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Exercise Better Than Ergonomics to Treat Upper-Body Work Injuries

they almost always get better.”

Orthopedic surgeon Nicholas A. DiNubile, M.D., a clinical assistant professor at the University of Pennsylvania, agrees that there is limited scientific proof that conservative interventions are effective for these injuries.

“It’s not that they are not effective though,” he said. “There is an important difference.” An orthopedic consultant for the Philadelphia 76ers and the Pennsylvania Ballet, DiNubile said that he is a great believer in physiotherapy interventions such as exercise and stretching as well as ergonomic workplace adjustments and taking breaks.

“One must be very careful, however, when interpreting interventions done in a workers’ compensation environment and trying to apply those findings to non-workers’ comp issues,” DiNubile said. He added that it is important for researchers to ask themselves whether they are really measuring that intervention — or if social or psychosocial issues might be involved.

“What applies in work-related injuries may not always be applicable to the average person who gets an injury,” DiNubile said.

Participants in the Cochrane review come primarily from the United States and Europe, where workers typically receive compensation when out of work because of work-related injuries. Verhagen said that she does not believe that workers with chronic pain would report that a particular intervention was not effective if, in fact, it worked. These factors were not considered in her study.

“I think normally, people would like to go back to work,” she said.

The quality of these studies were poor, Verhagen said, making it difficult to draw more conclusions about the effectiveness of many of these interventions. One limitation centered on varied and vague definitions of “work-relatedness.” In the Netherlands, “work-related” means that people have complaints that get worse when they are working, yet decrease or diminish on the
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