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A growing number of injuries to muscles and bones are resulting from the repetitive motions involved in using a computer or machinery, the vibrations of equipment, lifting heavy items or having to move in awkward ways to get a job done. These injuries can sometimes lead to rheumatic conditions.
Industrial rheumatology focuses on the relationship between a patient and his or her workplace. Doctors specializing in this field are trained in rheumatology and are familiar with analyzing work environments, the relationship between injuries to the muscles and bones and the development of rheumatic conditions and the Worker's Compensation system. They work with patients who already have rheumatic conditions and are in a work environment and those who develop injuries or symptoms because of the job. Examples of situations in which an industrial rheumatologist might become involved include:
- A worker injures his or her back and neck, becomes unable to sleep well, is always tired and develops widespread pain that is recognized as fibromyalgia. Did the work-related injury cause the fibromyalgia? Is the condition disabling - partially, fully, temporarily or permanently? Can the workplace be adapted to allow the worker to continue with his or her job safely?
- A working environment needs to be observed and analyzed to determine how it may be contributing to or causing a worker's symptoms. This might lead to recommendations for ergonomic changes to a workstation or modifications to the work environment.
- A person is developing symptoms of carpal tunnel syndrome, cubital tunnel syndrome or other chronic conditions from overuse of a joint.
- A person has rheumatoid arthritis, but his or her job involves overusing the wrists, fingers or other joints and needs to know how to make adaptations at work to avoid making the arthritis symptoms worse.
- A person develops widespread pain that does not go away.
An industrial rheumatologist may also be called on to:
- Develop a diagnosis based on a person's symptoms
- Determine whether the condition was caused or made worse by the patient's working conditions
- Evaluate whether a person is temporarily, partially or totally disabled and unable to work
- Analyze a working environment and recommend changes can be made to prevent a worker's condition from becoming worse or to eliminate it
- Recommend restrictions on an individual's work to prevent rheumatic conditions from developing or getting worse
A rheumatologist with experience in workplace issues may be called in to examine an injured worker by:
- The worker's personal physician or a specialist, such as an orthopedist
- The employer's physician or Worker's Compensation insurance plan
- Attorneys representing either the worker or the employer (Sometimes attorneys for both the employer and the worker call on an industrial rheumatologist to provide an independent, neutral opinion in what is referred to as an "agreed medical evaluation.")
- A judge in an industrial injury or worker's compensation case who is seeking an independent evaluation of an injured worker's medical situation
This specialization may also involve addressing the patient with a chronic rheumatic disease and the adjustments that need to be made in the workplace to accommodate the impairments from whatever illness the worker experiences. Many of these interactions involve society, patients and physicians. The rheumatologists at Cedars-Sinai are particularly skilled in this complex interplay of muscle and bone disorders and the workplace.