Viive Pille

Pshychological and social factors are generally more strongly assosiated with back pain than with shoulder pain. Furthermore, the association is stronger for non-specific pain than for pain with a specific diagnoosis. This means that a diagnoosis of general cervicobrachial pain may be more strongly related to psychological and social factors than are carpal tunnel syndrome or shoulder tendonitis.

 Highly demanding work and poor work content (repetitive tasks with short cycles) have been identified as risk factors for neck and shoulder pain.  Psychological factors and personality type may by determinants of muscle tension and the development of myofascial pain.

 Piece work is assosiated with neck and arm disoders when compared with work paid by the hour. This may be because of an increased work pace in addition to high psychological demand and low control in the work situation.  Management style, in terms of social support to employees, is claimed to be associated with increased reporting of neck and shoulder symptoms.

 Psychological stress and burnout are associated with depressioon. Depressive moods are associated with musculoskeletal pain.  For work related musculoskeletal disoders individual factors usually have a low magnitude of risk compared with relevant ergonomic factors.

 According to occupational health literature is growing evidence that psychosocial work factors may influence the development of musculoskeletal problems, including both low back and upper extremity disoders (Bongers et al. 1993).  Psychosocial work factors are defined as aspects of the work environment (such as work roles, work pressure, reltionships at work) that can contribute to experience of stress in individuals (Lim and Carayon 1994).

 Researches have suggested a variety of mechanism underlying the relationship between psychosocial factors and musculoskeletal problems (Sauter and Swanson 1996; Smith and Carayon 1996; Lim 1994; Bongers et al. 1993). These mechanisms can be classified into four categories:  Psychophysiological  Behavioural  Physical  Perceptual

 It has been demonstrated that individuals subjekt to stressful psychosocial working conditions also exhibit increased autonomic arousal (e.g. increased catcholamine secretion, increased heart rate and blood pressure, increased muscle tension etc.) (Francenhaeuser and Gardell 1976).

 This normal and adaptive pshycophysiological response which prepares the individuaal for action. However, prolonged exposure to stress may have a deleterious effect on musculoskletal function as well as health in general. For example, stress-related muscle tension may increase the static loading of muscles, thereby accelerating muscle fatigue and associaced discomfort (Westgaard and Bjorklund 1987; Grandejan 1986).

 Individuals who are under stress may alter their work behaviour in a way that increases musculoskeletal strain. For example, psycholgical stress may result in greater application of force than neccessary during typing or ohter manual tasks, leading to increased wear and tear on musculoskeletal system.

Psychosocial factors may influence the physical (ergonomic) demands of the job directly. For example, an increase in time pressure is likely to lead to an increase in work pace (increased repetition) and increased strain. Alternatively, workers who are given more control over their tasks may be able to adjust their tasks in ways that lead to reduced repetitvness (Lim and Carayon 1994).

 Sauter and Swanson suggest that the relationship between biomechanical stressors (ergonomic factors) and the development of musculoskeletal problems is mediated by pperceptual processes which are influenced by workplace pshychosocial factors. For example, symptoms might become more revident in dull, routine jobs than in more engrossing task which more fully occupy the attention of the worker (Pennebarker and Hall 1982).

 The data were analyzed from 181 questionnaires which were filled in correctly. Among these there were 69 men, the average age of 40,8 years and 121 women, the average age of 45,6 years. Two out of 192 did not have filled their gender. People who answered have been working with computers on the average for 9,5 years. Specifically 125 people up to 10 years (inclusive) and 56 people had been working with computers for over 10 years.

 In the first group (working with a PC up to 10 years inclusive) musculoskeletal diseases occurred in 67 (53,6%) people.  In the second group there were musculoskeletal diseases in 28 people (50%) (23 physician-diagnosed),

 Investigated workers 34  Women 25, men 9  Average age 46,7  Computer work approximately 6,9 hours per day  Occupational life 12,6 years  Kiva score 7,7

Standardized Nordic Questionarie for Analysis of Musculoskeletal Symptoms (Kuorinka et al., 1986) Pain regionNumber of workers (34) Severity of pain (0-10) Neck224,18 Shoulder right153,8 Shoulder left14 Elbow right24,7 Elbow left2 Wrist right74,57 Wrist left- Back164,31 Without complaints 12 workers.

17  The mechanical charateristics (tone, stifness) of mucles were recorded using a hand-held Myoton-3 myometer.  We investigated m. trapez, adductor pollicis, flexor digitorum and extensor carpi radialis.

 Our aim is to implement Metal Age method and combine it with massage during 4 months.  After 4 months to repeat Nordic Questionarie for Analysis of Musculoskeletal Symptoms and myotonometric measurements.

 Thank You!