The impact of smartphone use duration and posture on the prevalence of hand pain among college students.

BACKGROUND: Excessive smartphone usage among students can lead to discomfort in their hands and fingers. This study investigates the impact of smartphone holding posture, duration of usage, and the prevalence of wrist and finger pain among university students. METHODS: This cross-sectional study involved 213 university students who were selected based on inclusion criteria. Data was collected through a demographic information questionnaire. Participants self-reported five different postures for holding and interacting with a smartphone. The prevalence, frequency, severity, and interference of wrist and finger discomfort were assessed using the Cornell Hand Discomfort Questionnaires (CHDQ). RESULTS: The study revealed that the average age of participants was 21.3 ± 2.2 years. On average, they had been using smartphones for 7.9 ± 3.1 years and spent an average of 4.9 ± 2.5 h daily holding them in their hands. In terms of discomfort, more than 25% of students reported pain in areas C (thumb finger), E (Palm Pollicis), and F (wrist) of the right hand, which was significantly related to the duration of holding the smartphone in that hand. Additionally, smartphone holding duration significantly affected areas D (palm) and F of the left hand, with over 11% of students experiencing discomfort. The most prevalent posture among students (41% of participants) involved holding the smartphone with the right hand only, with the thumb touching the screen. Notably, areas B (χ2 = 21.7), C (χ2 = 10.27), D (χ2 = 65.54), and E (χ2 = 59.49) of the right hand, as well as areas C (χ2 = 6.58) and E (χ2 = 44.28) of the left hand, exhibited significant associations with the postures of holding the smartphone. CONCLUSIONS: The duration of smartphone use and the postures in which it is held contribute to the prevalence of discomfort in the thumb area and related muscles among right-handed students.

Therapeutic Interventions for Prevention of Musculoskeletal Pain Among Orthopedic Surgeons.

Orthopedic surgery is a physically demanding specialty. The factors contributing to musculoskeletal injury among surgeons often stem from positioning the patient, using non-ergonomic instruments, maintaining static postures, and performing repetitive movements. This article focuses on exercise techniques intended to combat the most common problematic static postures held during procedures. Each exercise explained in this article is organized into "preop," "intraop," and "postop" components. Preop includes strengthening movements, intraop provides postural recommendations, and postop focuses on mobilization and recovery. This article aims for efficient body conditioning, targeting the muscular posterior chain and supporting elements. [Orthopedics. 2024;47(4):e214-e216.].

Aetiologies of Leg Pain among Patients Presenting to a Vascular Surgery Clinic.

OBJECTIVE: To determine the frequency and pattern of different aetiologies of leg pain among patients visiting vascular surgery clinics. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Vascular Surgery Clinics of the Aga Khan University Hospital, Karachi, Pakistan, between February 2021 and June 2023. METHODOLOGY: This study examined patients presenting with leg pain for the first time at vascular surgery clinics. The socio-demographic and clinical data including the clinical symptoms, physical examination findings, and management of leg pain were noted using a specially designed proforma. RESULTS: In a total of 142 patients (200 limbs), 82 (57.7%) were females and 60 (42.3%) were males, with a mean age of 46.8 ± 15.1 years. The patients' mean body mass index (BMI) was 30.2 ± 7.9 kg/m2. Ninety-one (64.1%) patients had a predominantly standing job compared to 51 (35.9%) patients who had a predominantly sitting job. The most common aetiology of leg pain was chronic venous insufficiency (CVI), diagnosed in 107 (53.5%) patients, followed by neurogenic pain [41 (20.5%)], musculoskeletal pain including knee osteoarthritis [30 (15.0%)], and arterial insufficiency [22 (11.0%)].  Conclusion: CVI followed by neuropathic pain was the leading cause of leg pain in vascular surgery clinics at a tertiary care hospital. KEY WORDS: Chronic venous insufficiency, Arterial insufficiency, Vascular surgery, Leg pain, Musculoskeletal pain, Neuralgia.

[THE MUSCULAR COMPONENT OF FIBROMYALGIA PATHOPHYSIOLOGY].

INTRODUCTION: Fibromyalgia syndrome (FMS) is a chronic pain syndrome, prevalent in women more than men. The main symptoms are widespread musculoskeletal pain, fatigue, and weakness. To date, the pathophysiological mechanisms are unclear, and there are several pathogenic theories elucidating this condition. In this review, we summarized articles published in the past few years, regarding the effect of musculoskeletal dysfunction on FMS. We focused on the musculoskeletal system and central nervous system (CNS) disarrays.

