DVT defined
(DVT) Deep vein thrombosis is a condition in which a blood clot (thrombus) forms
in one or more of the deep veins in your body, usually in your legs. Deep vein
thrombosis can cause leg pain, but often occurs without any symptoms.
Deep vein thrombosis can develop if you're sitting still for a long time, such as
when traveling by plane or car or if you have certain medical conditions that affect
how your blood clots.
Deep vein thrombosis is a serious condition because a blood clot that has formed
in your vein can break loose, travel through your bloodstream and lodge in your
lungs, blocking blood flow (pulmonary embolism).
DVT explained or examples
What is a DVT/deep vein thrombosis?
A DVT is a blood clot that forms in a deep leg vein. Veins are blood vessels that take blood towards the
heart.
Deep leg veins are the larger veins that go through the muscles of the calf and thighs. They are not the
veins that you can see just below the skin, neither are they the same as varicose veins. When you have a
DVT, the blood flow in the vein is partially or completely blocked by the blood clot.
A calf vein is the common site for a DVT. A thigh vein is less commonly affected. Rarely, other deep
veins in the body can be blocked by blood clots.
A DVT is part of a group of problems together known as venous thromboembolism (VTE).
http://www.patient.co.uk/health/deep-vein-thrombosis-leaflet
Micropause defined
A Micropause is a small duration break taken frequently during periods
of continuous computer use. A Micropause should be taken every 5-10
minutes for between 5-15 seconds. By taking a Micropause you will
reduce eyestrain and release muscular tension. During a Micropause
you should,
Release your mouse and close your eyes or look away from the screen.
Rest your arms on the chair or drop them at your sides.
Lean back, breathe deeply, and allow your shoulders to ‘droop’.
A common advice that we get for workplace health issues related repetitive stress injuries (RSI) is to take
frequent breaks. Usually, people suggest that a 5-minute break every 45 to 60 minutes. But what about 10second breaks?
A lot of the stress comes from muscle fatigue. When muscles are fatigued then don’t do their jobs well. So
they need to rest from time to time to recover. Achieving the right amount of muscle recovery at the right
time not to difficult to understand. Muscles recover very quickly from low levels of fatigue but quite slowly
from high levels of fatigue. Once your muscles become tired and sore, recovery takes a long time.
Recovery at frequent periods from low-level fatigue will take only around ten seconds whereas high levels of
fatigue will take up to several hours. Think about how your body feels after a strenuous work-out.
One solution to muscle fatigue is micro pauses. They are very short breaks of 5 to 10 seconds every 4 to 10
minutes of repetitive motions (or stationary positions). Micro pauses relax you muscles and restore blood
flow. These micro pauses are small changes in your working activity that allow you to adopt different
postures, positions and eye focus.
The advantages of micro pauses

They take very little time and can easily be developed to become a healthy habit.
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They prevent fatigue build up.
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They are taken before discomfort occurs.
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Micro pauses are the most effective and efficient breaks you can take, but remembering to take them is difficult.
Examples of what to do in a micro pause

Look away from what you are working on and let go of the mouse if you are using the computer.

Drop your arms to your sides, lean back and allow your shoulders to droop and relax.

