Contents
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Glossary of terms that you're likely to hear from medical professionals
and equipment vendors.
Acknowledgements:
Kevin Byrne, MD - CorpMed, LLC;
for use of glossary terms from Ergo Health training software.
The following are general, umbrella terms used to describe a number of specific
injuries resulting from overuse of the body's soft tissues, such as tendons, nerves,
circulatory system, etc.
- CTD
- Cumulative Trauma Disorder
- MSD
- Musculoskeletal Disorder
- OOS
- Occupational Overuse Syndrome
- RMI
- Repetitive Motion Injury
- RSI
- Repetitive Strain Injury, or Repetitive Stress Injury
- ULD
- Upper Limb Disorder
Modifiers Frequently Used in Addition to Above Terms:
- UE
- Upper Extremity
(i.e. UEMSD)
- WR
- Work-Related Upper Limb Disorder
(i.e. WRULD)
- WU
- Work-Related Upper Extremity Musculoskeletal Disorder
(i.e. WUMSD)
Medial Multimedia Group: Patient Education Materials
http://www.sechrest.com/mmg/reflib/ctd.html
Workers Repetitive Injury Support Talk: Repetitive Strain Injuries
http://pages.sprint.ca/wrist/different.html
These are specific injuries that are typically related to the general terms noted
above.
- Adverse Mechanical Tension (AMT)
- Also known as 'neural tension', this is where the nerves running down to your arm have
become contracted and possibly compressed as a result of muscle spasms in the shoulders
and elsewhere. AMT can often misdiagnosed as or associated with one of the other RSIs. It
is largely reversible and can be treated with physiotherapy (brachial plexus stretches and
trigger point therapy).
http://www.demon.co.uk/rsi/amt-adv.txt.
Back Pain
http://www.sechrest.com/mmg/reflib/back/backpain.html
- Carpal Tunnel Syndrome (CTS)
- A condition of inflammation and damage (in severe cases) of the median nerve as it
passes through the so-called "carpal tunnel" in the wrist. This is a space
surrounded on three sides by carpal bones of the wrist and on one side by the flexor
retinaculum or transverse carpal ligament. The median nerve shares the carpal tunnel with
nine tendons which flex the fingers. If these tendons swell from cumulative trauma or
other conditions, such as pregnancy, the median nerve suffers from compression. The
pressure in the tunnel reduces the blood supply of the nerve, causing numbness, tingling,
and pain into the thumb, index, middle, and ring fingers. Eventually, weakness of the
thumb results. Surgery would only rarely be necessary, as early correction of the
offending risk factors nearly always alleviates the problem.
http://www.med.usf.edu/cpe/CTS/index.htm
http://www.geocities.com/CapitolHill/Lobby/2614/carpal.html
http://www.sechrest.com/mmg/ctd/cts/cts.html
http://www.sechrest.com/mmg/reflib/ctd/cts/cts.html
- Chronic pain and Stress
- http://www.geocities.com/CapitolHill/Lobby/2614/stress.html
- Cubital Tunnel Syndrome
- Cubital tunnel syndrome is a condition that affects the ulnar nerve where it crosses the
elbow. The symptoms are very similar to the pain that comes from hitting your funny bone.
The funny bone is actually the ulnar nerve on the inside of the elbow that runs in a
passage called the cubital tunnel! Sometimes this area becomes irritated from repeated
injury or pressure, leading to a condition called cubital tunnel syndrome. Symptoms are
tingling and numbness over the little finger.
http://www.sechrest.com/mmg/reflib/ctd/cubtun/cubtun.html
- De Quervain's Tenosynovitis and Intersection Syndrome
- Pain on the side of the wrist and forearm just above the thumb may be DeQuervain's
Tenosynovitis. This is a common problem that is usually easily diagnosed. Like many other
problems caused by repetitive injury to the hand and arm, this disorder results when the
tendons (and the covering of the tendons called the tenosynovium) become inflamed.
http://www.sechrest.com/mmg/reflib/ctd/deqerv/dqt.html
- Epicondylitis
- A tendonitis of the elbow from excessive, repetitive, or forceful movements of the
wrist. That’s right, muscle-tendon units moving the wrist originate at the elbow.
