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Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000






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I have been working in a large, chain grocery store as a clerk for two years. I'm starting to develop wrist and hand pain from lifting heavy things like gallons of milk and juice. I see other women who have been here longer than me, and they have constant pain and wear braces to support their wrists. If I stay with this job, am I going to end up like that?

Workers who are exposed to repetitive motions that result in pain, stiffness, loss of motion, and loss of function may have a condition called upper-extremity musculoskeletal disorder (UEMS). Knowing how a condition like this plays itself out is called the natural history. Telling you what to expect as the final outcome is the prognosis. Experts in this area tell us that there isn't a standard definition used by all to describe, define, or diagnose upper-extremity musculoskeletal disorders. That makes it difficult to categorize workers and then compare their outcomes in a study. A recent study from France was published with results from a three-year outcome for workers having UEMS. They were all involved in highly repetitive work like yours (supermarket cashiers, assembly-line manufacturing, and the packaging industry). After collecting all the data about the workers, their symptoms, their status three years after the initial survey, they found that the single, biggest predictor of the future was the presence of symptoms in more than one site. This was called multisite disorders. Workers who had a prior history of UEMS with a new set of symptoms had the worst results. This was especially true when they had pain in more than one of these areas: the neck, shoulder, elbow, wrist, and hand. But there are ways to keep your problem from getting worse. Just handling the groceries in a more energy- and joint-conserving fashion will help. Use the automated belt to bring the items right to you before picking them up. Use both hands together to lift and move anything that weighs more than one-pound. Don't pick up large containers of milk or juice with one hand. Use the handle with one hand (if available) and support under the bottom of the item with the other hand. Don't be afraid to wear a wrist support or splint. It could mean the difference between function and chronic disability. And start on a strengthening program for the wrists, hands, and upper extremities. Building muscle strength and mass can help protect the wrist ligaments and more delicate soft tissues of the wrist and hand that aren't able to handle the stresses and strains of repetitive work of this type.

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