Pointing the hands towards the floor and gently shaking the wrists is a good idea.
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Do this for 5 – 10 seconds.
Psychosocial
A common advice that we get for workplace health issues related repetitive stress injuries (RSI) is to take
frequent breaks. Usually, people suggest that a 5-minute break every 45 to 60 minutes. But what about 10second breaks?
A lot of the stress comes from muscle fatigue. When muscles are fatigued then don’t do their jobs well. So
they need to rest from time to time to recover. Achieving the right amount of muscle recovery at the right
time not to difficult to understand. Muscles recover very quickly from low levels of fatigue but quite slowly
from high levels of fatigue. Once your muscles become tired and sore, recovery takes a long time.
Recovery at frequent periods from low-level fatigue will take only around ten seconds whereas high levels of
fatigue will take up to several hours. Think about how your body feels after a strenuous work-out.
http://www.workpace.com/assets/Uploads/White-Papers/Wellnomics-White-paperPsychosocial-risk-factors-What-are-they-and-why-are-they-important.pdf
Environmental
What are ergonomic hazards?
Ergonomic hazards refer to workplace conditions that pose
the risk of injury to the musculoskeletal system of the
worker. Examples of musculoskeletal injuries include tennis
elbow (an inflammation of a tendon in the elbow) and carpal
tunnel syndrome (a condition affecting the hand and wrist).
Ergonomic hazards include repetitive and forceful
movements, vibration, temperature extremes, and awkward
postures that arise from improper work methods and
improperly designed workstations, tools, and equipment.
I am renovating my area and
purchasing new furniture, can
someone review the furniture?
A workstation outfitted with the proper furniture and
equipment can lead to a more comfortable and safer work
environment. Ergonomic injuries occur at workstations due
to reaching, bending, awkward postures and applying
pressure or force. If workstations are designed properly,
most ergonomic hazards can be reduced if not eliminated.
Prior to purchasing furniture or workstation equipment due
to renovations of existing space or new construction consult
Environmental Health and Safety to have the specifications
reviewed and to provide guidance.
What are the basic guidelines for
setting up a computer workstation
correctly?
Workstations that include video display terminals (VDTs)
should be ergonomically designed for both computer and
non-computer work. VDTworkstations should be adjustable
so users can easily change their working postures and
equipped with the following:

Adjustable and detachable keyboards;
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Display screens that tilt up and down;
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Brightness and contrast controls;

Flexible copy-holders that reduce the distance between the
screen and source material; and

Proper lighting and anti-glare filters should be installed to
prevent glare from the VDT screen. VDTs should be placed in
the workspace in such a way as to minimize or diminish glare.
What are the basic criteria for an
ergonomically designed chair?
When an employee spends six to eight hours in the chair,
the height of the chair and the work surface are critical. The
human body dimension that provides a starting point for
determining correct chair height is the “popliteal” height.
This is the height from the floor to the crease behind the
knee. The chair height is correct when the entire sole of the
foot can rest on the floor or a footrest and the back of the
knee is slightly higher than the seat of the chair. This allows
the blood to circulate freely in the legs and feet.
Armrests: Armrests should be large enough to support most
of the lower arms but small enough so they do not interfere
with chair positioning. Armrests should support your lower
arms and allow your upper arms to remain close to the torso
and made of soft material and have rounded edges.
Backrests: Backrests should support the entire back
including the lower region. The seat and backrest of the
chair should support comfortable postures that permit
frequent variations in the sitting position. The backrest angle
should be adjustable but lock into place or have a tension
adjustment.
Seats: Seat pans should be height adjustable and have a
user adjustment for tilt. Note: “users adjustment for tilt” is
defined as any method of activation the movement of the
seat pan/backrest. This can be either through the use of
manual devices (e.g. levers, knobs, adjustments) or by
movement of the body/body weight. Seat pans should be
padded and have a rounded, “waterfall” edge, wide enough
to accommodate the majority of hip sizes.
Base: Chairs should have a strong, five-legged base and
casters that are appropriate for the type of flooring at the
workstation.
http://safety.uchicago.edu/tools/faqs/ergonomics.shtml
Carpal tunnel syndrome defined
Carpal tunnel syndrome is a hand and arm condition that causes numbness, tingling
and other symptoms. Carpal tunnel syndrome is caused by a pinched nerve in your
wrist.
A number of factors can contribute to carpal tunnel syndrome, including the anatomy
of your wrist, certain underlying health problems and possibly patterns of hand use.
Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on
the palm side of your wrist. This tunnel protects a main nerve to your hand and the
nine tendons that bend your fingers.
Compression of the nerve produces the numbness, tingling and, eventually, hand
weakness that characterize carpal tunnel syndrome.
Fortunately, for most people who develop carpal tunnel syndrome, proper treatment
usually can relieve the tingling and numbness and restore wrist and hand function.
Probably not. When used alone, carpal tunnel exercises aren't likely to relieve
symptoms such as pain and numbness. And they don't replace other carpal tunnel
treatments, such as surgery, behavior modification or wrist splints.
Carpal tunnel syndrome is caused by compression of the median nerve as it passes
through the carpal tunnel and under the transverse carpal ligament at the wrist. A
number of factors can contribute to carpal tunnel syndrome, including the anatomy of
your wrist, certain underlying health problems and possibly patterns of hand use.
Nerve-gliding exercises — one type of carpal tunnel exercise — are meant to help
the median nerve move normally, but they can sometimes worsen symptoms. If a
median nerve remains trapped, nerve-gliding exercises can stretch, irritate or injure
the nerve.
Despite their limits, carpal tunnel exercises may be helpful in some situations:

To complement another treatment option. Carpal tunnel exercises may be
helpful for mild to moderate symptoms when combined with other treatments,
such as activity modification, wrist splinting or corticosteroid injections.

After surgery to prevent the nerve from becoming scarred in the incision
area. Range-of-motion exercises — which may include nerve-gliding exercises —
can be helpful when there has been significant trauma to the area, such as a
fracture that requires wrist surgery or repair near the carpal tunnel.
If your doctor recommends carpal tunnel exercises, start them gradually to ensure
they don't cause more harm than good.
What is the carpal tunnel?
There are eight small bones called carpal bones in the wrist. A ligament (also called retinaculum)
lies across the front of the wrist. Between this ligament and the carpal bones is a space called
the carpal tunnel. The tendons that attach the forearm muscles to the fingers pass through the
carpal tunnel. A main nerve to the hand (median nerve) also goes through this tunnel before
dividing into smaller branches in the palm.
The median nerve gives feeling to the thumb, index and middle fingers, and half of the ring
finger. It also controls the movement of the small muscles at the base of the thumb.
What is carpal tunnel syndrome?
This syndrome is a set of symptoms which is thought to be caused by compression (squashing)
of the median nerve in the carpal tunnel. About 1 in 1,000 people develops this syndrome each
year. Most cases occur in people aged in their 40s and 50s, but it can occur at any age. It is also
common during pregnancy. Women are affected 2-3 times more often than men.
What are the symptoms of carpal tunnel syndrome?
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

Pins and needles. This is tingling or burning in part, or all, of the shaded area shown above. This is
typically the first symptom to develop. The index and middle fingers are usually first to be affected.
Pain in the same fingers may then develop. The pain may travel up the forearm.
Numbness of the same finger(s), or in part of the palm, may develop if the condition becomes worse.
Dryness of the skin may develop in the same fingers.

Weakness of some muscles in the fingers and/or thumb occurs in severe cases. This may cause poor
grip and eventually lead to muscle wasting at the base of the thumb.
Symptoms can vary from person to person from mild to severe. One or both hands may be
affected. Symptoms tend to come and go at first, often after you use the hand. Typically,
symptoms are worse at night and may wake you up.
The symptoms may be eased for a while by raising the hand up or hanging it down. Flicking the
wrist may also give relief. Symptoms persist all the time if the condition becomes severe.
What causes carpal tunnel syndrome?
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



