Contenido

En el ámbito industrial, la principal fuente de enfermedades profesionales corresponde a la exposición de segmentos osteomusculares de los trabajadores a dolencias provenientes de actividades que requieren repetición, fuerza y posturas disfuncionales por períodos prolongados de tiempo. Un factor adicional, no menos importante, es la vibración que el manejo de algunas herramientas o máquinas pueden ocasionar a estos segmentos corporales.

Most common musculoskeletal diseases

Muscle tissues require adequate oxygenation and sufficient tissue perfusion to achieve the physiological metabolism of muscle function.

In the case of high repetition activities, the associated muscle masses "Muscular system (human anatomy)") do not reach complete relaxation, therefore the level of perfusion of the muscle cells and the tendon ends decreases significantly, giving rise to an anaerobic metabolism and an accumulation of waste substances that cause pain in the short term, and the progressive decrease in muscular capacity. Prolonging this situation begins to cause inflammation of the affected structures.

Constituye una enfermedad poco diagnosticada como enfermedad laboral y muchas veces se confunde con espasmo muscular, debido al estrés; se presenta en la realización de tareas que requieren posturas incómodas del cuello o permanencia en una posición estática tales como operar computadores o conducir.

Dentro del grupo de menores de 40 años se manifiesta el dolor antes de encontrarse cambios radiográficos; sin embargo, en los mayores de 40 años, en quienes esta enfermedad es menos común, lo primero que se encuentra son las alteraciones de la radiografía.

Los síntomas característicos son dolor agudo o de aumento gradual a nivel de nuca o interescapular alto, más intenso en la noche o al mantener la cabeza fija, que al examen físico puede que sólo muestre algo de restricción al movimiento. Puede encontrarse también síntomas regionales en hombro y brazo como dolor irradiado o parestesias debajo del codo o hasta los dedos pero sin abarcar toda la mano o incluso manifestarse como una cefalea inespecífica.

Para diagnosticarla, es necesario realizar una radiografía anteroposterior y lateral de columna cervical si se sospecha un problema importante tales como estenosis del espacio del disco u osteofitos.

Debe hacerse diagnóstico diferencial con enfermedad de columna torácica, tumor, infecciones, espasmo cervical, tumor de pancoast") o neuritis braquial") por radiculopatía.

Inicialmente deben tomarse medidas generales cómo evitar las posiciones que desencadenan el dolor y realizar ejercicios antes y durante las actividades en que se mantenga el cuello en una posición o posiciones incómodas además, dormir en sillón blando con el torso a 45°.

Si esto no fuese suficiente, puede implementarse el uso de collarín cervical blando, antiinflamatorios no esteroideos (AINE) o acetaminofén + codeína, junto con la aplicación de calor y masaje durante la primera semana.

Si se acompaña de una radiculopatía, puede considerarse la extirpación del disco, una corpectomía") o una laminoplastia").

Shoulder impingement syndrome

It occurs predominantly in activities in which there is excess use or after sudden overloads of this joint.

It begins with subacromial bursitis when this or the tendons of the rotator cuff are pinched against the coracoacromial ligament when performing movements above shoulder height. Subsequently, supraspinatus tendinitis and ulceration and partial tear appear that can evolve to a complete rupture of the cuff. Parallel to this, there is osteophytic degeneration of the acromion with more entrapment of the subacromial space. There may also be rupture of the head of the biceps.

Acute or gradual pain in the anterior shoulder that appears when performing new repetitive motion activities. Sometimes pain on the lateral side of the arm that sometimes radiates to the distal part, elbow and hand of variable intensity.

It consists of pain in the arm during abduction from 30° to 40° of elevation, above 90° in the forward flexion position, in elbow flexion at 90° the external rotation does not cause discomfort, the internal rotation is painful.

It is diagnosed by simple AP shoulder X-ray taken in internal and external rotation, axillary and exit. sclerotic and degenerative changes of the joint. In people over 70 years of age, the majority have cuff tears.

Differential diagnosis: angina due to AMI, acute shoulder infection, symptomatic degenerative arthritis, osteoarthritis of the glenohumeral joint is not common.