Lateral epicondylitis occurs at the origin of the lateral epicondyle, the major bony
prominence on the outside of the elbow. This usually occurs from excessive extension of
the wrist or holding the wrist up in extension as a static posture. It can also be caused
by repeatedly creating large divots in the grass while playing golf, and for this reason
is also called "golfer’s elbow." The pain of medial epicondylitis is
located where the wrist flexors originate at the medial epicondyle, the major bony
prominence at the medial or inner aspect of the elbow. This is also known as "tennis
elbow" since forceful overhand shots place stress on this tendon.
- Lateral - http://www.sechrest.com/mmg/reflib/ctd/latepi/latepi.html
Lateral epicondylitis is sometimes referred to as Tennis Elbow - not because only tennis
players get the problem, but because the backhand swing in tennis is a common activity
that can cause the problem. There are many other activities that can result in lateral
epicondylitis - such as painting with a brush or roller, running a chain saw, and using
many types of hand tools continuously. Each of these activities use the same muscles and
can result in lateral epicondylitis when these muscles are overused.
- Medial - http://www.sechrest.com/mmg/reflib/ctd/medepi/medepi.html
Medial epicondylitis is sometimes referred to as Golfer's Elbow - not because only golfers
get the problem, but because the golf swing is a common activity that can cause the
problem. There are many other activities that can result in medial epicondylitis - such as
chopping wood with an ax, running a chain saw, and using many types of hand tools
continuously. Each of these activities use the same muscles and can result in medial
epicondylitis when these muscles are overused.
- Fibromyalgia Syndrome(FMS)
- An underdiagnosed disorder of unknown etiology affecting over 5% of the patients in a
general medical practice and an estimated 2-4% of the general population, women more often
than men. Patients complain that they ache all over. A large number of other symptoms are
often present, particularly fatigue, morning stiffness, sleep disturbance, paresthesias,
and headaches. On examination, areas of focal tenderness called tender points can be
demonstrated in characteristic locations. Most patients can be helped substantially with
treatment. (W.R.I.S.T.
Related Information/Links)
http://www.geocities.com/CapitolHill/Lobby/2614/fibromyalgia.html
http://www.sover.net/~devstar/fmsdef.htm
http://www.sover.net/~devstar/phdefin.htm
"Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual" by Devin
J. Starlanyl M.D. and Mary Ellen Copeland M.A. M.S., copyright 1996 New Harbinger
Publications Oakland CA, 800-748-6273, http://www.sover.net/~devstar/physinfo.htm
FMS is a systemic neuroendocrine condition with, among other things, a disrupted
adrenal-hypothalamus-pituitary axis. It is nonprogressive (although it may seem so),
nondegenerative, and noninflammatory. It is responsible for diffuse body-wide pain, tender
points that hurt but don't refer pain, and sleep disturbances.
- Ganglion or Ganglionic Cyst
- A round, localized swelling of a tendon sheath. They are most common about the wrist and
appear as slightly firm, moveable knobs, usually about one centimeter (1/2 inch) in
diameter. They are very common, even in those who do not use computers (yes there are
still a few holdouts). Ganglia are not dangerous. They sometimes become inflamed, at which
time some anti-inflammation medication is useful (for those who can take these
medications). Surgery should only very rarely be considered as a treatment.
http://www.geocities.com/CapitolHill/Lobby/2614/gang.html
- Guyon's Canal Syndrome
- Guyon's canal syndrome is a common nerve compression affecting the ulnar nerve as it
passes through a tunnel in the wrist called Guyon's canal. This problem is similar to
carpal tunnel syndrome, but involves a completely different nerve! Sometimes both
conditions can be causing a problem in the same hand.
