risk factors were lack of appropriate breaks, poor office ergonomics and high organisational stress. The commonest personal risk factors included hypermobile joints, hypothyroidism, hyperuricemia, inflammatory arthritis and Osteoporosis. Common clinical features were persistent discomfort or stiffness of neck and shoulder, fatigue or pain, swelling, skin discolouration, temperature changes, catching or snapping with movement, loss of grip strength or clumsiness of hand, numbness, burning or tingling. Common diagnoses were Myofascial Pain Syndrome (80%), Thoracic Outlet Syndrome (50%), Fibromyalgia (30%), Wrist Tendinitis (8%), Cubital Tunnel Syndrome (5%) and Complex Regional Pain Syndrome (5%). 95% of employees recovered completely, while 5% recovered partially and still had mild discomfort and pain. CONCLUSION: We recommend an on-site clinic for the effective management of WRMSD. The advantages of on-site clinics include: 1.Convenience of employees, saving time and greater compliance, 2. Promoting earlier reporting of symptoms and hence a quicker and easier recovery, 3. Better follow up regarding recovery, work modifications and return to original work, 4. Allows on-site workstation assessment and modifications, 5. Maintenance of recovery by monitoring posture, breaks and exercises, 6. More effective coordination with members of Human Resources, Facilities, Health and Safety team, etc., 7. Improved awareness levels regarding Ergonomics among Management and Employees.