The treatment aims to resolve pain and muscle stability. It begins with conservative measures such as passive exercise and avoiding work with the shoulder above the head or it is possible to inject corticosteroid with local anesthetic with a 25 needle towards the greater tuberosity 2.5 cm below the anterior lateral quadrant of the acromion. The diagnosis is made if the pain improves immediately. Open surgery or arthroscopy to decompress the space, bursectomy and debridement, and cuff repair if necessary may also be considered in more complicated cases.

Thoracic outlet syndrome

It is a compression of the neurovascular bundles coming from the neck and thorax below the clavicle towards the armpit. It is rare and has various causes such as supernumerary ribs, scalene syndrome, costiform process, pectoralis minor syndrome, non-thrombotic occlusion of the subclavian vein or simple inflammation. It generally occurs in jobs in which it is necessary to adopt uncomfortable positions with the arm above the head for long periods of time and is correlated with people with long necks and stooped shoulders.

It is very common to experience paresthesia and pain that radiates to the arm, there are problems with overhead activities, the hand feels heavy, and there are symptoms in the muscles innervated by the ulnar as well as symptoms of venous compression.

It is necessary to differentiate it from other pathologies such as cervical disc disease or compression of the ulnar nerve in the cubital tunnel, for which a simple x-ray of the cervical spine can be performed looking for cervical ribs, transverse processes or hypoplasia of the first rib or pancoast tumors.

carpal tunnel syndrome

Wristband for support in carpal tunnel syndrome. Carpal tunnel syndrome is often the justification for an occupational illness claim. It is usually caused by a combination of factors that increase pressure on the nerve and tendons in the wrist. It may be a congenital predisposition in some individuals, having the carpal tunnel simply smaller in some people than in others. Other factors that contribute to the diagnosis include trauma or injuries to the wrist that cause swelling, such as a sprain or fracture; as well as hormonal, autoimmune actions and work stress (repeated use of manual vibration tools, for example), among others.

There is little clinical data to prove whether repetitive, forceful hand and wrist movements during work or leisure activities can cause carpal tunnel syndrome. Repetitive movements performed in the normal course of work or other daily activities can lead to repetitive motion disorders[5]​ such as bursitis (inflammation of a small insulating joint bursa) and tendinitis (inflammation of the tendons). Writer's cramp—a condition caused by poor motor coordination, pain, and pressure in the fingers, wrist, or forearm as a result of repetitive activity—is not a symptom of carpal tunnel syndrome.

Lateral humeral epicondylitis

Also called tennis elbow, as it occurs due to repetitive dorsiflexion or repetitive forced extension of the wrist, collagenous necrosis occurs at the insertion into the epicondyle of the extensor carpi radialis brevis muscle and at the origin of the extensor radialis longus.

Pain that radiates to the back of the forearm can occur at night at rest but is most commonly related to activity (gripping, dorsiflexion of the wrist). On physical examination, the symptoms can be reproduced by asking the patient to do forced dorsiflexion or pain is found in the lateral epicondyle on palpation.

It is prevented with general strengthening of the elbow and forearm muscles and appropriate use of hand tools.

It is treated by suppressing the causative activity, applying NSAIDs and triamcinolone acetonide (40 mg), injected into the painful area. However, adverse reactions such as fat necrosis, local skin atrophy or depigmentation may occur. Surgery is rarely necessary and is intended to release the common extensor.

Quervain's tenosynovitis

It affects the first dorsal extensor compartment of the wrist and is due to excessive abuse of the thumb and repetitive gripping.

The patient has a history of repetitive gripping maneuvers, presents pain and/or inflammation on the radial side of the base of the thumb, intense pain when the patient is asked to perform ulnar deviation of the hand (hammering), known as the Finkelstein maneuver.

It is appropriate to reduce the triggering activities, lidocaine (1 mL) injected with a 25-gauge needle followed by triamcinolone acetonide into the sheath of the first common dorsal extensor; NSAIDs; immobilization; in severe cases: common extensor sheath surgery.

medial epicondylitis

Also called epitrochleitis, golfer's elbow or pronator-flexor syndrome, it is caused by excessive use of the finger flexors and wrist flexors and pronators. It affects golfers, baseball pitchers, and manual workers.

It shows local hyperesthesia, pain during exercise or flexion of the wrist against resistance.

It is treated with rest, a band on the proximal forearm, and injected steroids.

