Syndromes

Wrist and/or Hand pain

Wrist and/or Hand pain

Carpal Tunnel Syndrome

What is it?
Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on the main nerve that runs through the wrist.

Site/Area of pain
Pain is located at the heel of the hand and may refer to the index, middle and ring fingers.

Type of pain/Symptoms

• Numbness 
• Pins and needles in the thumb, index and middle finger 
• Pain mostly intense at night 
• Shooting/Sharp pain from the wrist 
• Radiated or referred pain into the arm and shoulder 

Most Common Occupational Related Causes

• Carpal tunnel syndrome can be caused by a combination of factors;
• Typing for prolonged periods without rest 
• Forceful and repetitive movements with your hands using the mouse or keyboard 
• Faulty positioning of the keyboard at an increased tilt causing excessive bending of the wrist 
• Size of your hand does not conform to the size of your mouse thereby causing excessive bending forces to the nerves and tendons of the wrist/hand 

Conservative measures of treatment consist of;

• Rest from any positions or movements that make the symptoms worse 
• Non-Steroidal anti-inflammatory medication and ice to reduce the inflammation 
• Wearing a wrist splint, especially at night to keep the wrist in a neutral position 
• Ergonomic review and necessary changes 
• Seek professional advice for optimal treatment option. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes to stretch your hands and upper limb 
• Ultra-Flat, soft touch or split keyboard to reduce finger travel time while typing 
• 3M Joystick or Evoluent mouse to change hand position while mousing 
• Wrist rests for keyboard or mouse use to position the wrist in a neutral alignment and decrease pressure on the nerve at the wrist 
• Wireless IT accessories to reduce drag on upper limb/hand 

de Quervain’s Syndrome (Thumb Pain)

(Other clinical names: as washerwoman’s sprain, Radial Styloid Tenosynovitis, de Quervain disease, de Quervain’s Tenosynovitis, de Quervain’s Stenosing Tenosynovitis or mother’s wrist)

What is it?
A common condition of inflammation around the tendons that control the thumb.

Site/Area of pain
Pain is located at the thumb side of the wrist.

Type of pain/Symptoms 

When condition is severe, catching or snapping with thumb movement or numbness on the back of the thumb and index finger may be experienced.

Most Common Occupational Related Causes
Carpal tunnel syndrome can be caused by a combination of factors;

• Typing for prolonged periods without rest causing toxin build up in hand muscles and tendons. 
• Forceful and repetitive movements with your hands using the mouse or keyboard predisposing finger tendons to fatigue 
• Faulty positioning of the keyboard at an increased tilt causing excessive bending of the wrist. 
• Size of your hand does not conform to the size of your mouse which may predispose the thumb to get overused. 

Conservative measures of treatment consist of;

• Rest from any positions or movements that make the symptoms worse 
• Non-Steroidal anti-inflammatory medication and ice to reduce the inflammation 
• Wearing a wrist/thumb spica splint to offload overused tendons of the thumb (seek professional advice) . 
• Gentle joint mobilisations, wrist and finger stretches as well as strengthening exercises introduced by a professional. 
• Workplace assessment and review recommendations. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes to stretch your hands and upper limb 
• Flat or soft touch keyboard to reduce finger travel time while typing 
• Vertical or Joystick mouse to change hand position while mousing 
• Wrist rests for keyboard or mouse use to position the wrist in a neutral alignment and prevent extreme thumb positions. 
• Wireless IT accessories to reduce drag on upper limb/hand 
• Reduce repetitive clicking by using keyboard shortcuts

Elbow and/or Forearm pain

Lateral Epicondylagia (Pain on the outside of the elbow)

Other clinical names: Tennis elbow, lateral Epicondylitis, Extensor Carpi Radialis Brevis tendinosis/tendinopathy.

What is it?
It is a common cause of elbow pain most often from repetitive stress and thereby small tears to the tendon fibres of the elbow.

Site/Area of pain
Outside of the elbow and top of the forearm and/or sometimes wrist

Type of pain/Symptoms

• Pain on the outside of the elbow when the hand is bent back at the wrist against resistance. 
• Sharp pain while lifting or grasping objects 
• Pain radiating down the forearm when pressing just below the elbow bone on the outside

Most Common Occupational Related Causes

• Typing for prolonged periods without rest causing toxin build up forearm muscles. 
• Forceful and repetitive movements with your hands using the mouse or keyboard predisposing forearm muscles to fatigue Faulty positioning of the keyboard at an increased tilt causing excessive bending back of the wrist. 
• Size of your hand does not conform to the size of your mouse which may force the wrist to become hyperextended. 
• Typing with your elbows and forearms unsupported can create forearm muscle fatigue. 

