Work-related Musculoskeletal Disorders in Physiotherapists as a Risk Factor for Depression - Essay Example

? Work-related Musculoskeletal Disorders in Physiotherapists as a Risk Factor for Depression: INTRODUCTION: The change in technology, strategy and other work related factors has led to the change in the functioning and subsequent demands of employees (Burnett, 2007). As work demands rises, there comes the rise in the risk factors employees expose themselves. Through Ergonomics, scientists hold that, Work- related musculoskeletal disorders are the main risk factors that emerge from extreme and mostly repetitive exertions (Jacobs, 2008). These strains may include routine overhead work, having the neck in strenuous positions for long periods of time and continuous exposure to whole body vibrations (Burnett, 2007). It is imperative to remember that humans interact with more than the physical objects at the workplace. These interactions may include human-human interactions and human-system interactions. Findings suggest that physiotherapists are at a higher risk of experiencing musculoskeletal disorders than other professions. This is because their line of duty is often repetitive, labor intensive and involve direct contact with patients (Adegoke et al, 2008; Nkhata et al, 2010). A study conducted by Adegoke and colleagues (2008) revealed that 72% of physiotherapists have modified their treatment for patients as a result of the physiotherapists’ injury. Even more shocking is the fact that 12% of physiotherapists change their area of practice while 13% leave their profession altogether! This indicates that musculoskeletal disorders have a devastating impact on a physiotherapist’s life, professionally and personally. A range of factors may be involved, including, but not limited to biological, psychological, and social; these factors may interchangeably dominate the experience for an individual. This paper will discuss the advent of musculoskeletal disorders in physiotherapists as the risk factor for depression. BIOLOGICAL RISK FACTORS: The most common work-related musculoskeletal disorders include back pain, hernia, sprains and strains and Carpal tunnel syndrome (Jacobs, 2008). An examination of pre and post conditions reveals some fascinating facts about the biological conditions of persons affected by work-related musculoskeletal disorders. One of the main biological factors is age (Reilly, 2002). The age of an individual significantly increases their susceptibility to depression during and after WRMDs. Research indicates that biological risk factors increasing the likelihood of depression by at least three percent with the increase of an individual’s age (Burnett, 2007). In light of this, musculoskeletal disorders will only add to the potency of depression by adding pain and suffering to the individual. Older persons are prone to illnesses ranging from arthritis to diabetes (Jacobs, 2008). Preexisting health conditions always factor in the biological risks for depression. Conditions such as cardiovascular disease and atherosclerosis, like age, compromise the emotional intelligence of individual dealing with musculoskeletal disorders (Reilly, 2002). PSYCHOLOGICAL RISK FACTORS: The psychological state of persons during work is crucial not only for productivity but also for their safety. At all times, an individual needs to be fully aware of their environment and its risk factors. If there is psychological turmoil, chances are that this individual will be excessively aware or unaware of the environmental risk factors at work (Snooks, 2009). Both instances are also detrimental to the psychological safety of the individual in regard to musculoskeletal disorders. Agitation, sluggishness and guilt, all symptoms of unipolar depression, may cause individuals to be unaware of the strenuous nature of the activities at the workplace. These conditions may result from an episode of musculoskeletal disorder (Snooks, 2009). These individuals, while ignoring their strenuous environment worsen their existing musculoskeletal disorders and in extension their unipolar depression symptoms. Also, depressed individuals have a tendency of complaining of aches and pains. Establishing whether these claims of pain are truly musculoskeletal disorders or psychosomatic proves challenging especially when trying to diagnose and thereby mitigate the condition (National Research Council, 2001). Orenius and colleagues report that fear of pain can be more disabling than the pain itself (Orenius et al, 2012). Depression affects self efficacy and a person’s level of self-efficacy will influence his or her return-to-work capacity. Therefore, Psychological distress owing to musculoskeletal disorders affects coping skills, which in turn, impacts on the ability to function normally. SOCIAL RISK FACTORS: In my view, social factors