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Invited Review: Occupational nerve injuries
Invited Review: Occupational nerve injuries
FREE MEMBER CME!

Abstract
Occupational nerve injuries span a broad array of pathologies and contribute toward functional limitation, disability, and economic impact. Early and accurate recognition, treatment, and management of workplace factors rely on a thorough understanding of the anatomic and biomechanical factors that drive nerve injury. This review explores the interplay between anatomy, biomechanics, and nerve pathology common to occupational nerve injury and provides the treating physician with a rational, evidence-based approach to diagnosis and to occupational aspects of management. Assessment of potential occupational nerve injury begins with a detailed understanding of the employee's work duties through a biomechanical lens. One must consider likelihood of occupational causation while accounting for predisposing conditions or preexisting symptoms. Beyond overt crush injury or laceration, potential mechanisms of nerve injury, with effects compounded over time, include compression, stretch, vibration, and repetitive or high-force movements of regional muscles and joints. Injury often occurs at nerve locations that experience higher pressures, changes in pressure over time, or abrupt changes in trajectory, often near a tethered point. This understanding, coupled with condition-specific knowledge presented in this review, equips managing physicians to diagnose occupational nerve injury and enhance treatment recommendations with rational activity modifications or equipment that can protect the nerve or decrease likelihood of continued injury. Long-term management often involves follow-up to assess effectiveness of interventions in the setting of the work environment, with gradual progression of the worker toward return to unrestricted duty or to a point of maximal medical improvement.

Objectives: The objectives of this activity are to:1)Be able to accurately assess individuals with possible occupational nerve injuries. (2) Understand neuroanatomical and biomechanical factors predisposing to occupational nerve injuries and incorporate this understanding into the assessment of possible occupational nerve injuries. (3) Recognize common upper and lower extremity occupational nerve injuries.


ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


CREDIT DESIGNATION
The AANEM is accredited by the American Council for Continuing Medical Education (ACCME) to providing continuing education for physicians. AANEM designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 5/6/2027

DISCLOSURE INFORMATION
The authors had no financial conflicts of interest.


FORMAT
PDF
Authors
Sandra L. Hearn MD, Shawn P. Jorgensen MD, Joelle M. Gabet MD, Gregory T. Carter MD.
Summary
Availability: On-Demand
Expires on May 06, 2027
Cost: Member: $0.00
Non-Member: $25.00
Credit Offered:
1 CME Credit
1 CEU Credit


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