http://www.sechrest.com/mmg/reflib/ctd/gcs/guy.html
- Impingement Syndrome
- The shoulder is a very complex piece of machinery. Its elegant design gives us the
ability to do many things. This design gives the shoulder joint great range of motion but
not much stability. As long as the parts of this elegant machine are in good working
order, the shoulder can move freely and painlessly. An injury to the shoulder, or wear and
tear in the parts of the shoulder, can lead to pain with movement or stiffness in the
shoulder. Many people are probably familiar with the term bursitis. Any pain in the
shoulder is sometimes mistakenly referred to as bursitis. The term bursitis really only
means that the part of the shoulder called the bursa is inflamed. In reality, there are
many different problems that can lead to symptoms from inflammation of the bursa, or
bursitis. Impingement is one of those things that can cause bursitis.
http://www.sechrest.com/mmg/reflib/ctd/impinge/impinge.html
- Intersection Syndrome
- Intersection Syndrome is a painful condition that affects the thumb side of the forearm
where two muscles cross over - or intersect - two underlying wrist tendons.
http://www.sechrest.com/mmg/reflib/ctd/is/intersct.html
- Myofascial Pain Syndrome
- Chronic MPS is a musculoskeletal chronic pain syndrome. It is nonprogressive (although
it may seem so), nondegenerative and noninflammatory. It is composed of many Trigger
Points (TrPs), which refer pain locally or to a distance, and cause other symptoms in very
precise, specific patterns. It seems progressive because each TrP can develop satellite
and secondary TrPs, which can form secondaries and satellites of their own. With treatment
of the TrPs and underlying perpetuating factors, however, these TrPs can be
"reversed" and minimized or eliminated.
http://www.frontiernet.net/~painrel/about.htm
http://www.sover.net/~devstar/cmpsdef.htm
-
- Pronator Teres Syndrome
- Occurs when nerves are compressed between muscles in the forearm right below the elbow.
This compression results when the forearm is repeatedly rotated, especially with wrist
flexion or extension, or with forceful movements.
- Radial Tunnel Syndrome
- Radial tunnel syndrome is a condition that can cause aching in the forearm just below
the elbow. The symptoms of radial tunnel syndrome can be confused with lateral
epicondylitis - or tennis elbow. Radial tunnel syndrome can be difficult to diagnose
because the tests that are available to look for the problem are not very accurate. This
means that your doctor must rely mostly on the history that you give and the physical exam
to make the diagnosis.
http://www.sechrest.com/mmg/reflib/ctd/radtun/radtun.html
Raynaud's Syndrome, white finger
http://www.geocities.com/CapitolHill/Lobby/2614/whitefing.html
Reflex Sympathetic Dystrophy
http://www.geocities.com/CapitolHill/Lobby/2614/rsd.html
RSDHope: http://www.rsdhope.org
- Rotator Cuff Syndrome
- Inflammation of the rotator cuff, a band of tendons from muscles in the back of the
shoulder that course in a narrow slot under the collar bone. Unless posture is correct,
the tendons become pinched or "impinged" by the bones in the shoulder. The
tendons form a cuff at they insert onto the humerus (upper arm bone). Constant reaching
forward for the mouse or keyboard tends to cause or aggravate rotator cuff tendonitis.
Tarsal Tunnel Syndrome
http://www.geocities.com/CapitolHill/Lobby/2614/carpal.html
- Tender Points
- The Copenhagen official Fibromyalgia Syndrome definition states that you must have at
least 11 out of 18 specified tender points to be diagnosed with FMS. Tender points hurt
where pressed, but do not refer pain elsewhere -- that is, pressing a tender point does
not cause pain in some other part of the body.
http://www.sover.net/~devstar/tpdef.htm
- Tendonitis
- An inflammation of a tendon. Repeated tensing of a tendon can cause inflammation.