Ulnar nerve compression

Produced by entrapment, irritation or subluxation of the ulnar nerve as it passes through the cubital tunnel. It is related to previous elbow injuries, growing osteophytes, cubitus valgus, subluxated nerve that comes out of the groove, prolonged pressure on the nerve that causes inflammation or injury to nearby body structures. It occurs in professions in which prolonged support is maintained on the elbows.

Patients present acute pain on the medial aspect of the elbow, paresthesias in the distribution of the nerve, the symptoms worsen with flexion or support of the elbow on a table. Tinel sign over the cubital tunnel, weakness of the interosseous muscles and the adductor pollicis.

The diagnosis is clinical, it must be differentiated from compression of the nerve at the level of Guyón's canal, here there are no sensory alterations in the little finger and half of the ring finger.

With conservative treatment, avoid pressure on the flexed elbow; if there is atrophy of the interossei, surgical decompression is performed with medial epicondylectomy or transposition of the nerve to a submuscular position.

Se piensa que la mayoría de los cánceres de adultos se deben a una combinación de factores originados por el tipo de vida y por la exposición ambiental. Mientras que solo un 20% corresponde a cánceres originados por factores endógenos (propios de cada individuo), el 80% restante corresponde a exposiciones a factores exógenos o medioambientales, como pueden ser el asbesto, el tabaco o la exposición a factores ambientales laborales.

Dos agentes preocupantes son la exposición a la radiación solar y la exposición a lámparas de bronceado, ambos emisores de rayos ultravioletas, productores de células malignas en la piel.

Phases

The carcinogenesis process consists of three phases:

In Spain, Royal Decree 1299/2006,[8]​ of November 10, which approves the list of occupational diseases in the Social Security system and establishes criteria for their notification and registration. BOE no. 302 of December 19.

In Argentina in 1995, the Occupational Risk Law No. 24,557 was sanctioned and promulgated.

In Mexico, worker protection is present in article 123 of the Constitution and in the Federal Labor Law Archived on November 14, 2020 at the Wayback Machine. The treatment of occupational diseases depends on the social security institution to which the workplace is registered, be it the ISSSTE or the IMSS.

In Colombia everything related to safety and health at work is regulated by law 1072 of 2015 of the Ministry of Labor.

Contenido

En el ámbito industrial, la principal fuente de enfermedades profesionales corresponde a la exposición de segmentos osteomusculares de los trabajadores a dolencias provenientes de actividades que requieren repetición, fuerza y posturas disfuncionales por períodos prolongados de tiempo. Un factor adicional, no menos importante, es la vibración que el manejo de algunas herramientas o máquinas pueden ocasionar a estos segmentos corporales.

Most common musculoskeletal diseases

Muscle tissues require adequate oxygenation and sufficient tissue perfusion to achieve the physiological metabolism of muscle function.

In the case of high repetition activities, the associated muscle masses "Muscular system (human anatomy)") do not reach complete relaxation, therefore the level of perfusion of the muscle cells and the tendon ends decreases significantly, giving rise to an anaerobic metabolism and an accumulation of waste substances that cause pain in the short term, and the progressive decrease in muscular capacity. Prolonging this situation begins to cause inflammation of the affected structures.

Constituye una enfermedad poco diagnosticada como enfermedad laboral y muchas veces se confunde con espasmo muscular, debido al estrés; se presenta en la realización de tareas que requieren posturas incómodas del cuello o permanencia en una posición estática tales como operar computadores o conducir.

Dentro del grupo de menores de 40 años se manifiesta el dolor antes de encontrarse cambios radiográficos; sin embargo, en los mayores de 40 años, en quienes esta enfermedad es menos común, lo primero que se encuentra son las alteraciones de la radiografía.

Los síntomas característicos son dolor agudo o de aumento gradual a nivel de nuca o interescapular alto, más intenso en la noche o al mantener la cabeza fija, que al examen físico puede que sólo muestre algo de restricción al movimiento. Puede encontrarse también síntomas regionales en hombro y brazo como dolor irradiado o parestesias debajo del codo o hasta los dedos pero sin abarcar toda la mano o incluso manifestarse como una cefalea inespecífica.

Para diagnosticarla, es necesario realizar una radiografía anteroposterior y lateral de columna cervical si se sospecha un problema importante tales como estenosis del espacio del disco u osteofitos.

