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Nurses who work in hospitals are exposed to various occupational hazards and are recognized as having high rates of musculoskeletal pain. This study aims to estimate the level of exposure to work-related hazards for nurses working in hospitals and derive factors that affect back pain, upper limb pain, and lower limb pain. This study was conducted on 462 nurses from the 6th Korean Working Condition Survey (KWCS) data, deriving exposure time related to physical, biochemical, and ergonomic hazards. Also, using binomial logistic regression analysis, this study determines the factors influencing musculoskeletal pain by comprehensively considering work-related factors and physical, biochemical, and ergonomic hazards. The exposure time for standing is the highest, followed by repetitive movements, awkward postures, patient lifting/carrying, infection, heavy object handling, and vibration. The average exposure times to occupational hazards were higher for nurses experiencing pain in their back, upper limbs, and lower limbs than those without pain complaints. Factors that contribute to back pain include years of work experience (p = 0.002), type of healthcare establishment (p = 0.001), exposure level to vibration (p = 0.029), and awkward posture level (p < 0.001). Factors affecting upper limb pain include the type of shift work (p = 0.013), handling heavy objects (p < 0.001), awkward postures (p = 0.033), and repetitive movements (p = 0.002). The factors that influence lower limb pain are awkward posture (p = 0.001), patient lifting/carrying (p = 0.002), and repetitive movements (p = 0.006). This study emphasizes the importance of implementing strategies to improve occupational hazards to prevent or alleviate musculoskeletal pain. These findings provide practical guidance for managing risk factors and preventing musculoskeletal disorders among nursing professionals. [ABSTRACT FROM AUTHOR]

Background: Tight filum terminale is a rare and challenging condition to diagnose because it presents with nonspecific symptoms and unclear imaging findings. This report documents an atypical case of tight filum terminale. Case presentation: The patient was a previously healthy Asian 18-year-old male presenting with recurrent upper extremity and back pain, initially treated as nonspecific musculoskeletal pain. Notably, the patient's symptoms were inconsistent with the dermatome, showing no correlation with his skin's sensory innervation areas. In contrast to typical tight filum terminale presentations focused on lower extremity and lumbar region disturbances, this patient experienced pain and weakness predominantly in the upper extremities and back, hypothesized to result from traction myelopathy exacerbated by thoracic disc herniation. Investigations including blood and nerve function tests were inconclusive. However, a magnetic resonance imaging scan revealed a combination of tight filum terminale and tiny thoracic disc herniation. A diagnosis of tethered spinal cord syndrome was confirmed following further tests and imaging. The filum terminale was surgically removed, resolving the symptoms at a 7-month follow-up. Conclusions: This case underlines the importance of including tight filum terminale as a differential diagnosis in cases of unexplained upper or lower extremity pain. Primary care practitioners, particularly those managing undefined symptoms, should consider tight filum terminale in their diagnostic approach. [ABSTRACT FROM AUTHOR]

Background: Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain and most frequently utilised for Failed Back Surgery Syndrome (FBSS). BurstDR™ also known as DeRidder Burst-SCS, a novel waveform, has demonstrated superiority to conventional tonic stimulation of the thoracic spine in FBSS. There are case reports of an improvement in multidimensional pain outcomes using DeRidder Burst-SCS in the cervical spine for chronic neck and cervical radicular pain. The safety and efficacy of cervical DeRidder Burst-SCS stimulation still however remain undetermined. Methods/design: This is a prospective, multicentre feasibility trial evaluating the safety and therapeutic efficacy of DeRidder Burst-SCS stimulation for the treatment of chronic intractable neck pain with or without radiation to the arm, shoulder, and upper back. After baseline evaluation, subjects will undergo an SCS trial using the Abbott Invisible Trial system according to standard clinical procedures. During the trial phase, SCS leads will be implanted in the cervical epidural space. At the end of the SCS trial, subjects experiencing at least 50% pain relief will be considered for permanent implant. Pain intensity, medication usage, and other multidimensional pain outcomes will be collected. The timing of these will be at baseline, end of the SCS trial and at 3-, 6-, and 12-month visits. Incidence of adverse events will be collected throughout the study duration. Discussion: The results of this feasibility study will validate the efficacy and safety of DeRidder Burst-SCS stimulation in the cervical spine. The results obtained in this study will potentially be used to generate a level 1 evidence-based study with formal statistical hypotheses testing. Trial registration: www.clinicaltrials.gov Identifier: NCT03159169. [ABSTRACT FROM AUTHOR]

