Upper limb disorders: Occupational aspects of management 2009

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The term ‘upper limb disorders’ covers a large number of musculoskeletal conditions that affect the shoulder, elbow, forearm, wrist or hand.  This national guideline offers evidence-based advice on the management of four upper limb disorders in the workplace: carpal tunnel syndrome, non-specific arm pain, tenosynovitis and lateral epicondylitis (tennis elbow).

The guideline is accompanied by summary leaflets for employers, employees and health care professionals.

Key recommendations

There is a substantial body of evidence regarding interventions for upper limb disorders but, to date, there has been insufficient focus on occupational outcomes in trials of interventions for upper limb disorders.

  • Employers should consider offering computer operators with carpal tunnel syndrome the opportunity to trial different computer keyboards.
  • In workers with non-specific arm pain, who have been absent from work for at least four weeks, multidisciplinary rehabilitation programmes including both physical and psychosocial approaches should be offered, or facilitated, by employers.
  • There is a need for experts in this field to agree consensus definitions of conditions to facilitate further research. When investigators are researching interventions for upper limb disorders, they should address important work outcomes such as sickness absence and job retention. Further work is needed on computer workstations and alternative input devices.

Because of the paucity of high-quality published evidence to address our key questions, we also made a number of research recommendations. These aim to build an evidence base for the workplace management of upper limb disorders.

Who's involved

Organisations

The Faculty of Occupational Medicine

NHS Plus