contribute to a vast range of complications in the workplace. The work environment can either contribute to a musculoskeletal disorder by either making it worse or doing nothing to improve it. When an employee is subject to an environment that makes them feel intimidated and constrained because little control over their work conditions, they will feel dissatisfied. Environments outside the workplace also contribute to an employee’s satisfaction; therefore, social networking and support is crucial (Bergman, 2005). As mentioned earlier, human-human interaction is paramount. Living with pain can lead to social isolation, interrupted ability to maintain roles such as grocery shopping and child care and increased dependence on others for support. Job loss, compromises financial security through work disability and high health care expenses; lower income depicts more pain problems (POLESHUCK 2008). This is because low income earners cannot afford expensive treatment. Also, low income earners do more menial (difficult, extreme and mostly repetitive exertions) than average and high income earners. Studies show that individuals who value self reliance are prone to stress when they start feeling inadequate. This self loathing that accompanies insufficiency may eventually lead to depression or worsen the symptoms. BIRECTIONALITY & INTERACTION: An individual with musculoskeletal disorder is likely to face anxiety which may lead to depression when faced with the task of paying rehabilitation bills to mitigate this condition. Depressed persons may also disregard their safety at the workplace leading to an increase in their chances of getting hurt and facing greater/additional difficulties with their musculoskeletal disorders (Hadler, 2004). A second link is that of biological risk factors. Age increases an individual’s chances of musculoskeletal disorder and depression. Studies show that the deteriorating health conditions of older persons make them more susceptible to depression (Snooks 2009). The symptoms of musculoskeletal disorders are also similar to those of depression and its related conditions such as anxiety and stress (National Research Council, 2001). Migraines, lower back pain and stomach upsets, (also associated with irritable bowel syndrome) get associated with stress at work. This stress emerges from a combination of when a job is too demanding due to its complexity or strenuous nature, and when an employee is unable to meet these demands. Strain and complexity of tasks is also a reason why musculoskeletal disorders are on the rise (National Research Council, 2001). Upper extremity musculoskeletal disorders also have a link to instances of depression. An increase in the incidents of impairment, disability or pain relies on an individual’s psychosocial environment. The nature of the psychosocial environment is subject to the cognitive interpretations of events and situations in which case persons may consciously or subconsciously link depression and Musculoskeletal Disorders (Acton, 2012). Often, musculoskeletal disorders and depression frequently co-occur. Individuals with musculoskeletal disorders are at an increased risk for depression, and individuals with depression face increased risks for musculoskeletal pain (Poleshuck et al, 2008). Furthermore, following a review of current literature, Lloyd and colleagues reported that while depression can precede musculoskeletal disorders in up to 50% of cases, pain severity relates to the extent of depression (Lloyd et al, 2008). Lepine & Briley’s meta-study, as well, (Lepine & Briley, 2004) support the concept of depression being an antecedent for musculoskeletal disorders. However, there are still some inconclusive studies, as determined by Orenius, in which he states that the underlying mechanisms of the correlation between depression and musculoskeletal pain remain unclear (Orenius, 2012). References: Acton, Q. A. (2012). Issues in Neuropsychology, Neuropsychiatry, and Psychophysiology: 2011 Edition. New York: Scholarly Editions. Adegoke, B., Akodu, A., & Oyeyemi, A. (2008): Work-related musculoskeletal disorders among Nigerian physiotherapists, BMC Musculoskeletal Disorders, 9:112. Doi: 10.1186/1471-2474-9-112. Bergman, S. 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I., Koskela, T., Koho, P., Pohjolainen, T., Kautiainen, H., Haanpaa, M., Hurri, H. (2012): Anxiety and Depression Are Independent Predictors of Quality of Life of Patients with Chronic Musculoskeletal Pain. Journal of Health Psychology. Doi: 10.1177/1359105311434605 Poleshuck, E.L., Bair, M. J., Kroenke, K., Damush, T. M., Tu, W., Wu, J., Krebs, E. E., Giles, D. E. (2009): Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression. General Hospital Psychiatry, 31, 116-122. Reilly, T. (2002). Musculoskeletal Disorders in Health-Related Occupations. New York: IOS Press. Read More