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Work related upper limb disorders: getting down to specifics
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Musculoskeletal disorders of the upper limb and neck are a common cause of morbidity, and in some occupational groups they contribute importantly to loss of time from work.1-5 Community-based surveys have indicated point prevalences of 4-20% for pain at specific sites in the neck and upper limb,6-9 with lifetime prevalences as high as 60%. Morbidity surveys in primary care have found an annual incidence of first consultation for upper limb disorders of approximately 25 per 1000 person years, with rates increasing from 25 to 45 years of age and then levelling off.10
Upper limb pain may arise from discrete pathological conditions,
such as adhesive capsulitis, rotator cuff tendinitis, lateral epicondylitis, and tenosynovitis, or as part of non-specific regional pain syndromes. However, few community surveys have included a clinical
examination as an integral component, to enable a distinction to be
drawn between these very different categories of disorder. Furthermore,
the relative contribution of specific and
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