Musculoskeletal Disorders (MSDs) are injury or disorder of muscles, nerves, tendons, joints, cartilage, or spinal discs. They are not caused by slips, trips, falls, motor vehicle accidents, or other accidents. MSDs are considered work-related when the work activities and work conditions significantly contribute to their development or exacerbation but are not the sole determinant of causation (source: World Health Organization, 1985).
WRMSDs are classified into two broad categories:
It can be treated completely with a skilled hands-on manual therapy approach for release of muscle & fascia,along with joints, nerves and other soft tissue techniques. The effect of this technique is proved by researchers and the studies have been published in indexed journals. This treatment is given in four phases:
PHASE I (Severe Discomfort): Trigger Point Therapy (TPT) (Ischemic compression, PRT, INIT), Myofascial release (MFR), Relaxation & Breathing technique and Stretching exercises.
PHASE II (Moderate Discomfort): Soft- tissue (TPT & MFR), Nerves & Joints Mobilisation, Self- Stretching. (Mild Discomfort): Stretching exercises, Progressive Strengthening Exercises, Postural Retraining, Body Mechanics and Ergonomics Training
PHASE III: In this phase continue with self-stretching exercises, free exercises and begin progressive strengthening exercises followed by relaxation techniques
PHASE IV (Maintenance): Further Strength Training, Aerobic Conditioning and Yoga Therapy
The potential for a quick and complete recovery is enhanced if the patient seeks competent medical interventions like manual physical therapy with ergonomic workplace analysis at an early stage.
The trademarked Skilled Hands-on Approach for Release of Myofascia, Articular, Neural and Soft-tissue mobilization (SHARAN) rehabilitation protocol management is followed. There are four interlinked phases here.
Phase 1 – Severe discomfort in the initial stage: Management – Myotherapy soft tissue mobilisation, neural mobilisation, rib mobilisation, clavicular mobilisation, scapula thoracic mobilisation and physiotherapeutic modalities like IFT, US. These are followed by assisted stretches.
Phase 2 – Moderate discomfort in the upper limb and neck region: Management – It is a follow up to Phase 1 which includes more self-stretching exercises, a range of motion exercises and relaxation techniques like breathing exercises, Alexander techniques and yoga therapy.
Phase 3 – Mild discomfort: Management: In this phase, continue with self-stretching exercises, free exercises and begin progressive strengthening exercises followed by relaxation techniques.
Phase 4 – Maintenance phase: Management – This consists of postural maintenance, generalized whole body stretching and strengthening exercises in order to maintain the length and strength of muscle.
Adequate micro and macro breaks should be taken in between work: Do the stretches and strengthening exercise at least thrice a week. If there is any flare up of symptoms in phase 4, stop all the exercises and immediately consult a physiotherapist for further clarification.