Conservative measures of treatment consist of;

• Rest from any positions or activity that make the symptoms worse 
• Ice painful area to reduce inflammation and promote healing 
• Obtain clear diagnosis from a professional for optimal management of condition 
• Forearm stabilising brace to offload painful area (seek professional assistance) 
• Workplace assessment and review recommendations. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes to rest hand after prolonged use 
• Joystick or Vertical mouse to change hand position while mousing 
• Flat or soft touch keyboard to reduce finger travel time while typing 
• Wireless IT accessories to reduce drag on upper limb/hand 
• Forearm support to reduce pressure on forearm when typing or mousing.

Medial Epicondylagia( Pain on the inside of the elbow)

Other clinical names; Golfer’s Elbow, Medial Epicondylitis, Pronator Teres syndrome

What is it?
It is a common cause of pain most often from repetitive stress to the common flexor tendon and forearm muscle group that attach to the inside of the elbow.

Site/Area of pain
Inside of the elbow and top of the forearm and/or sometimes inside surface of wrist

Type of pain/Symptoms

• Pain at the inside of elbow is a classic symptom. 
• The pain may increases when flexing the wrist, and may radiate down the forearm. 
• Activities that use the flexor muscles in a bending motion or grasping with the hand can increase the symptoms. 

Most Common Occupational Related Causes

• Typing for prolonged periods without rest causing toxin build up forearm muscles. 
• Forceful and repetitive movements with your hands using the mouse or keyboard predisposing forearm muscles to fatigue 
• Faulty positioning of the keyboard at an increased tilt causing excessive bending back of the wrist. 
• Leaning heavily on the elbows while gripping the mouse forcefully can create soft tissue overload to the common flexor muscle group on the inside of the elbow. 
• Typing with your elbows and forearms unsupported can create forearm muscle fatigue. 
• Size of your hand does not conform to the size of your mouse which may force the wrist to become hyperextended. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes to rest hand after prolonged use 
• Joystick or Vertical mouse to change hand position while mousing 
• Flat or soft touch keyboard to reduce finger travel time while typing 
• Wireless IT accessories to reduce drag on upper limb/hand 
• Forearm support to maintain neutral wrist position and proper forearm support 

Ulnar nerve Neuropathy at the elbow

Other clinical Names: Ulnar Nerve entrapment

What is it?
Ulnar neuropathy is an inflammation or compression of the ulnar nerve, which runs on the inside of the elbow joint.

Site/Area of pain
Inside of the elbow and outer side of the arm and hand near the little finger.

Type of pain/Symptoms

• Pain at the inside of elbow is also associated with numbness and tingling in the outer side of the arm and hand near the little finger.
• Weakness is ever-present in a main muscle controlling wrist movement as grip and dexterity may become affected. 
• Activities that use the flexor muscles in a bending motion or grasping with the hand can increase the symptoms. 

Most Common Occupational Related Causes

• Leaning heavily on the elbows while gripping the mouse forcefully can create compression on the ulnar nerve. 
• Typing for prolonged periods without rest causing toxin build up forearm muscles. 
• Holding phone handset for prolonged period of time can create sustained compression at the elbow and thereby starve the nerve from any oxygen. 

Conservative measures of treatment consist of;

• Rest from any positions or activity that make the symptoms worse 
• Use of nonsteroidal anti-inflammatory drugs to control swelling around the nerve. 
• The use of splints or cushions can ease the discomfort and the stress on the ulnar nerve (Consult professional for proper advice).
• Stabilising brace to offload painful area (seek professional assistance) 
• Obtain clear diagnosis from a professional for optimal management of condition (e.g.: nerve stretches and mobilisation as needed) 
• Workplace assessment and review recommendations. 
• Surgery may be necessary if conservative measures fail. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes to rest hand after prolonged use 
• Joystick or Vertical mouse to change hand position while mousing 
• Flat or soft touch keyboard to reduce finger travel time while typing 
• Wireless IT accessories to reduce drag on upper limb/hand 
• Forearm support to maintain neutral wrist position and proper forearm support 
• Use a headset when on the phone 

Neck Tension Syndrome (Pain in neck and shoulder)

Other clinical names: Trapezius myalgia, “Tech Neck”, Postural related neck pain, cervical strain, Cervical Facet Joint Irritation.

What is it?
Neck pain most commonly as a result of muscular fatigue secondary to overuse.

Site/Area of pain
Pain at the base of the neck and between the shoulders and often radiated into the upper arm.

