Determining causation of work-related upper extremity disorders

Area of Science:

• Occupational health
• Biomechanics
• Epidemiology of musculoskeletal disorders

Background:

• Establishing causation for work-related upper extremity disorders requires understanding philosophical constructs and precise definitions.
• Current terminology like 'repetitive stress' may be misleading.

Purpose of the Study:

• To critically evaluate the role of repetition as a causative factor in work-related upper extremity disorders.
• To advocate for a more comprehensive approach to understanding upper extremity pain.

Main Methods:

• Review of philosophical principles of causation.
• Analysis of the preponderance of evidence regarding repetition and physical injury.
• Examination of current terminology used in describing upper extremity disorders.

Main Results:

• The majority of evidence does not support repetition as a significant risk factor for physical injury.
• Existing terms like 'repetitive stress,' 'repetitive strain,' and 'cumulative trauma' lack strong scientific backing.

Conclusions:

• The concept of repetition as a primary cause of upper extremity disorders is not well-supported by evidence.
• Clinicians should abandon terms implying repetition as the main cause and educate patients on multifactorial risks for upper extremity pain.