Purpose: Being able to transfer in and out of their wheelchair is an important task for wheelchair users that can be affected by a variety of different factors. The aim of this study was to investigate the interplay between personal characteristics, wheelchair users' transferring technique and the other factors that can affect the performance of wheelchair transfers. Method: A cross-sectional survey study was designed to recruit wheelchair users, aged 18 or older, performing sitting-pivot or standing-pivot wheelchair transfers, independently or with assistance. Results: Forty-two usable surveys were returned. Transferring technique is usually determined by the individual's impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The presence of upper limb pain increased the difficulty reported for certain types of transfers while the use of assistive technologies appears to be only partially successful in facilitating the performance of wheelchair transfers. Conclusion: This study highlights the complexity of the factors included in the performance of wheelchair transfers. Findings from this survey can be utilized to broaden the boundaries of future research. Transferring technique is usually determined by the individual?s impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The performance of wheelchair transfers exacerbate the painful symptomatology of the person, regardless of their medical condition or transferring technique. The presence of pain increases the reported difficulty of wheelchair trasnfers. Use of assistive technologies during transfers is linked to the increased body weight of the person, while the choice of the type of assistive technology seems to be dependent of the transferring technique used by the person. Overall, available ATs are only moderately effective in enabling people to perform wheelchair transfer and they can be cause of frustration for the users due to their high cost and limited functionality. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers. Methods: Institution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05. Results: The overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders. Conclusions: A higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers. [ABSTRACT FROM AUTHOR]

Background: Recent research has suggested that wide international variation in the prevalence of disabling regional pain among working populations is driven largely by factors predisposing to musculoskeletal pain in general and not specific to individual anatomical sites. We sought to confirm this finding, using data from an independent source.Methods: Using data from the fifth (2010) and sixth (2015) European Working Conditions Surveys, we explored correlations between the one-year prevalence of pain in the back and neck/upper limb among people of working age across 33 European countries, and between changes in pain prevalence at the two anatomical sites from 2010 to 2015.Results: Each survey recruited ≥1000 participants per country, response rates ranging from 11 to 78%. In 2010, the estimated one-year population prevalence of back pain ranged from 23% in Ireland to 66% in Portugal, and that of pain in the neck/upper limb from 25% in Ireland to 69% in Finland, the prevalence of pain at the two anatomical sites being correlated across the 33 countries (r = 0.42). A similar pattern was apparent in 2015. For back pain, the percentage change in prevalence from 2010 to 2015 varied from - 41.4% (Hungary) to + 29.6% (Ireland), with a mean across countries of - 3.0%. For neck/upper limb pain, the variation was from - 41.0% (Hungary) to + 44.1% (Romania), with an average of - 0.1%. There was a strong correlation across countries in the change in pain prevalence at the two anatomical sites (r = 0.85).Conclusions: Our findings accord with the hypothesis that international variation in common pain complaints is importantly driven by factors that predispose to musculoskeletal pain in general. [ABSTRACT FROM AUTHOR]

Introduction: Thoracic outlet syndrome (TOS) refers to a spectrum of syndromes related to the compression of the brachial plexus (neurogenic TOS), subclavian vein or artery in the general region of the thoracic outlet, which is the area just above the first rib and behind the clavicle. Case report: We report a 27-year-old healthy man who presented to the emergency department with right upper limb pain, tingling and weakness. Point-of-care ultrasonography was performed following a dynamic protocol in the supraclavicular fossa in the right upper limb. A congenital cervical rib, as well as narrowing of the costoclavicular gap, causing vein, artery and spinal roots compression was evidenced. This maneuver reproduced the symptoms, confirming the suspicion of neurogenic TOS. Discussion: Early diagnosis is important, because the neurogenic compression associated with neurogenic TOS, if prolonged, can lead to muscle weakness and atrophy, being irreversible. Selected patients with neurogenic TOS who have progressive weakness, disabling pain, or who have failed to improve with conservative measures are considered for first rib resection. Conclusion: Using the dynamic approach during point-of-care ultrasonography examination, in combination with physical examination and cervical radiography, could help identify neurogenic TOS. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to evaluate the incidence rate of post-stroke upper limb spasticity and its correlation with cerebral infarction site. Methods. A total of 498 inpatient and outpatient cases are included in the present study. The post-stroke upper limb spasticity rate of different cerebral infarction site was calculated. Results. A total of 498 patients with cerebral infarction are enrolled in this study. Of these patients, 91 have dropped out and 407 have completed the study. Of the completed cases, 172 are in the spasm group and 235 are in the non-spasm group. The total incidence of upper limb spasticity is 34.5%. The incidences of upper extremity spasms are 12.5%, 20%, 22.5%, 35%, 40%, and 42.5% in 2 weeks, 1 month, 2 months, 3 months, 6 months, and 12 months, respectively. The incidence of upper extremity spasms increases with time. The incidences of upper limb spasticity are 12.1%, 63.3%, 58.5%, 9.4% and 8.3% when cerebral infarction occurs in the cortical and subcortical mixed areas, basal ganglia and internal capsule, cerebral cortex, brainstem and cerebellum respectively. The incidence of upper limb spasticity varies in different infarction sites (P < 0.05). Conclusion. The post-stroke upper limb spasticity rates were different according to the different cerebral infarction site. Patients with the ganglia and internal capsule infarctions had the highest risk of developing post-stroke upper limb spasticity. [ABSTRACT FROM AUTHOR]

