clinical ergonomic job analysis and consultation: Facilitating work reentry in a case with upper extremity cumulative trauma-related disability

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Abstract
The management of work-related recurrent and chronic upper extremity cumulative trauma disorders (UECTDs) represents a challenge particularly when return to work is a treatment goal. Many of these work-related UECTDs may be the consequence of exposure to such physical stressors as repetition, excessive force, awkward and sustained posture in addition to psychosocial stressors in the workplace. Pain and associated disability can be exacerbated by these ergonomic and psychosocial stressors. The application of ergonomic principles and techniques in the context of clinical management of UECTDs may assist in efforts to return the injured worker to work and reduce the likelihood of increased symptoms, discomfort, and disability. This paper presents a case of a 43-year-old dental hygientist unable to work for a period of 2 months due to recurrent episodes of pain in the neck, right shoulder, and arm radiating to the right thumb experienced episodically over a 10-year duration. The case is presented to illustrate the application of ergonomic principles and techniques in the clinical management of a chronic episodic UECTD. The implementation of an ergonomic job analysis and subsequent ergonomic interventions at the workplace that occurred in conjunction with rehabilitation was associated with anecdotal improvements in pain, function, and comfort levels upon returning to work. While the case highlights the potential utility of ergonomics in the management of an occupational musculoskeletal upper extremity disorder, the need for reliable, valid, cost effective, and time efficient methods to assess ergonomic exposure within a clinical context remain to be developed.