Ergonomic risks and musculoskeletal pain in hospital cleaning workers: Convergent Care Research with mixed methods.

OBJECTIVE: to analyze exposure to ergonomic risks and the occurrence of musculoskeletal pain in workers in the Hospital Cleaning Service. METHOD: Convergent Care Research, with data production designed using mixed methods, implemented with 149 hospital cleaning workers. The methodological strategy of the convergent parallel project was employed, using observation, photographic records, questionnaires and convergence groups. The results were integrated through joint display. Data analysis with descriptive and inferential statistics and content analysis. RESULTS: the mixing of data highlighted the multifactorial nature of exposure to ergonomic risks (uncomfortable work postures; repetitive movements; prolonged orthostatism; use of equipment not adapted to the psychophysiological needs of workers) and musculoskeletal pain in the population investigated. The latter was prevalent in the lumbar spine, ankles or feet, wrists or hands, thoracic spine and shoulders. The concept of ergonomic risk was expanded and was influenced by the psychosocial aspects of work. CONCLUSION: the workers investigated are exposed to modifiable multifactorial ergonomic risks related to musculoskeletal pain. It is possible to promote innovations and teaching-learning actions to minimize them, such as the continuing education program, collectively constructed with recommendations for improvements.

A 3-Year-Old With Gingival Hemorrhage and Musculoskeletal Pain.

A 3-year-old had spontaneous gingival hemorrhage and bilateral limb weakness with inability to bear weight. He had no preceding oral trauma or recent infection, took no regular medications, and had no recent use of aspirin or nonsteroidal anti-inflammatory drugs; his diet was limited to primarily chicken nuggets and milk. What is the diagnosis and what would you do next?

Work-related musculoskeletal pain among physical therapists: a cross-sectional study in Kyoto and Shiga prefectures, Japan.

OBJECTIVES: This study aimed to determine the actual working conditions and prevalence of musculoskeletal pain among physical therapists in Japan, and the risk factors associated with low back pain (LBP) and upper limb pain (ULP). METHODS: A cross-sectional study of physical therapists in the Kyoto and Shiga prefectures was conducted using a self-administered questionnaire. The survey contents included questions regarding personal, work-related, and musculoskeletal pain factors. Logistic regression models were used to analyze factors associated with LBP and ULP. RESULTS: Responses from 1479 participants were included in the analyses. The prevalence of LBP at the time of the survey and in the past year was 40.1% and 74.3% in females, and 37.8% and 69.9% in males, respectively. The prevalence of ULP was 34.8% and 64.2% in females, and 27.2% and 53.3% in males. The numbers of patients who performed manual therapy per day, worked using a fixed-height bed, performed manual therapy, had job dissatisfaction and stress, were over 40 years old, and slept less than 6 hours were associated with LBP and ULP. Assistance task was a risk factor only for LBP, and female sex a risk factor only for ULP. CONCLUSIONS: The prevalence of LBP and ULP among physical therapists in Japan was as high as that in nurses and care workers. Work-related factors associated with LBP and ULP were identified among physical therapists. Thus, to prevent work-related musculoskeletal disorders, measures to reduce the physical burden from the perspective of occupational health are required.

Ergonomic interventions to reduce upper limb musculoskeletal pain during robotic surgery: a narrative review.

There is a high prevalence of upper limb musculoskeletal pain among robotic surgeons. Poor upper limb ergonomic positioning during robotic surgery occurs when the shoulders are abducted, and the elbows are lifted off the console armrest. The validated rapid upper limb assessment can quantify ergonomic efficacy. Surface electromyography and hand dynamometer assessment of strength are the most common methods to assess muscle fatigue. A literature review was performed to find evidence of ergonomic interventions which reduce upper limb musculoskeletal pain during robotic surgery. There is a paucity of studies which have reported on this topic. In other occupations, there is strong evidence for the use of resistance training to prevent upper extremity pain. Use of forearm compression sleeves, stretching, and massage may help reduce forearm fatigue. Microbreaks with targeted stretching, active ergonomic training, improved use of armrest, and optimal hand controller design have been shown to reduce upper limb musculoskeletal pain. Future studies should assess which interventions are beneficial in reducing surgeon upper limb pain during robotic surgery.

A case of NMDAR Encephalitis with muscular pain as the main presentation.

