The most common condition for which workers’ compensation claims are lodged are Musculoskeletal Disorders. In 2012/13, musculoskeletal disorders made up over 90 percent of all serious claims in Australia (Safe Work Australia, 2013).
Musculoskeletal injuries can be classified in four ways:
- Acute: Acute injury with specific event.
- Cumulative: Impairment built up over time with no particular event.
- Chronic: Long term problem without recent specific event.
- Acute on Chronic: Acute exacerbation of a long standing problem, with a recent specific event.
In roles that involve significant manual handling, the most commonly seen injuries are acute and cumulative, attributable to either the high load or repetitive nature of the tasks undertaken.
What are the most common injuries?
Lower back injuries make up the large majority of work-related injuries. They can range from less serious muscle strains, or joint sprains, to more serious injuries such as disc prolapses, commonly known as “bulges”. When large enough, these prolapses can compress or inflame nerves in the lower back, leading to referred pain or symptoms such as pins and needles, numbness or weakness in the lower limbs. These injuries can occur from a traumatic event, but can just as often result from something as innocuous as rotating to reach for something, bending to tie a shoe lace, or picking up something unexpectedly heavy or awkward. Lower back pain can also gradually come on over time, and is usually associated in these circumstances with repetitive bending and/or twisting with load.
At the opposite end of the spine, neck injuries can often stem from stiffness or overloading of the joints and muscles of the neck. Over time, these structures can become the source of pain. Poor posture, inappropriate workstation set up, repetitive reaching or rotating, and sustained neck flexion (i.e. looking down) are all major contributing factors to the development of neck pain.
Another common complaint in the manual handling setting is shoulder pain. Shoulder joints are built for mobility over stability, and are therefore more susceptible to injury if subjected to high forces or when moving into awkward positions. Muscular strains in the shoulder can be acute/traumatic, or occur as “wear and tear” over time. Acute muscular strains often occur when a worker is lifting/pushing/pulling a heavy load in an awkward position – i.e. away from the body or above shoulder height. Shoulder “Impingement” is a common cumulative condition in which a tendon becomes pinched and compressed in the front of the shoulder. The condition can generally worsen over time if the cause of the problem is not addressed. Causative factors include muscular imbalances or weakness, bony spurs, and repetitive overhead reaching.
Most manual handling jobs require either heavy and/or repetitive gripping, and it is the muscles in our forearms that provide the strength to grip. If these muscles are overworked, it can lead to the development of tennis elbow or golfers elbow injuries. These conditions, known as epicondylalgia, occur when the muscle tendons of the forearm pull on their attachment to the bone at the outer side or the inner side of the elbow. They commonly occur when a worker is not accustomed to a load: e.g. when new to a job or when returning from leave, during a particularly busy time or when a worker may be working more hours than normal. As you can see, tennis elbow and golfers elbow are conditions that affect workers in manual jobs just as much as athletes!
Other slightly less common, but equally as serious, injuries include: Joint sprains associated with slips, trips and falls, i.e. ankle, knee or wrist; and repetitive strain injuries involving the wrist and hand.
What can be done?
There are many strategies for reducing the risk of musculoskeletal injury in the manual handling workplace! Follow this link to find some handy tips recommended by Axis Physiotherapist – Sam Hutchins.
Safe Work Australia. (2014). Australian Workers’ Compensation Statistics 2012-13.