Occupational musculoskeletal disorders.

Musculoskeletal disorders of the workplace include the acute, cumulative and chronic injuries or illnesses of the soft tissues which are caused by mechanical stress, strain, sprain, vibration, inflammation, or irritation. The successful management of occupational musculoskeletal disorders must account for workplace conditions (ergonomics and work practices), psychosocial factors, diagnostic uncertainties, and the need for active modalities (exercises and a progressive increase in activities of daily living), rather than passive (bed rest and traction). Although most occupational musculoskeletal disorders respond to conservative measures such as ice or heat, protective devices such as, neutral splints for carpal tunnel syndrome, nonsteroidal anti-inflammatory drugs, and progressive strengthening, resolution may take months. Prevention is often more important than treatment, and may entail workplace revisions and special worker training. Worker selection programs--strength testing, pre-placement radiographs, and inquiries about prior low back pain--have poor predictive value.