BACKGROUND: Persistent somatoform pain disorder (PSPD) is often the initial diagnosis in patients seeking treatment in psychiatric departments, making it challenging to consider organic nervous system diseases. However, autoimmune encephalitis can present with atypical initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture, with antibody support, plays a crucial role in diagnosing autoimmune encephalitis. CASE PRESENTATION: This report describes a 40-year-old male adult patient who was initially diagnosed with persistent somatoform pain disorder in 2022. The patient reported a reduction in pain while resting on his back. There were no fever or relevant medical history. Despite 8 months of symptomatic treatment, the symptoms did not improve. Moreover, the patient developed confusion, gibberish speech, non-cooperation during questioning, and increased frequency and amplitude of upper limb convulsions. Lumbar puncture revealed elevated protein levels and protein-cell dissociation. The autoimmune encephalitis antibody NMDAR (+) was detected, leading to a diagnosis of autoimmune encephalitis (NMDAR). CONCLUSION: Autoimmune encephalitis (NMDAR), starting with persistent somatoform pain (PSPD), often presents with atypical symptoms and can be easily misdiagnosed. Therefore, it is important to consider the possibility of organic nervous system disease in time, and to test serum or cerebrospinal fluid antibodies to rule out organic nervous system disease after symptomatic treatment of mental disorders is ineffective. This approach facilitates the early diagnosis of autoimmune encephalitis and other underlying organic neurological disorders.

Association between musculoskeletal pain and exposures to awkward postures during work: a compositional analysis approach.

OBJECTIVES: This study aimed to explore the association between arm elevation and neck/shoulder pain, and trunk forwarding bending and low back pain among home care workers. METHODS: Home care workers (N = 116) from 11 home care units in Trondheim, Norway, filled in pain assessment and working hours questionnaire, and wore 3 accelerometers for up to 7 consecutive days. Work time was partitioned into upright awkward posture, nonawkward posture, and nonupright time, i.e. sitting. Within a compositional approach framework, posture time compositions were expressed in terms of log-ratio coordinates for statistical analysis and modeling. Poisson generalized linear mixed models were used to analyze the relationship between arm elevation in upright postures and neck/shoulder pain, and between trunk forward bending in upright postures and low back pain, respectively. Isotemporal substitution analysis was used to investigate the association of pain assessment with the reallocation of time spent in the different postures. RESULTS: Time spent in awkward postures was modest, especially for the more extreme angles (60° and 90°). Adjusting for age, gender, and body mass index, our study suggested that the compositions of time spent by home care workers in awkward postures were significantly associated with pain assessment (P < 0.01). Isotemporal substitution analysis showed that reallocating 5 min from upright posture with arms elevated below to above 60° and 90° was associated with a 6.8% and 19.9% increase in the neck/shoulder pain score, respectively. Reallocating 5 min from a forward bending posture while upright below to above 30°, 60°, and 90° was associated with 1.8%, 3.5%, and 4.0% increase in low back pain, respectively. CONCLUSIONS: Although the exposure to awkward postures was modest, our results showed an association between increased time spent in awkward postures and an increase in neck/shoulder pain and low back pain in home care workers. As musculoskeletal pain is the leading cause of sickness absence, these findings suggest that home care units could benefit from re-organizing work to avoid excessive arm elevation and trunk forward bending in workers.

Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment.

BACKGROUND: Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. METHODS: We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. RESULTS: All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. CONCLUSION: WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

Using teleconsultation for health aspects of computer-based workers in the new normal situation (post COVID-19) of the world.

BACKGROUND: The use of teleconsultation platforms enabling health professionals to provide advice especially in the new normal post COVID-19 situation has increased in both developing and developed countries. This teleconsultation has also expanded beyond that of post COVID-19 application to other purposes such as in the treatment of musculoskeletal pain. OBJECTIVE: The purpose of this commentary is to focus on presenting a feasible guide related to physical as well as psychological aspects in relation to computer based workers that could be taught to the computer-based workers using teleconsultation platforms. METHODS: A multi-criteria search was performed among available guidelines and approaches related to the physical and psychological aspects used for computer-based workers. RESULTS: A continuation of musculoskeletal pain creates a feedforward loop of pain and distress. Several conventional methods exist to manage musculoskeletal pain, however, the new normal situation following COVID-19 has rendered many of these moot, especially in computer based workers and with the increased reliance on teleconsultation platforms. CONCLUSIONS: During the COVID-19 pandemic, individuals were required to stay home due to varying levels of lockdown protocols and provide their usual services using online platforms both increasing sedentary behaviour in computer based workers and limiting the tools available to health professionals. Following in what is now the worldwide new normal post COVID-19 situation, individuals have adapted and accepted that they receive much of their necessary health advice using teleconsultation platforms as well.