Type of pain/Symptoms

• Aching discomfort at the base of neck and upper back. 
• Discomfort can be located to one side of neck and shoulder and/or upper arm 
• Headaches due to tension in neck muscles 
• Intermittent muscle spasms in neck muscles 
• Dull pain may refer to the upper limb, elbow, forearm and hands 

Most Common Occupational Related Causes

• Sitting unsupported and leaning forward in chair for prolonged periods 
• Monitor height not in line with seated eye level and/or to far to the side 
• Cradling handset with neck during long phone conversations can compress joint structures thereby causing muscle tension. 
• Insufficient back support from chair 
• Typing with your elbows and forearms unsupported can create neck muscle fatigue. 
• Repetitive head tilting while referring to documents 

Conservative measures of treatment consist of;

• Use of nonsteroidal anti-inflammatory drugs and muscle relaxant medication to subdue muscle irritation and promote relaxation respectively. 
• Use of heat to relieve muscle tension 
• Neck stretches, deep tissue work, joint mobilisations provided by a professional 
• Postural strengthening program prescribed by a professional 
• Workplace assessment and review recommendations. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes and stretch neck muscles 
• Use a Monitor arm or monitor stand to promote optimal monitor height 
• In-line document stand to neutralise neck position and prevent unnecessary head tilting while referring to documents 
• Make sure the chair back is high enough to support the spine while seated and not push the shoulders forward. 
• Headset to promote neutral neck posture during phone use. 

Cervical Radiculopathy (Cervical Disc syndrome, Spinal Stenosis)

What is it?
Injury to the vertebrae or disks in the neck causing a pressure on the nerve roots exiting close to the spine.

Site/Area of pain
Discomfort on one side of the neck and back of the arm, sometimes radiating to the fingers.

Type of pain/Symptoms

• Pain that radiates down into your arms from your neck 
• Pins and needles or numbness in forearm and particular fingers 
• Pain often exacerbated with certain positions of the neck 
• Weakness in your arm is a warning sign that the condition is serious. 

Most Common Occupational Related Causes

• Sitting unsupported and leaning forward in chair for prolonged periods 
• Unnecessary repetitive reaching 
• Insufficient back support from chair forcing neck and spine to slouch 
• Typing with your elbows and forearms unsupported can create neck muscle fatigue and nerve pressure. 
• Cradling handset with neck during long phone conversations can compress nerve structures. 
• Repetitive head tilting while referring to documents can reduce joint space for the nerve exiting the spine. 

Conservative measures of treatment consist of;

• Use of nonsteroidal anti-inflammatory drugs, muscle relaxants to subdue muscle irritation and promote relaxation respectively. 
• Time off work will be necessary to allow healing to occur. 
• Seek professional advice for neck stretches, deep tissue work, and joint mobilisations. 
• Postural strengthening program prescribed by a professional once symptoms settle. 
• Seek professional medical assistance if muscle weakness is evident. 
• Workplace assessment by a professional and review recommendations 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes, avoid prolonged neck positions. 
• Use a monitor arm or monitor stand to promote optimal monitor height 
• In-line document stand to neutralise neck position and prevent unnecessary head tilting while referring to documents 
• Make sure the chair back is high enough to support the spine while seated and not push the shoulders forward. 
• Forearm support to maintain neutral wrist position and proper forearm support 
• Headset to promote neutral neck posture during phone use.

Shoulder and Arm Pain

Thoracic Outlet Syndrome

What is it?
It is a compression injury to the nervous or blood vessel bundles from narrow passageways at the base of the neck passing under your collarbone and into your arm.

Site/Area of pain
Shoulder and Arm

Type of pain/Symptoms

• The arms and hands feel cool and tire easily. 
• Vague, aching pain in the neck, shoulder, arm, or hand. 
• Overhead activities are particularly difficult. 

Most Common Occupational Related Causes

• Sitting unsupported and leaning forward in chair for prolonged periods 
• Unnecessary repetitive reaching (especially, overhead movements). 
• Insufficient back support from chair forcing neck and spine to slouch as the shoulders follow 
• Typing with your elbows and forearms unsupported and shoulders rolled forward can compress nerves and blood vessels in the armpit. 

Conservative measures of treatment consist of;

• Use of nonsteroidal anti-inflammatory drugs to ease the pain 
• Physical therapy can help strengthen the muscles surrounding the shoulder so that they are better able to support the collarbone.
• Postural exercises can help you stand and sit straighter, which lessens the pressure on the nerves and blood vessels. 
• If you are overweight, your physician may recommend that a weight loss program. 
• You will need to change your workstation and avoid strenuous activities. 
• In rare instances, surgery may be recommended if conservative treatment fails. 