Eventually, the fibers of the tendon start separating, and can even break, leaving behind
debris which induces more friction, more swelling, and more pain. "Sub-acute"
tendonitis is more common, which entails a dull ache over the wrist and forearm, some
tenderness, and it gets worse with repetitive activity.
http://www.geocities.com/CapitolHill/Lobby/2614/tendonitis.html
- Tenosynovitis
- Inflammation of the tendon sheath surrounding a tendon. A common example is
DeQuervain’s Disease, which occurs at the thumb (radial) side of the wrist. Sometimes
this can result in a creaking sound when the tendon moves inside the inflamed sheath.
Chronic tenosynovitis occurs when the repetitive activity is mild or intermittent: not
enough to cause acute inflammation, but enough to exceed the tendon sheath's ability to
lubricate the tendon. As a result, the tendon sheath thickens, gets inflamed, and you've
got your problem.
http://www.geocities.com/CapitolHill/Lobby/2614/tenso.html
- Thoracic Outlet Syndrome (TOS)
- The Thoracic Outlet Syndrome affects the nerves and blood vessels of the neck and
shoulder. This disorder results from certain working postures which cause the bundle of
nerves and blood vessels to be compressed or stretched. Example postures are: when the
shoulder is pulled down and back, or when the shoulder is raised. Symptoms include
numbness, tingling and burning sensations along the inner arm, forearm, hand and fingers.
Serious damage to the tissues of the hand and arm can result if the condition goes
untreated.
This condition is a very frustrating problem - both for the patient and for the physician.
It is extremely difficult to prove that the diagnosis of Thoracic Outlet Syndrome is
correct, because there is no test that has a high degree of accuracy in showing the
problem. Usually, the diagnosis is made after all other causes of the symptoms have been
ruled out - a frustrating and slow process sometimes!
http://www.sechrest.com/mmg/reflib/ctd/tos/tos.html
http://www.whiplash101.com/thoracic_outlet_syndrome.htm
- Trigger Finger and Thumb
- Trigger finger, and thumb, is a condition affecting the movement of the tendons as they
bend the fingers or thumb toward the palm of the hand. This movement is called flexion.
http://www.sechrest.com/mmg/reflib/ctd/trigger/trigger.html
- Trigger Points
- Trigger Points (TrPs) are found as extremely sore points occurring in ropy bands
throughout the body. They can also be felt as painful lumps of hardened fascia. The bands
are often easier to feel along the arms and legs. TrPs can occur in the myofascia, skin,
ligaments, bone lining, and other tissues. They can be caused by a surgical incision, as
is often the case with abdominal surgery. You have probably never heard of TrPs, yet they
are quite common. Each specific TrP on the body has a referred pain or other symptom
pattern that is carefully documented in the Trigger Point Manuals.
http://www.sover.net/~devstar/trpdef.htm
- Myofascial Trigger Point Therapy
- A therapeutic protocol for the relief and control of myofascial pain and dysfunction.
The goal of treatment is the recovery from or a significant reduction in myofascial pain.
The treatment goal is achieved through a systematized approach consisting of ischemic
compression, location and correction of perpetuating factors, passive and active stretch
techniques and a comprehensive home program. Success may be measured subjectively by the
level of pain reduction experienced by the patient and objectively through increased range
of motion, strength, endurance and other measures of improved function.
http://www.frontiernet.net/~painrel/mission.htm
- Physiotherapy
- This involves mobilizing the neck and upper back, which are usually stiff in cases of
RSI, together with 'neural stretches' to lengthen contracted nerves, which appear to cause
pain in some forms of RSI.
- Trigger Point Therapy
- This is superficially similar to accupressure or shiatsu but also employs stretching and
exercise. It immediately relaxes muscles that are in spasm, and can also help back ache
and migraine. Some physiotherapists practise this in the UK, but a comprehensive book and
self treatment tools are also available from the US.
- Abduction
- Moving away from the body.