Association between ergonomic risk exposures and insomnia symptoms: a mediation analysis of the 5th Korean working conditions survey.

BACKGROUND: This study investigates the relationship between ergonomic risk exposures and insomnia symptoms, using data representative of Korea's general working population. METHODS: Data from the 5th Korean Working Conditions Survey were used for this study. The eligible population (employees) for the current study was 37,026. Insomnia symptoms were estimated using the minimal insomnia symptom scale (MISS) questionnaire. Logistic regression analysis was conducted to explore the association between ergonomic risks and insomnia symptoms. RESULTS: All the investigated ergonomic risks increased odd ratios (ORs) for insomnia symptoms: Tiring or painful positions (OR, 1.64; 95% CI, 1.43-1.88); lifting or moving heavy loads (OR, 2.33; 95% CI, 1.99-2.71); long periods of standing (OR, 1.47; 95% CI, 1.29-1.69); and repetitive hand or arm movements (OR, 1.46; 95% CI, 1.29-1.67). The mediated proportion of musculoskeletal pain was 7.4% (95% CI, 5.81-10.13), and the mediated proportion of feeling of exhaustion was 17.5% (95% CI, 5.81-10.13). CONCLUSIONS: This study provides evidence for the relationship between ergonomic risks and insomnia symptoms, for which musculoskeletal pains and the feeling of exhaustion may be potential mediators.

The Unseen Strain: Investigating the Awareness of Rhinoplasty Surgeons Regarding Their Spine Health.

BACKGROUND: Musculoskeletal pain is a common occupational health problem among surgeons that can affect work productivity and quality of life. OBJECTIVES: The aim of the study was to investigate the prevalence and causes of back pain among rhinoplasty surgeons, evaluate their routine practice, and identify unique risk factors. A further goal was to measure functional disabilities with the Total Disability Index (TDI) questionnaire. METHODS: A structured online questionnaire was distributed to plastic surgeons performing rhinoplasty internationally. The questionnaire comprised sections on biodata, routine practice posture, length of practice, surgical duration, and the history of surgery or hospitalization related to these issues. In the second part of the survey, participants were asked to complete the TDI questionnaire. RESULTS: The prevalence of back pain was reported by 93.6% of surgeons, with low back pain being the most common (76.7%). The average pain intensity for low back pain was 44.8 ± 26.8. The mean TDI score was calculated as 31 ± 12.1, with 58.2% of surgeons experiencing mild to moderate disability. Significant associations were found between musculoskeletal pain severity and disability index and factors such as BMI, exercise, years of rhinoplasty practice, number of surgeries performed per week, and average procedure length. Interestingly, only 16.4% of rhinoplasty surgeons had previous ergonomic training or education. CONCLUSIONS: Musculoskeletal issues related to the spine are prevalent among rhinoplasty surgeons. It is imperative to educate surgeons about this underestimated health problem, provide proper physical rehabilitation targeting ergonomic concerns, and make changes to current practices to address this issue effectively.

Systematic Review of Injuries and Chronic Musculoskeletal Pain Among High-speed Boat Operators.

INTRODUCTION: High-speed boat operators constitute a population at risk of work-related injuries and disabilities. This review aimed to summarize the available knowledge on workplace-related injuries and chronic musculoskeletal pain among high-speed boat operators. MATERIALS AND METHODS: In this systematic review, we searched Medline, Embase, Scopus, and the Cochrane Library Database for studies, published from 1980 to 2022, on occupational health and hazards onboard high-speed boats. Studies and reports were eligible for inclusion if they evaluated, compared, used, or described harms associated with impact exposure onboard high-speed boats. Studies focusing on recreational injuries and operators of non-planing boats were excluded. The primary outcome of interest was the incidence of acute injuries. The secondary outcome measures comprised the presence of chronic musculoskeletal disorders, pain medication use, and days off work. RESULTS: Of the 163 search results, 5 (2 prospective longitudinal and 3 cross-sectional cohort studies) were included in this systematic review. A total of 804 cases with 3,312 injuries sustained during 3,467 person-years onboard high-speed boats were included in the synthesis of the results. The pooled incidence rate was 1.0 per person-year. The most common injuries were related to the lower back (26%), followed by neck (16%) and head (12%) injuries. The pooled prevalence of chronic pain was 74% (95% CI: 73-75%) and 60% (95% CI: 59-62%) of the cohort consumed analgesics. CONCLUSIONS: Despite very limited data, this review found evidence that high-speed boat operators have a higher rate of injuries and a higher prevalence of chronic pain than other naval service operators and the general workforce. Given the low certainty of these findings, further prospective research is required to verify the injury incidence and chronic pain prevalence among high-speed boat operators.

