Stress has role in overuse syndrome

Psychological stress and unhappiness at work are leading predictors of occupational overuse syndrome, fresh research has revealed.

This calls into question the widely held belief that pain in the forearm is caused purely by repetitive movements of the arms or wrists.

In the past many doctors dismissed complaints of occupational overuse syndrome (OOS), or repetitive strain injury (RSI), as it is also known, as being "all in the mind."

The condition is now recognised as having a physical cause.

But research published in the British Medical Journal suggests that psychological factors as well as physical strain play a large role.

Professor Gary Macfarlane and colleagues from the University of Manchester, in north-west England, surveyed more than 1200 people in Greater Manchester over two years.

The participants, aged 18 to 65, were asked to indicate the site of any pain experienced during the previous month lasting at least one day. Details of work history were obtained for all the volunteers and further information collected for those who reported forearm pain.

A total of 105 participants, or 8.3 per cent, said they had experienced pain in their forearm, with little difference between men and women.

The researchers found that increased risk of pain was associated with high levels of psychological distress. Dissatisfaction with support from colleagues or supervisors emerged as the stress factor with the strongest effect.

The two physical factors that contributed most to forearm pain were repetitive movements of the arm and wrist respectively.

The researchers said the findings illustrated the danger of trying to pin down a problem such as forearm pain to a single cause. They wrote: "Our study emphasises the multifactorial nature of forearm pain in the population.

"It confirms a long-suspected relation between work-related repetitive movements and onset of forearm pain, but also that the onset of symptoms can be predicted by high levels of psychological distress and adverse work-related psychosocial experiences."

The team said that, in the future, misleading terms such as repetitive strain injury that imply a single cause should be avoided.