Background: Due to the COVID -19 pandemic, many people in the public sector, including teachers, have had to work remotely via social media. This may have contributed to their exposure to musculoskeletal pain. Objective: The purpose of this study was to investigate upper extremity disorders as a consequence of online teaching. Material and Methods: This cross-sectional study involved 410 teachers (75% male and 25% female) with a mean age of 40.1 years working with telecommunications. Participants were asked to fill out an online survey that included sociodemographic information, type of pain, location of pain, and a self-assessment of pain intensity. Results: The majority of participants (92%) reported upper limb pain. Among the upper limbs, the shoulder was the most commonly affected joint, as 29% of teachers who had upper limb complaints reported pain in the shoulder. Teachers also reported pain sensations in different parts of the upper limbs as follows: 20% in the wrist, 14% in the hands, 12% in the arm, 8% in the elbow, and 8% in the forearm. In addition, 48% of teachers reported that they rarely exercise. Conclusion: Despite telecommunications helping teachers to stay healthy by reducing the risk of infections, they also impose new requirements on the workplace that can endanger the health of workers. Preventive factors, such as upper limb exercises during remote work or the provision of an ergonomic environment by health policy makers, can also help reduce the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

The article offers information on the extensive upper limb neurological examination of individual muscle function, sensation in homonymous innervated territories, and nerve trunk allodynia. It mentions that two examiners blinded to symptom status performed manual muscle testing of six muscles in 82 upper limbs with or without pain, weakness, and/or numbness/tingling. It also mentions that there was good correlation between findings and symptoms for one examiner.

The rationale and methods for applying manual muscle testing as an important part of the neurological examination of upper limb patients is presented. A simple, rapid and valid assessment of the strength in six upper limb muscles is described. In the authors' experience, the outcome of this screening can explain symptoms in a major proportion of patients with so-called 'non-specific' upper limb disorders. This diagnostic contribution may represent an important step towards a better understanding of these frequent conditions. [ABSTRACT FROM AUTHOR]

There is considerable uncertainty over the diagnosis, treatment and management of upper limb pain, which has implications for patient care. Research into patient experiences and evaluation of health-care has been neglected and the study presented here aims to fill this gap.A two-staged, mixed methodology was adopted. Phase 1 involved a postal survey of a random sample (n = 2781) of the working age population (25–64) of an area in south-west England. Phase 2 consisted of follow-up, informal face-to-face interviews with a purposive sample of 47 informants identified, according to pre-defined criteria, from the survey sample.Our data showed that concerns about the effectiveness of treatments for alleviating pain were fundamental to users’ evaluations of both orthodox and non-orthodox health-care. This took priority over the need for a diagnosis and other information. There was a general recognition that the treatments available were, at least, only partially effective and the pragmatic approach led some to eventually withdraw from both orthodox care and complementary and alternative medicines (CAM).Patients’ priorities for health-care, in this context, were perceived to involve the provision of treatments which alleviated pain and were safe and painless. Orthodox and non-orthodox care needed to be more closely integrated into primary care services. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 30-year-old Spanish man whose medical examination showed tenderness, redness, swelling and distention of the superficial veins of his left arm. It notes he had no previous medical history presented to medical attention in Japan in January 2018 with a two-day history of left arm pain.

Few options exit to treat medically refractory upper limb neuropathic pain. Chronically implanted peripheral nerve stimulation (PNS) may be a solution in cases of topographically limited pain due to a peripheral nerve lesion, when spinal cord stimulation is not possible or inefficient. We report the outcome of a consecutive series of 26 patients suffering from chronic refractory upper limb neuropathic pain treated by brachial plexus nerve root stimulation o or suprascapular nerve stimulation. The technique consisted in the percutaneous, ultrasound-guided, implantation of one electrode (Pisces Quad, Medtronic) close to the suprascapular nerve or the cervical nerve roots within the brachial plexus. All the patients underwent a trial stimulation using externalized lead during 10-15 days. In case of positive trial, the electrode was then connected to a subcutaneous stimulator (Itrel 3 or 4, Medtronic). Chronic stimulation parameters were: mean pulse width 168 microseconds (range 90-210), mean frequency 56 Hz (range 20-85), mean voltage 1.13 Volt (range 0.3-2.1 V). The stimulation voltage was set below the threshold inducing muscle contractions or paresthesia. In this study, 24 patients could be evaluated and 2 patients were lost immediately after surgery. After one year of stimulation, 65% of the patients were improved ≥50%, including 12 patients (46%) improved ≥70%. At last follow-up (mean follow-up 28 months), the mean pain relief was 68%. Out of 20 patients still using thestimulation, 12 were very satisfied, 6 were satisfied, and 2 were poorly satisfied. Four patients were explanted due to loss of efficacy or complications. Medications related to chronic pain were completely stopped in 6 out of 20 patients after the surgery, reduced in 9 and unchanged in 5. Complications were: shock-like sensations (2 cases), superficial infection (1), electrode fracture (2) and electrode migration (2). In this pilot study, suprascapular nerve or brachial plexus roots PNS provided a relatively safe, durable and effective option to control upper limb neuropathic pain. [ABSTRACT FROM AUTHOR]