- Flexion
- Movement of a joint that generally brings it closer to the midline of the body. When
typing, flexion pulls the wrist downward and curves the fingers. Sit-ups are an example of
flexion of the back. Flexion bends the knee and elbow. The palm is on the flexor side of
the hand.
- Extension
- The opposite movement from flexion. When keying, extension moves the wrist upwards or
back. Extension of the elbow or knee straightens the joint. A "back bend" is an
example of extension of the back.
- Hyperextension
- An abnormal movement beyond the normal limit of extension, such as more than the 180
degrees of extension of the knee or elbow.
- Ulnar Deviation of the Wrist
- Turning the hands out, away from the center of the body. This awkward position is a risk
factor for CTD. It is common in heavy keyboard users, since their elbows are necessarily
out farther.
- Radial Deviation of the Wrists
- Turning the hands inward, toward the center of the body. This is a risk factor for CTD.
- Pronation
- Pronation of the wrists turns them palm side down, as in typing. Supination is the
opposite.
- Supination
- Supination of the wrists turns them palm side up. Pronation is the opposite.
- Pinch grip
- The grip used for a pencil.
- Overspanning
- Opening the fingers our wide.
- Power grip
- The grip used for a hammer.
- Ligament
- A band of collagen fibers that connects bone to bone. An example is the transverse
carpal ligament, which connects two carpal bones at the wrist, forming the roof of the
carpal tunnel.
- Nerve
- Nerves provide sensory, motor, and automatic functions. The arm and hand are served by
the ulnar, median, and radial nerves. Sensory feedback from the fingers affects the
ability to grasp and manipulate items. When this sensory function is impaired, from cold
or nerve compression, our hands become clumsy and manipulations become difficult. The
nerves are a common site for CTDs. Nerve disorders can also be brought on by mechanical
pressure. This pressure can be applied by badly designed tools or leaning against heard
work surfaces.
- Tendon
- A flat fibrous structure in the body that connects a muscle to bone. They are composed
of parallel collagen fibers and because they require little blood supply, they appear
whitish, much like a ribbon. Tendons and tendon sheaths can become irritated from repeated
exertions in certain postures, and from mechanical stress. Tendon disorders can affect the
hand, wrist, elbow and shoulder. Symptoms usually involve a dull ache, with occasional
swelling, in the affected area. Moving or exerting force often makes these symptoms worse.
Recovery from these conditions is often very slow.
- Physiatry
- Physiatry derives from the Greek words physikos (physical) and iatreia (art of healing).
A Physiatrist is a physician who creatively employs physical agents as well as other
medical therapeutics to help in the healing and rehabilitation of a patient. Treatment
involves the whole person and addresses the physical, emotional and social needs that must
be satisfied to successfully restore the patient's quality of life to its maximum
potential.
- Musculoskeletal
- Referring to the muscles, nerves, tendons, ligaments, cartilage, bone, joints, and
spinal discs.
- Muscle Tendon Unit
- All muscles have a tendon at either end to attach to two different bones. The collagen
fibers that make up the tendon also go through the muscle. Although the tendons don’t
shorten as the muscle does when it contracts, they are part of the assemblage which causes
movement.
- Trigger Points
- In neuromuscular training I learned that "trigger points" are highly irritable
places in muscles or connective tissue that are painful and often refer pain to other
sites. They are sites of neurological overload due to injury, overuse, etc. These painful
sites respond positively to many massage techinques. Trigger points can be held at bay or
eliminated entirely by regular bodywork, stretching exercises, lifestyle changes. (CarmenTK@AOL.COM)
- Ba Duan Jin
- These Chinese exercises were invented several thousand years ago and used by monks and
soldiers to improve their strength and health. Ba Duan Jin employs gentle stretching to
stimulate the blood circulation and relieve any aches or pains.
- Chi Kung
- This Chinese discipline, which is related to Tai Chi Chuan, involves standing in certain
positions that enhance the 'chi' or energy. It is very useful for short term pain relief
and long term healing, and can also be used to prevent work-related health problems.
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