None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
BACKGROUND Work-related upper limb disorder ( WRULD ) , repetitive strain injury ( RSI ) , occupational overuse syndrome ( OOS ) and work-related complaints of the arm , neck or shoulder ( CANS ) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements , awkward postures and impact of external forces such as those associated with operating vibrating tools .
Work-related CANS , which is the term we use in this review , severely hampers the working population .
OBJECTIVES To assess the effects of conservative interventions for work-related complaints of the arm , neck or shoulder ( CANS ) in adults on pain , function and work-related outcomes .
Low-dose amitriptyline for treatment of persistent arm pain due to repetitive use
& NA ; Amitriptyline is sometimes used to treat arm pain related to repetitive use , but rigorous evidence of its benefit is lacking . This r and omized controlled trial investigated whether amitriptyline provided greater pain relief or improved arm function than a placebo pill in adults with arm pain associated with repetitive use that had persisted for at least 3 months . Participants ( N = 118 ) were r and omly assigned to receive 25 mg of amitriptyline or a placebo pill for 6 weeks . The primary outcome was intensity of pain ( 10‐point numerical rating scale ) and secondary outcomes were arm symptoms , arm function , grip strength , mood , and sleep . Assessment s were done at baseline , 3 and 6 weeks of treatment , and 1 month after the treatment ended . Changes in arm pain were not statistically significant . However , the amitriptyline group improved more than the placebo group in arm function ( p = 0.023 ) and sense of well being ( p = 0.034 ) . In a longitudinal analysis , the amitriptyline group 's arm function score improved 0.45 points per week faster than placebo after adjusting for subject characteristics ( p = 0.015 ) . At the treatment 's midpoint , the amitriptyline group reported more “ troublesome side‐effects ” than the placebo group ( 52.5 % vs. 27.1 % , p = 0.005 ) , but this difference decreased by the end of the treatment ( 30.5 % vs. 22.0 % , p = 0.30 ) . The most frequent side effect was drowsiness . In conclusion , this study found that low‐dose amitriptyline did not significantly decrease arm pain among these participants but did significantly improve arm function and well being . Future research is needed to explore the effects of higher doses and longer duration of treatment
None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
BACKGROUND Work-related upper limb disorder ( WRULD ) , repetitive strain injury ( RSI ) , occupational overuse syndrome ( OOS ) and work-related complaints of the arm , neck or shoulder ( CANS ) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements , awkward postures and impact of external forces such as those associated with operating vibrating tools .
Work-related CANS , which is the term we use in this review , severely hampers the working population .
OBJECTIVES To assess the effects of conservative interventions for work-related complaints of the arm , neck or shoulder ( CANS ) in adults on pain , function and work-related outcomes .