Ergonomic Suggestions;

• Take regular breaks every 30-40 minutes, avoid prolonged unsupported sitting positions. 
• Use a monitor arm or monitor stand to promote optimal monitor height 
• Make sure all necessary documentation and equipment are within easy reach. 
• In- line Document stand to neutralise neck position and prevent unnecessary head tilting while referring to documents 
• Make sure the chair back is a high back chair to support the spine while seated and not push the shoulders forward. 
• Forearm support to promote forearm and wrist support while seated  

Lower Back Pain

Low back pain (general)

Clinical names for this condition: Spinal Stenosis, Spondylosthesis, Degenerative Disk Disease

What is it?
Low Back pain is a sudden or gradual onset of pain in the low back. The nature of the condition can be quite complex as many structures around the low spine can contribute to the discomfort.

Site/Area of pain
Pain mostly between the bottom of the ribs and the top of the legs at the back.

Type of pain/Symptoms

• Dull, aching pain in the low back can be constant or movement related. 
• Pain may radiate down into the buttock and sometimes in the front, side, or back of your leg. 
• The pain may become worse with activity or with prolonged sitting. 
• Occasionally, numbness and tingling down the leg and into the foot is most often due to a disc compressing on the nerves exiting close to the spine. 

Most Common Occupational Related Causes

• Conservative treatment is successful in most cases of low back pain 
• Sitting unsupported and leaning forward in chair for prolonged periods can compress discs in the low back 
• Sitting with the legs unsupported or knees higher than hip can slouch the pelvis and strain your back. 
• Insufficient lumbar support from chair or poorly adjusted chair 
• Monitor is too close forcing you to lean forward in order to view the screen. 

Conservative measures of treatment consist of;

• Conservative treatment is successful in most cases of low back pain 
• Use of nonsteroidal anti-inflammatory, analgesics and muscle relaxant drugs can help to decrease inflammation and relieve muscle spasm 
• Short –term rest and activity modification to offload injured structures in the spine. 
• Seek Physiotherapist’s help for manual therapy and exercises to help treat the condition. 
• Workplace assessment and review recommendations. 

Ergonomic Suggestions;

• Avoid prolonged sitting and get up regularly to stretch your spine every 30-40 minutes 
• Find an ergonomic chair with proper lumbar support 
• Make sure monitor distance and height are adequate for task and workstation dimensions. Use a monitor arm or monitor stand to help promote correct set-up. 
• A footrest may be needed to help support lower back by having the feet supported. 

Eyes

Nearsightedness

Clinical names for this condition: Myopia

What is it?
This relates to having good vision up close, but have trouble seeing things in the distance. The image in the distance will look blurred.

Site/Area of pain
Eyes

Type of pain/Symptoms
Poor distance vision

Most Common Occupational Related Causes
Constantly focusing on things close to you (i.e. computers, PDA’s, SmartPhones) 

Conservative measures of treatment consist of;

• Visit an eye specialist for their recommendations 
• Glasses, contact lenses, or surgery may be suggested. 
• Review the ergonomic suggestions below. 

Ergonomic Suggestions;

• After reading for 30 minutes, take a 1 – 2 minutes break and focus on things in the distance to relax your eyes. 
• Make sure there is enough indirect light in your work area, and try to avoid your desk facing a wall. 

Farsightedness

Clinical names for this condition: Presbyopia

What is it?
This relates to having good vision for distance viewing, but have trouble viewing up close. The image up close will look blurred.

Site/Area of pain
Eyes

Type of pain/Symptoms
Poor close vision

Most Common Occupational Related Causes
No definite cause, some people may be born with farsightedness, where others may get it as they get older. 

Conservative measures of treatment consist of;

• Visit an eye specialist for their recommendations. 
• Prescription glasses may be recommended. 

Ergonomic Suggestions;
Exercising your eyes a few times a day by focusing up close and then focusing on something in the distance (at least 10 metres away), and then focusing up close again. 

Astigmatism

Clinical names for this condition: Astigmatism

What is it?
Astigmatism is a form of visual impairment in which part of the vision is blurred, due to an irregularity in the curvature in front of the eye (cornea).

Site/Area of pain
Eyes

Type of pain/Symptoms

• Blurred vision either near or far distances. 
• Headaches 
• Fatigue 
• Eye strain 

Most Common Occupational Related Causes

• Can be heredity and present at birth. 
• Other causes can be from pressure from the eyelids on the cornea. 
• Incorrect posture. 
• Increased close work using your eyes. 

Conservative measures of treatment consist of;

• Visit an eye specialist for an eye exam and their recommendations. 
• Medication and/ or surgery may be recommended. 

Ergonomic Suggestions;

• Check that your posture is correct for your work environment. 
• Take rest breaks every now and then when reading for extended periods of time and use your eyes to focus and different things around you.