Helliwell P S, Taylor W J
Musculoskeletal Academic Unit, University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK.
Postgrad Med J. 2004 Aug;80(946):438-43. doi: 10.1136/pgmj.2003.012591.
Pain in the forearm is relatively common in the community. In the workplace forearm pain is associated with work involving frequent repetition, high forces, and prolonged abnormal postures. Nevertheless, other factors are involved in the presentation and the continuation of the pain. Notable among these factors are psychosocial issues and the workplace environment-the attitude to workers and their welfare, the physical conditions, and design of the job. Primary prevention may be effective but active surveillance is important with early intervention and an active management approach. Physical treatments have not been extensively evaluated. In the established case, management should be multidisciplinary, addressing physical aspects of the job but also addressing the "yellow, blue, and black flags" which should be viewed as obstacles to recovery. For the worker "on sick" a dialogue should be established between the worker, the primary care physician, and the workplace. Return to work should be encouraged and facilitated by medical interventions and light duty options. Rehabilitation programmes may be of use in chronic cases.
前臂疼痛在社区中较为常见。在工作场所,前臂疼痛与频繁重复、高强度以及长时间异常姿势的工作有关。然而,疼痛的出现和持续还涉及其他因素。其中值得注意的因素包括心理社会问题和工作场所环境——对工人及其福利的态度、身体状况以及工作设计。一级预防可能有效,但积极监测很重要,需要早期干预和积极的管理方法。物理治疗尚未得到广泛评估。对于已确诊的病例,管理应是多学科的,既要解决工作的身体方面问题,也要解决应被视为康复障碍的“黄旗、蓝旗和黑旗”问题。对于“生病”的工人,应在工人、初级保健医生和工作场所之间建立对话。应通过医疗干预和轻体力工作选项鼓励并促进其重返工作岗位。康复计划可能对慢性病患者有用。