Debe hacerse diagnóstico diferencial con enfermedad de columna torácica, tumor, infecciones, espasmo cervical, tumor de pancoast") o neuritis braquial") por radiculopatía.

Inicialmente deben tomarse medidas generales cómo evitar las posiciones que desencadenan el dolor y realizar ejercicios antes y durante las actividades en que se mantenga el cuello en una posición o posiciones incómodas además, dormir en sillón blando con el torso a 45°.

Si esto no fuese suficiente, puede implementarse el uso de collarín cervical blando, antiinflamatorios no esteroideos (AINE) o acetaminofén + codeína, junto con la aplicación de calor y masaje durante la primera semana.

Si se acompaña de una radiculopatía, puede considerarse la extirpación del disco, una corpectomía") o una laminoplastia").

Shoulder impingement syndrome

It occurs predominantly in activities in which there is excess use or after sudden overloads of this joint.

It begins with subacromial bursitis when this or the tendons of the rotator cuff are pinched against the coracoacromial ligament when performing movements above shoulder height. Subsequently, supraspinatus tendinitis and ulceration and partial tear appear that can evolve to a complete rupture of the cuff. Parallel to this, there is osteophytic degeneration of the acromion with more entrapment of the subacromial space. There may also be rupture of the head of the biceps.

Acute or gradual pain in the anterior shoulder that appears when performing new repetitive motion activities. Sometimes pain on the lateral side of the arm that sometimes radiates to the distal part, elbow and hand of variable intensity.

It consists of pain in the arm during abduction from 30° to 40° of elevation, above 90° in the forward flexion position, in elbow flexion at 90° the external rotation does not cause discomfort, the internal rotation is painful.

It is diagnosed by simple AP shoulder X-ray taken in internal and external rotation, axillary and exit. sclerotic and degenerative changes of the joint. In people over 70 years of age, the majority have cuff tears.

Differential diagnosis: angina due to AMI, acute shoulder infection, symptomatic degenerative arthritis, osteoarthritis of the glenohumeral joint is not common.

The treatment aims to resolve pain and muscle stability. It begins with conservative measures such as passive exercise and avoiding work with the shoulder above the head or it is possible to inject corticosteroid with local anesthetic with a 25 needle towards the greater tuberosity 2.5 cm below the anterior lateral quadrant of the acromion. The diagnosis is made if the pain improves immediately. Open surgery or arthroscopy to decompress the space, bursectomy and debridement, and cuff repair if necessary may also be considered in more complicated cases.

Thoracic outlet syndrome

It is a compression of the neurovascular bundles coming from the neck and thorax below the clavicle towards the armpit. It is rare and has various causes such as supernumerary ribs, scalene syndrome, costiform process, pectoralis minor syndrome, non-thrombotic occlusion of the subclavian vein or simple inflammation. It generally occurs in jobs in which it is necessary to adopt uncomfortable positions with the arm above the head for long periods of time and is correlated with people with long necks and stooped shoulders.

It is very common to experience paresthesia and pain that radiates to the arm, there are problems with overhead activities, the hand feels heavy, and there are symptoms in the muscles innervated by the ulnar as well as symptoms of venous compression.

It is necessary to differentiate it from other pathologies such as cervical disc disease or compression of the ulnar nerve in the cubital tunnel, for which a simple x-ray of the cervical spine can be performed looking for cervical ribs, transverse processes or hypoplasia of the first rib or pancoast tumors.

carpal tunnel syndrome

Wristband for support in carpal tunnel syndrome. Carpal tunnel syndrome is often the justification for an occupational illness claim. It is usually caused by a combination of factors that increase pressure on the nerve and tendons in the wrist. It may be a congenital predisposition in some individuals, having the carpal tunnel simply smaller in some people than in others. Other factors that contribute to the diagnosis include trauma or injuries to the wrist that cause swelling, such as a sprain or fracture; as well as hormonal, autoimmune actions and work stress (repeated use of manual vibration tools, for example), among others.

There is little clinical data to prove whether repetitive, forceful hand and wrist movements during work or leisure activities can cause carpal tunnel syndrome. Repetitive movements performed in the normal course of work or other daily activities can lead to repetitive motion disorders[5]​ such as bursitis (inflammation of a small insulating joint bursa) and tendinitis (inflammation of the tendons). Writer's cramp—a condition caused by poor motor coordination, pain, and pressure in the fingers, wrist, or forearm as a result of repetitive activity—is not a symptom of carpal tunnel syndrome.

