Are disorders only local?
Before reading any further, remember the scope of this discussion: not only I focus solely on occupational disorders but also I try to render the general mechanisms understable to a non-specialised audience.
Sport injuries are decently well-known and described. Further, they can usually be easily located. When pain occurs to computer workers or musicians, it is rarely that simple: if at the beginning, local disorders (e.g., tendonitis) can be diagnosed, pain tends to spread and become non-specific, at a speed that varies from person to person. Further, office workers who have been diagnosed with a tendonitis often experience that treating the latter is just not enough. If one does not find out why it has occured, it either reappars quickly or is replaced by another one (or another kind of injury) at the same place or somewhere else. The tendonitis is only the visible part of the iceberg.
Therefore, the causes of the disorders have to be investigated, which is where the complications arise: It is rarely possible to simply relate a local disorder to a simple cause, a combination of factors being usually involved. Let us see the pain as the consequence of a certain unbalance between what is required from a given anatomical element (muscle, joint, etc) and the ability of the latter to deliver. For example, muscles become painful when they are asked to give more than they can. What they can give depends on a number of factors, including the amount of oxygen that they are supplied with. The oxygen supply depends on how "open" the blood vessels are, i.e. depends among others on the pressure exerted on the blood vessels by the surrounding structures e.g., by any muscle in the neighbourhood of the blood vessel considered. The question can then become: Why are muscles in this region so tense? Are they misused, are they trying to protect some overused joints, is there a degenerative disease somewhere, is the tension a reaction to a certain psychological stress, is it a combination of all this?
A global overview of the issues is therefore mandatory.
Risk factors
The known risk factors for occupational health disorders like musculoskeletal disorders (CANS, RSI) and back pain are the following:
- psychosocial factors: under this heading are grouped psychological (stress, anxiety, ability to cope with stress, catastrophizing behaviour, etc) and social (social support, effort vs. reward inbalance, income, etc) factors
- nature of the task
- posture
- rest-break schedule (how often and for how long do you take breaks, alternate tasks, etc)
- lifestyle (do you smoke, drink, practice a regular physical activity, have a healthy diet, etc)
- medical history (have you had an accident, operation, etc)
- genetics.
The 3 last ones are important factors, but this website focuses on the first 4 ones. For the sake of clarity, I usually regroup nature of the task, posture and rest-break-schedule: what you are doing, in which posture and for how long.
According to the latest findings of Dutch researchers, this global risk factor is more important than the psychosocial ones for certain subjects (e.g. musicians), whilst the opposite can be observed for others (e.g., computer workers). In other words, musicians first have to focus on their posture whilst office workers should ideally first be screened in order to assess their ability to cope with pain and stress.
Should this be verified, the content of the following pages would directly be relevant to musicians. It would maybe be more indirectly relevant to office workers: those of the "catastrophizing type" first have to work on this weaker trait of their personality. But beyond the psychoanalytic work to be done there, these subjects have to gain knowledge of their symptoms and of how they arise (understanding the "pathomechanics" makes the pain much less scary) and to aquire a "toolbox" of exercises to be carried out for reducing the pain as soon as it occurs (pain is less scary if one knows that it will disappear). In that sense, the content of this website is relevant to catastrophizing office workers as well.
Finally, this website is relevant to anybody who wishes to take prevention seriously in his daily life: you do not need to be a musician or a computer worker for being willing to avoid having back or neck pain when driving, lifting, etc.
