History
It is important to do an effective assessment including history of the symptoms. Ask about the symptoms’ specific characteristics as well as identification of date(s) of onset, aggravating and relieving factors, radiation of symptoms, work tasks etc.
General factors such as occupational history, past medical history with particular reference to joint and soft tissue disorders as well as previous trauma or surgery will be helpful. Family history and the use of medication can further contribute to the picture of causes in these cases.
Waddell and Burton have identified that many common chronic disorders including upper limb problems, have complex multimodal causation. Psychological and work organisational factors are likely to contribute to this model (Waddell G, Burton K Work and Health: changing how we think about common health problems. 2006. The Stationary Office ISBN 0 11 703394 4)
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