Lateral humeral epicondylitis

Also called tennis elbow, as it occurs due to repetitive dorsiflexion or repetitive forced extension of the wrist, collagenous necrosis occurs at the insertion into the epicondyle of the extensor carpi radialis brevis muscle and at the origin of the extensor radialis longus.

Pain that radiates to the back of the forearm can occur at night at rest but is most commonly related to activity (gripping, dorsiflexion of the wrist). On physical examination, the symptoms can be reproduced by asking the patient to do forced dorsiflexion or pain is found in the lateral epicondyle on palpation.

It is prevented with general strengthening of the elbow and forearm muscles and appropriate use of hand tools.

It is treated by suppressing the causative activity, applying NSAIDs and triamcinolone acetonide (40 mg), injected into the painful area. However, adverse reactions such as fat necrosis, local skin atrophy or depigmentation may occur. Surgery is rarely necessary and is intended to release the common extensor.

Quervain's tenosynovitis

It affects the first dorsal extensor compartment of the wrist and is due to excessive abuse of the thumb and repetitive gripping.

The patient has a history of repetitive gripping maneuvers, presents pain and/or inflammation on the radial side of the base of the thumb, intense pain when the patient is asked to perform ulnar deviation of the hand (hammering), known as the Finkelstein maneuver.

It is appropriate to reduce the triggering activities, lidocaine (1 mL) injected with a 25-gauge needle followed by triamcinolone acetonide into the sheath of the first common dorsal extensor; NSAIDs; immobilization; in severe cases: common extensor sheath surgery.

medial epicondylitis

Also called epitrochleitis, golfer's elbow or pronator-flexor syndrome, it is caused by excessive use of the finger flexors and wrist flexors and pronators. It affects golfers, baseball pitchers, and manual workers.

It shows local hyperesthesia, pain during exercise or flexion of the wrist against resistance.

It is treated with rest, a band on the proximal forearm, and injected steroids.

Ulnar nerve compression

Produced by entrapment, irritation or subluxation of the ulnar nerve as it passes through the cubital tunnel. It is related to previous elbow injuries, growing osteophytes, cubitus valgus, subluxated nerve that comes out of the groove, prolonged pressure on the nerve that causes inflammation or injury to nearby body structures. It occurs in professions in which prolonged support is maintained on the elbows.

Patients present acute pain on the medial aspect of the elbow, paresthesias in the distribution of the nerve, the symptoms worsen with flexion or support of the elbow on a table. Tinel sign over the cubital tunnel, weakness of the interosseous muscles and the adductor pollicis.

The diagnosis is clinical, it must be differentiated from compression of the nerve at the level of Guyón's canal, here there are no sensory alterations in the little finger and half of the ring finger.

With conservative treatment, avoid pressure on the flexed elbow; if there is atrophy of the interossei, surgical decompression is performed with medial epicondylectomy or transposition of the nerve to a submuscular position.

Se piensa que la mayoría de los cánceres de adultos se deben a una combinación de factores originados por el tipo de vida y por la exposición ambiental. Mientras que solo un 20% corresponde a cánceres originados por factores endógenos (propios de cada individuo), el 80% restante corresponde a exposiciones a factores exógenos o medioambientales, como pueden ser el asbesto, el tabaco o la exposición a factores ambientales laborales.

Dos agentes preocupantes son la exposición a la radiación solar y la exposición a lámparas de bronceado, ambos emisores de rayos ultravioletas, productores de células malignas en la piel.

Phases

The carcinogenesis process consists of three phases:

In Spain, Royal Decree 1299/2006,[8]​ of November 10, which approves the list of occupational diseases in the Social Security system and establishes criteria for their notification and registration. BOE no. 302 of December 19.

In Argentina in 1995, the Occupational Risk Law No. 24,557 was sanctioned and promulgated.

In Mexico, worker protection is present in article 123 of the Constitution and in the Federal Labor Law Archived on November 14, 2020 at the Wayback Machine. The treatment of occupational diseases depends on the social security institution to which the workplace is registered, be it the ISSSTE or the IMSS.

In Colombia everything related to safety and health at work is regulated by law 1072 of 2015 of the Ministry of Labor.