It’s confusing isn’t it?
Repetitive Strain Injury (RSI).
Cumulative Trauma Disorders ( CTD).
Work-Related Upper Limb Disorders (WRULD)
Work-related Musculoskeletal Disorder (WMSD)
Are they the same? Do they mean the same thing?
Or are they different?
It gets confusing as you read articles and papers from different countries.
Different Terms in Different Countries
In the USA, Cumulative Trauma Disorder (CTD) is commonly used. While in Australia and Canada, Repetitive strain injuries (RSI) is the common terminology. Japan prefers the term Cervicobrachial syndrome. And in the UK, Work-related Upper Limb Disorder is the preferred term, according to a paper published by Intech.
Why are they called different names?
These names are all terminologies for Work-Related Musculoskeletal disorders. They are named after the factors believed to cause workplace injuries. But that is somewhat erroneous because these terminologies don’t describe the various types of workplace injuries.
Let me elaborate.
History of Workplace Injuries
This is not a new phenomenon: Work activities causing injuries.
In the 18th century, an Italian Physician, Dr Bernadino Ramazzini (1633 – 1714), was the first to document the relationship between work and certain injuries. In his 1700 publication, De Morbis Artificum (Diseases of Workers) he wrote about the workplace injuries he saw in his medical practice.
For example, he said;
‘’The maladies that afflict the clerks aforesaid arise from three causes: First, constant sitting, secondly the incessant movement of the hand and always the same direction, thirdly the strain on the mind from the effort not to disfigure the books by errors or cause loss to their employers when they add, subtract, or do other sums in arithmetic.’’
He described it as;
“diseases reaped by certain workers …from irregular motions in unnatural postures of the body.’’
He observed and described over 50 trades, among those included were miners, chemists, potters, painters, tobacco workers, tanners, weavers and coppersmiths.
All these identified work-related injuries but there was no collective name to describe them. They were usually named after the profession where they were identified. For instance , ‘Housemaid’s knee’, ‘Bricklayer’s shoulder’, Washer Woman’s Sprain’, Drummer’s Palsy’ Pipe Fitter’s Thumb, Flute Player’s hand , Seamstress Wrist.
In the 19th century , Reynauld’s phenomenon, also called Dead Finger or Jackhammer Disease, was found to be caused by loss of blood supply from repetitive movement. Numerous research revealed that these injures only manifested themselves after a long period of time. So, in 1906, the Workers’ Compensation Act was passed in the UK and Cumulative Trauma Disorder (CTD) became recognised as a term used to describe workplace injuries.
Later in the 1960s, the study of tendons in the hand revealed that repetitive tasks caused biomechanical strain to the musculoskeletal system. Repetitive Strain Injuries (RSI) then became recognised as another term for workplace injuries.
Over the years, as more causal factors were found, other terminologies for workplace injuries were used. For example, Overuse Syndrome described the ‘injuries caused by overuse. Occupational Cervicobrachial Disorder described injuries of the neck and upper limb caused by work. Another name commonly used is the Work-Related Upper Limb Disorder. It is widely used because most workplace injuries affects the shoulders, arms, forearms, hands and wrists (upper limb).
Other names you might have heard are Repetitive Motion Injuries to describe injuries of the upper limb caused by repetitive movement e.g. typing.
But all these terms couldn’t sum up the causal factors of work-related injuries or the body parts affected. So in 1985, World Health Organisation (WHO) reported that the causes of work-related injuries were multifactorial. That meant that these injuries were consequences of the worker exposed to a number of risk factors and not one. The risk factors noted included;
- vibration ,
- awkward posture,
- organisational factors
- environmental factors e.g. heat and cold.
So a new name had to be found that would encompass all these causal factors.
Musculoskeletal Disorder was Already in Use
In the medical field, musculoskeletal disorders (MSD) is used to describe injuries (disorders) that affect the structures of the musculoskeletal system. It encompasses all the injuries caused by movement including back pain, neck pain, shoulder and heel pain.
Damage to any structure of the musculoskeletal system is classified as musculoskeletal disorder.
So in recent times, work-related musculoskeletal disorder (WMSD) was adopted by several occupational health and safety regulatory bodies. It described injuries and illnesses caused by work activities which was different from work accident e.g. fall from height.
Work-related musculoskeletal disorder is defined as injuries to the musculoskeletal system caused by repetitive, cumulative and over-exposure to workplace risk factors.
Different Terminology, Same Workplace Injuries
So what’s the difference between RSI, CTD and work-related musculoskeletal disorder?
In summary, they are terms used to describe workplace injuries. Although some terms are now obsolete, others are still branded about. But the rightful term for workplace injuries is Work-Related Musculoskeletal Disorders and many countries have adopted its use.
To know more about Work-Related Musculoskeletal Disorder. Check out this post: All you need to know about work-related musculoskeletal disorder.
Putz-Anderson, V. (1988). Cumulative Trauma Disorders: A Manual for Musculoskeletal Diseases of the Upper Limbs, Taylor & Francis.