Health

A missing link in ergo training

December 20, 2000
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Most health and safety professionals agree that a solid ergonomics program starts with basic training directed at both employees and management. As a trainer, you may briefly touch upon medical solutions for the various cumulative trauma disorders (CTDs), but hesitate to go into much detail — probably because you’ve been advised that only medical professionals should dispense medical information. But my personal experiences as both an ergonomic trainer and a recent patient have convinced me that ergonomic instruction must go deeper into the medical aspects of CTDs. I hope sharing my experience will persuade you to do the same.

Puzzling symptoms

As I worked at my desk one morning, I became aware of a slight tingling sensation located under my right ring, middle, and index finger. Because it was not that bothersome, I was not concerned. But I became concerned when 24 hours later, the tingling became a definite numbness.

I knew that the median nerve could be involved when I explained my symptoms to an internal medicine specialist, but I was jolted when I heard the words carpal tunnel syndrome. As a professional, I knew what causes these disorders, and I hadn’t been exposed to any kind of cumulative or singular trauma. Because of my skepticism, the doctor ordered some additional X-rays of my spine.

After checking the X-rays and finding nothing unusual, the physician said he was ordering an EMG to determine if I did indeed have carpal tunnel syndrome. The test involved applying electrical impulses through the nerves of my arm, which was slightly uncomfortable but only lasted about 15 minutes. I had to wait two days for the results.

My doctor’s verdict: carpal tunnel syndrome and a visit to a surgeon. I wanted to see the best surgeon he knew because I was still not convinced that I had a carpal tunnel problem. And I made up my mind that I wouldn’t have surgery until I was absolutely convinced I needed it.

When I went to the surgeon, I took the EMG report with me, but he tossed it aside and said he would make his own determination as to whether or not I had carpal tunnel. He spent about 15 minutes placing my hand, arm, and wrist in various positions and asking me to describe the feelings. He asked me if I had injured myself recently, whether the feeling was more numbness or tingling, and many more related questions.

Then came the diagnosis I was confident he would reach: He was sure I did not have carpal tunnel syndrome. While he wasn’t sure what was wrong with me, he wouldn’t operate. I asked why the EMG indicated I had a carpal tunnel syndrome. He told me that while the tests help with diagnosis, they aren’t always accurate. He said he would send a report back to my doctor and have him take it from there.

Additional tests, physical therapy and various medications did nothing for me. The numbness in my fingers, which also progressed to my shoulder, went away almost as fast as it came. Today, I still don’t know what I had or what caused my problem, or whether I may be affected again. But I’m grateful that I avoided the pain and anxiety of unnecessary surgery and the residual loss of strength in my hand that goes along with this type of surgery.

Lesson learned

This experience has led me to believe that ergonomics training must be more informative about CTD treatments. Better-informed CTD patients are better able to discuss whether the suggested course of treatment, especially if it is surgery, is right for them.

As trainers, we should describe the symptoms of the disorder, the type of tests used for diagnosis, which treatments are indicated, and how often surgery becomes the final procedure. A number of web sites contain a wealth of accepted CTD medical information that can be used as handouts, such as the Medical Multimedia Group site at www.sechrest.com/mmg/.

I think most medical professionals would agree that an early diagnosis and aggressive treatment, along with immediate ergonomic correction of the causing activities, could mitigate and control further symptoms in many CTDs without surgery. We who are involved in ergonomics have a duty to make this information known as best we can.

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