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February/March 2014 (vol. 10/5)
Work-related upper limb disorders
There is no consistent evidence that conservative therapies (rather than clinical interventions) provide any benefit for work-related disorders of the neck, arm or shoulder, according to this Cochrane systematic review. It includes 62 papers covering 44 studies with a combined total of 6,580 participants, and assesses 25 different interventions, including exercise, ergonomics, behavioural therapies (eg relaxation, cognitive strategies, biofeedback), massage, electrical therapy and manual therapy. There is very low quality evidence that exercise does not affect pain, sick leave, disability or recovery. There is low quality evidence that ergonomic interventions do not decrease short-term pain, but can improve it in the long term. There is no evidence for any consistent effects of behavioural or other interventions.
Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults, Cochrane Database of Systematic Reviews 2013; 12: CD008742
Occupational Health at Work February/March 2014 (vol. 10/5) pp40