Edorium Journal of

Occupational and Environmental Medicine

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Review Article
Work-related upper limb "overuse" syndromes: A review of historical descriptions and interpretations suggesting a psychogenic origin
Jørgen Riis Jepsen
Associate Professor, Consultant, Department of Occupational Medicine, Hospital of South-Western Jutland, Østergade 81-83, DK-6700 Esbjerg

Article ID: 100004O01JJ2016

Address correspondence to:
Jørgen Riis Jepsen
MD, Associate Professor, Consultant
Department of Occupational Medicine
Hospital of South-Western Jutland, Østergade 81-83, DK-6700

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How to cite this article
Jepsen JR. Work-related upper limb "overuse" syndromes: A review of historical descriptions and interpretations suggesting a psychogenic origin. Edorium J Occup Environ Med 2016;2:19–25.

A previous review of historical descriptions and theories about the character and pathogenesis of writer's cramp and other comparable chronic upper limb "overuse" work-related pain syndromes has indicated that somatic dysfunctions explain symptoms and findings. The first case studies and case series suggested that these conditions were caused by pathology affecting the peripheral nerves. The general perception gradually changed, however, with symptoms becoming attributed to central nervous system dysfunction and ultimately to represent a psychiatric condition. Work-related upper limb disorders remain diagnostically challenging to clinicians and there is still a tendency to see many patients' pain as a psychiatric problem when a standard physical examination does not explain the condition. This article describes reports of writer's cramp and comparable occupational upper limb "overuse" conditions that have occurred sporadically and epidemically, and reviews interpretations from the nineteenth century that relate symptoms to psychogenic conditions.

Keywords: Historical medicine, Nerve afflictions, Neurological examination, Occupational medicine, Upper limb disorders, Work-related disorders

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Author Contributions
Jørgen Riis Jepsen – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
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The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
© 2016 Jørgen Riis Jepsen et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.

About The Author

Dr. Jørgen Riis Jepsen is Consultant at Department of Occupational Medicine, Hospital of South-Western Jutland and Associate professor at Centre of Maritime Health and Society, Institute of Public Health, University of Southern Denmark, both located in Esbjerg, Denmark. He earned the degree as medical doctor at the University of Odense in 1973. He has published more than 150 research papers in national and international academic journals and authored 5 books and 5 book chapters. His research interests include rehabilitation issues, work-related upper limb disorders and maritime health.

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