A study of wrist pain in industry — theories of causation

Arm pain has been reported in industry as a major reason for absence, particu larly amongst those whose jobs are heavy or repetitive. The purpose of this study was to identify the precise anatomical sites and nature of the conditions affecting industrial subjects. A modular physical examination was devised with an introductory module performed 'blind' to minimize bias, and a series of optional sub-modules to cope with the great variety of conditions.

The results of the examination of 332 subjects (220 with arm pain and 112 with none) demonstrated joint dysfunctions in 60% of 70 subjects reporting wrist pain. Some 20% of the wrist joint dysfunctions were 'hidden', which may explain the reports of 'nil findings'. In contrast to this there were lower than expected frequencies of tendinitis, tenosynovitis and carpal tunnel syndrome.

Theories of causation are discussed together with the implications for industry, and suggestions are made for assessment procedures.