Feeling Sore After Work?
The aches and pains we experience often are the not the simple and inevitable result of getting old. Frequently, chronic joint pain results from our work. With the exception of sleep, we spend more of lives working than we spend on any other activity. And when it comes to jobs that require the same motion, over and over, this repetition causes damage. Called repetitive use injuries or cumulative trauma, these injuries most frequently occur in the wrist, elbow, knee, shoulders, neck or back.
Work does not have to be strenuous in order to cause damage. Even jobs that are not physically demanding cause injuries to our bodies. For example, secretaries can develop lower back pain. Drivers can suffer knee injuries from the repeated flexing required to operate the pedals. Just like injuries caused from falls and other accidents, workers' compensation is available to help people whose repetitive use injuries render them unable to ultimately perform their jobs.
Below, we describe the more common repetitive traumas that employers often dismiss as old age but, in fact, often are caused by work. Following these descriptions, we will provide some information regarding the rights of workers afflicted by these conditions in Pennsylvania.
A misnomer, most people who develop tennis elbow have pain at the elbow as well as other portions of the forearm. Doctors refer to this condition as “lateral epicondylitis”. Lateral epicondylitis occurs when the tendons near the elbow are overused and become inflamed. The inflammation ultimately degenerates the tissue. Because the tendons of the elbow are involved when the hand is used, the wrist is moved and the forearm rolled, they can become overloaded in a person who repeatedly grips, lifts, twists, reaches or throws. When two motions are combined, such as bending the wrist while rotating the forearm, injuries are even more likely to occur.
Lateral epicondylitis appears in a variety of circumstances. Many times the symptoms will begin with a slight ache that gradually worsens over time as a person performs the same repetitive movement at work. Other persons will experience a sudden onset of the disease after starting a new job or different type of work. Treatment options range from simple rest to surgery for more severe cases of the disease. Unfortunately, surgery does not always improve an afflicted person’s symptoms.
Shoulder Impingement Syndrome
Chronic shoulder pain is not normal and most often results from trauma due to overuse or traumatic injury. Common in those whose work requires them to do significant overhead work, impingement syndrome occurs when the rotator cuff tendons and bursa become inflamed. As the condition persists, the tendons begin to thin and then rip resulting in a rotator cuff tear. Symptoms typically include difficulty reaching up and behind, pain when moving the arm overhead and weakness in the muscles. Common workplace activities that cause the syndrome include lifting, painting, welding, construction and electrical outfitting.
Mild cases of shoulder impingement are treated by avoiding overhead activity while taking anti-inflammatory medications. Arthroscopic surgery may be necessary for more severe cases of impingement or where the shape of the shoulder’s bones contribute to the severity of the symptoms. Shoulder impingement can be a life changing injury. If your work requires frequent use of your arms while extended, your shoulder’s condition could prevent you from ever being able to return to your work without experiencing pain.
Unfortunately, it is not uncommon for persons suffering from shoulder impingement and/or rotator cuff injuries to develop problems in both shoulders. This results because persons with an injured shoulder tend to compensate for their injury by using their other arm much more than they otherwise would. This overuse of the "good" arm can lead to that shoulder becoming injured as well.
Commonly caused by repetitive stress, knee arthritis occurs when the cartilage between the leg and knee bones becomes worn and torn. Typical symptoms include pain and tenderness, inflexibility, stiffness when standing and walking and grating sounds when the knee is flexed or bent. Jobs that contribute to the deterioration of knee cartilage include those that require driving, repeated squatting, kneeling (with or without heavy lifting), climbing stairs and walking.
Arthritis is a permanent and irreversible condition because the cartilage between the bones will not grow back. Treatment of knee arthritis also involves rest and the use of anti-inflammatory medications. Your doctor may also instruct you to wear a knee brace in an effort to reduce the pressure to the afflicted area. Severe cases of knee arthritis require surgery, including arthroplasty.
