ORIGINAL PAPER
A cross-sectional study of the upper limb non-neurogenic physical findings in computer operators and their relation to pain and neurological findings
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Hospital South West Jutland, Esbjerg, Denmark
(Department of Occupational Medicine)
Online publication date: 2021-04-23
Corresponding author
Jørgen Riis Jepsen
Hospital South West Jutland, Department of Occupational Medicine, Finsensgade 35, DK-6700 Esbjerg, Denmark
Int J Occup Med Environ Health. 2021;34(5):679-91
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ABSTRACT
Objectives: The character of upper limb disorders in computer operators is subject to debate. While nerve involvement is suggested by the presence
of pain, paresthesia and subjective weakness, these symptoms are mainly interpreted as related to pathologies outside the nervous system. Findings in
a previous study involving computer operators indicated peripheral nerve afflictions with specific locations in symptomatic subjects. Based on the same
sample, this study addresses the relation of non-neurogenic findings to pain and neurological findings. Material and Methods: Overall, 96 computer
operators scored their perceived pain in the neck, shoulder, elbow, and wrist/hand on a Visual Analogue Scale of 0–9. They underwent 2 sets of blinded
physical examinations of selected non-neurogenic and neurological items, respectively. The authors analyzed correlations between the scores of each
non-neuropathic finding, and a) mean pain scores for each and all regions, and b) scores for neurological patterns reflecting brachial plexopathy,
median neuropathy (the elbow), and posterior interosseous neuropathy, respectively, and their combination. Kendall’s rank correlation test was applied
for all statistical analyses. Results: A median pain level of 1 or 0.5 was reported by 80 and 57 participants on the mouse-operating or contralateral
side, respectively. Non-neurogenic and neurological findings were frequent. The mean overall pain correlated with palpation soreness of the neck insertions,
and of the trapezius and supraspinatus muscles. Neck and elbow pain correlated with palpation soreness at the neck insertions and the lateral
epicondyles, respectively. Significant correlations on the mouse-operating side were identified between posterior interosseous neuropathy and lateral
epicondyle soreness, and between median neuropathy and any neurological pattern, and trapezius and lateral epicondyle soreness. Conclusions: Pain
correlated with palpation soreness, which again correlated with the neurological patterns. Palpation soreness may be less significant as a marker of
a painful disorder as it correlated no better with regional than with overall pain. The physical examination of computer operators should include
a sufficient neurological assessment. Int J Occup Med Environ Health. 2021;34(5):679–91