Adverse Health Effects and Perceived Musculoskeletal Pain in the Sawmill Workers of West Bengal, India.

The present study aimed to determine the prevalence of musculoskeletal pain, unfavorable working conditions, and assessment of occupational injuries among sawmill workers. The Nordic Musculoskeletal Questionnaire, measurement of handgrip strength, working environment, and occupational injuries were assessed among 135 sawmill workers participating in the study. The data showed that sawmill workers complained of discomfort (pain) felt primarily in the low back region of the body followed by the shoulders, hands, knees, upper back, and wrist. This study indicated that sawmill workers had less handgrip strength due to more intense manual work than control subjects. Based on the results of this study, it was concluded that sawmill workers were highly affected due to working in an awkward posture with manual material handling for an extended period of time and that these factors may lead to work-related musculoskeletal disorders as well as occupational injuries. Proper training, a proper work-rest schedule, and modifications of some working procedures may reduce injuries and work-related musculoskeletal pain.

Associations between the severity of menopausal symptoms and musculoskeletal pain in postmenopausal Portuguese women.

OBJECTIVE: To analyze the association of the severity of the menopausal symptoms with musculoskeletal pain in Portuguese postmenopausal women. METHODS: A cross-sectional, observational study was conducted on 167 women (63.85 ± 9.36 years). The Menopause Rating Scale was used to evaluate the menopausal symptoms severity, while the Nordic Musculoskeletal Questionnaire was employed to assess the localization of the musculoskeletal pain, and multi-located pain was determined if two or more body regions were affected. Depression (Hospital Anxiety and Depression Scale), age, body mass index (BMI) and physical activity level were considered as potential confounders. RESULTS: A greater severity of the somato-vegetative menopausal symptoms was related to the prevention from usual activities because of pain in the neck, shoulders, elbows, wrists/hands and knees (R2 of Nagelkerke = 0.064, 0.043, 0.074, 0.045 and 0.045, respectively). Associations were also observed between greater age and pain in the knees, ankles and feet (R2 of Nagelkerke = 0.036 and 0.034, respectively), and being physically inactive with upper back pain (R2 of Nagelkerke = 0.060). Higher depressive symptoms were linked to pain in the hip/thighs and knees (R2 of Nagelkerke = 0.067 and 0.085, respectively), as well as being physically inactive was related ton in the neck (R2 of Nagelkerke = 0.053). Only a greater BMI was related to multi-located pain in the last 7 days (R2 of Nagelkerke = 0.041). CONCLUSIONS: The findings of our study showed that, taking into account possible confounders, greater severity of the menopausal symptoms at a somatic-vegetative level was associated with more anatomical regions with musculoskeletal pain.

The impact of procedural activities on musculoskeletal pain experienced by pregnant surgeons.

BACKGROUND: Two-thirds of surgeons report work-related musculoskeletal disorders (WRMD). There is limited data on WRMD symptoms experienced by pregnant surgeons. METHODS: We distributed an electronic survey via personal contacts to attending and trainee surgeons across six academic institutions to assess the impact of procedural activities and surgical ergonomics (SE) on WRMD symptoms during pregnancy. RESULTS: Fifty-three respondents were currently or had been pregnant while clinically active, representing 93 total pregnancies. 94.7% reported that symptoms were exacerbated by workplace activities during pregnancy and 13.2% took unplanned time off work as a result. Beyond 24 weeks of pregnancy, 89.2% of respondents continued to operate/perform procedures, 81.7% worked >24-h shifts and 69.9% performed repetitive lifting >50 pounds. No respondents were aware of any institutional pregnancy-specific SE policies. CONCLUSIONS: Procedural activities can exacerbate pain symptoms for the pregnant surgeon. SE best practices during pregnancy warrant further attention.