Orthopedic problems of the upper extremities. Assessment and diagnosis.

1. Cumulative trauma or repetitive motion disorders are among the most commonly reported occupational illness, and mainly affect the neck and upper extremities. 2. The etiology of cumulative trauma disorders includes nerve compression secondary to inflammation and tendinitis secondary to microtearing at tendon insertions and/or friction irritation of the tendons. 3. Work postures, such as forward flexed position of head, neck, and shoulders; static loading of muscles; as well as repetitive motions can cause cumulative trauma disorders or aggravate pre-existing problems. 4. The occupational health nurse is in a unique position to encourage early reporting of these problems so that conservative treatment can be initiated, identify ergonomic issues at the worksite and institute change, and work closely with the orthopedist to manage clients effectively with clear communication and collaboration.