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EDITORIAL |
Unravelling the mystery of work-related upper limb disorder
Academic Unit of Musculoskeletal Disease, University of Leeds, Leeds, UK
Correspondence to: Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK. E-mail: Howard.Bird@leedsth.nhs.uk
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Work-related upper limb disorder (WRULD) remains an enigma [1]. Many rheumatologists attest to the occurrence of symptoms involving various parts of the arm, particularly the hands, wrist and forearm, as a result of overexertion in the workplace, based upon their clinical experience. Orthopaedic surgeons are less convinced, possibly because they see fewer follow-up patients. Often a clearly defined medical symptom is present on both history and examination. Examples are tenosynovitis, epicondylitis and carpal tunnel syndrome. Some have argued forcefully that such specific conditions can be caused by work [2]; others have taken a more balanced viewpoint [3]. Orthopaedic surgeons often argue that such conditions are invariably constitutional, only aggravated rather than caused by the workplace.