Occupational cervicobrachial syndromes. A review

Abstract

The cervibrachial syndromes related to work form an important group of rheumatic diseases. Surveys of rheumatic complaints in different occupations have been made for half a century. In these studies the cervicobrachial pain syndromes are preceded only by back diseases as a cause of occupational rheumatism. The nomenclature of rheumatic diseases is difficult to systematize, and the differences in diagnostic criteria are partly reflected in the results of field surveys. Moreover, official statistics based on the International Classification of Diseases are only of limited value when the socioeconomic burden of these diseases is being estimated. What is also confusing is the role of work in the etiology or symptomatology of rheumatic diseases. Obviously there is no universal cause, such as 'wear and tear' or 'usage,' for the common rheumatic syndromes. The role of occupational medicine today is to detect and report the defined patterns of occupational overuse associated with defined clinical syndromes. In the present review the cervicobrachial syndromes are divided into four entities, namely, the cervical syndrome, the tension neck syndrome, the humeral tendinitises, and the thoracic outlet syndrome. Each of these syndromes is discussed separately, and their incidence, etiology, pathogenesis and clinical signs are considered from an occupational point of view. The frozen shoulder and acromioclavicular syndromes have not been included because of the scant relevant literature focusing on the occupational aspects of these entities.