Spinal Disc Herniation
Between each vertebrae of your spine sits an intervertebral disc. Discs are soft and compressible; their purpose is to act as a shock absorber for the spine. Each disc consists of an outer ring, referred to as the annulus fibrosus, and a soft central portion, referred to as the nucleus pulposus. A herniated disc occurs when there is a tear in the outer ring, and the soft center of the disc protrudes through the tear. As we age, intervertebral discs lose fluid making them less flexible and thinner. This process is known as degenerative disc disease. As the discs lose their fluid and flexibility, they become more susceptible to injury. Hence if your job exposes your intervertebral discs to wear and tear, you are at risk of developing a herniated disc. Occupations that are known to wear down and tear discs include those that require constant sitting or squatting. Persons whose jobs require frequent lifting are also particularly prone to suffering a herniated disc In fact, sitting and bending to lift can increase the pressure on a spinal disc by a factor of 15 or more.
Herniated discs most often occur in the lower (lumbar) back, although neck (cervical) injuries are also common. Lumbar symptoms include sciatica (pain, burning and numbness radiating down the leg) as well as low back pain. Cervical symptoms can include pain in the neck and radiating pain and numbness down the arm. Your doctor may refer to this radiating pain as radiculopathy, which can result from the herniated disc causing pressure on a nerve root leaving the spinal cord. This pressure frequently is referred to as nerve root impingement.
While the majority of instances resolve within a few months, approximately 15% of persons afflicted will not recover from their back pain. Care for a herniated disc begins with conservative treatment including rest, physical therapy and anti-inflammatory drugs. If conservative treatment fails, then surgery may be recommenced, particularly for persons who experience sciatic or radicular pain.
Cubital Tunnel Syndrome and Carpal Tunnel Syndrome
Both of these diseases are caused by increased pressure upon the nerves of your hand. Carpal tunnel syndrome occurs when the tunnel the median nerve travels through in the wrist narrows. The disease often begins as an ache in the wrist that extends into the hand or forearm. Often, persons afflicted notice tingling and/or numbness in their thumb and index, middle or ring fingers. They may also drop objects more frequently than they had in the past. Work-related factors include repetitive wrist work, forceful exertion, posture and vibration.
There is some dispute as to whether repetitive motion causes this disease. For this reason, more and more employers are denying carpal tunnel claims carte blanche and leaving injured workers to fend for themselves. Any one who has ever experienced the disease, however, will tell you that repetitive activity worsens their pain. An injury or disease does not have to be caused by your work in order to be covered by workers’ compensation in Pennsylvania. So long as one’s employment aggravates a pre-existing disease, the disease is a compensable work injury.
Cubital tunnel syndrome, on the other hand, develops from increased pressure on the ulnar nerve in the area of elbow commonly referred to as the “funny bone”. Early symptoms of cubital tunnel include elbow pain and tingling in the ring and little fingers. As the disease progresses, the hand can weaken and even become deformed. Activity that requires frequent bending of the elbows, especially if combined with twisting, causes this disease. Persons working desk jobs are also susceptible to this condition if they lean on their elbows frequently.
I think I might have a repetitive injury, what should I do?
Workers with chronic pain should carefully review their working conditions. If these conditions involve repetitive movements or stresses to the area of their body where they suffer pain, then it is likely they are suffering from a compensable work injury. Those workers are strongly advised to seek medical advice from their physician, as well as to seek legal advice from an experienced workers' compensation attorney.
If you or someone you know is experiencing chronic pain that may be related to work, please call Kobylinski + Kobylinski if you have any questions or concerns. We never charge a fee for initial consultations, and we can provide legal assistance on a contingent basis—meaning you will never have to pay us a fee unless and until we obtain a monetary award.
Canadian Centre for Occupational Health and Safety
© Copyright 2013 Kobylinski + Kobylinski, a Limited Liabilty Corporation. All Rights Reserved. Authored by David M. Kobylinski, Esquire.