In most cases it is not clear why it occurs. It is thought that some minor changes occur in the
tendons and/or other structures going through the carpal tunnel. This may cause an increase in
pressure within the tunnel. The increase in pressure is thought to compress and restrict the blood
supply to the median nerve. As a result, the function of the median nerve is affected causing the
symptoms. Carpal tunnel syndrome is more common in manual workers, especially with jobs using a
lot of wrist movement such as scrubbing or wringing. So, overuse of the hand may be a factor in
some cases to trigger the changes in the structures in the carpal tunnel, leading to this condition
developing.
Your genes may play a part. There seems to be some hereditary (genetic) factor. About 1 in 4
people with carpal tunnel syndrome has a close family member (father, mother, brother, sister) who
also has or had the condition.
Bone or arthritic conditions of the wrist such as rheumatoid arthritis or wrist fractures may lead to
carpal tunnel syndrome.
Various other conditions are associated with carpal tunnel syndrome. For example: pregnancy,
obesity, an underactive thyroid, diabetes, the menopause, other rare diseases, and a side-effect of
some drugs. Some of these conditions cause water retention (oedema) which may affect the wrist and
cause carpal tunnel syndrome.
Rare causes include cysts, growths, and swellings coming from the tendons or blood vessels passing
through the carpal tunnel.
Do I need any tests?
Often the symptoms are so typical that no tests are needed to confirm the diagnosis.
If the diagnosis is not clear then a test to measure the speed of the nerve impulse through the
carpal tunnel may be advised (nerve conduction test). A slow speed of impulse down the median
nerve will usually confirm the diagnosis.
What are the treatment options for carpal tunnel syndrome?
Decision Aids
Doctors and patients can use Decision Aids together to help choose the best course of action to take.
p
Compare the options for Carpal Tunnel Syndrome.
General measures
Try not to over-use your wrist by excessive squeezing, gripping, wringing, etc. If you are
overweight, losing some weight may help. Painkillers may be prescribed to ease the pain. If the
condition is part of a more general medical condition (such as arthritis) then treatment of that
Not treating may be an option
In up to 1 in 4 cases the symptoms go without treatment within a year or so. (In about 2 in 3
cases that develop during pregnancy the symptoms go after the baby is born.) So, not treating is
an option, particularly if symptoms are mild. The situation can be reviewed if symptoms get
worse. Symptoms are most likely to go in people less than 30 years old.
A wrist splint
A removable wrist splint (brace) is often advised as a first active treatment. The aim of the splint
is to keep the wrist at a neutral angle without applying any force over the carpal tunnel so as to
rest the nerve. This may cure the problem if used for a few weeks. For example, in one research
trial comparing splinting with surgery, about 1 in 3 people treated with a splint was satisfied with
the relief of symptoms it gave. A splint may be a bit cumbersome to use during the daytime.
However, it is common to wear a splint just at night, which is often sufficient to ease symptoms.
A steroid injection
An injection of steroid into, or near to, the carpal tunnel is an option. One research trial found that
a single steroid injection eased symptoms in about 3 in 4 cases. In this trial the symptoms
returned in some people. However, about half of the treated people were free of symptoms a
year later. Other studies report variable success rates with steroid injections. It is not clear how
steroids work in this condition. Steroids are known to reduce inflammation. However, there is no
obvious inflammation in most cases. Steroids also reduce the effect of other chemicals, which
may play a part in increasing the pressure within the carpal tunnel.
Surgery
A small operation can cut the ligament over the front of the wrist and ease the pressure in the
carpal tunnel. This usually cures the problem. It is usually done under local anaesthetic. You will
not be able to use your hand for work for a few weeks after the operation. A small scar on the
front of the wrist will remain. There is a small risk of complications from surgery. For example,
following surgery there is a small risk of infection and damage to the nerve or blood vessels.
Other treatments
Over the years, a wide range of other treatments have been advocated. For example, diuretics
(water tablets), exercises, vitamin B6, chiropractic manipulation of the wrist, yoga, magnet
therapy, and treatment with ultrasound. None of these treatments has good research evidence to
support its use and so they are not commonly advised. Steroid tablets may ease symptoms in
some cases. However, there is a risk of serious side-effects from taking a long course of steroid
tablets. Also, a local injection of a steroid (described above) probably works better. Therefore,
steroid tablets are not usually advised.
Which is the best treatment for me?
A nonsurgical option may be advised if symptoms are mild. For example, if symptoms come and
go and mainly consist of tingling, pins and needles or mild discomfort. A splint may work but a
steroid injection is probably the most effective nonsurgical treatment.
If you try a nonsurgical treatment and it does not work, do return to your doctor. In particular, if
you have constant numbness in any part of your hand, or if you have any weakness of the
muscles next to the thumb. These symptoms mean that the nerve is not working well and is at
risk of permanent damage.
Surgery gives the best chance of long-term cure. It is quite a common operation. It is done if
symptoms persist despite other treatments, or if symptoms are severe and the nerve is in danger
of permanent damage.
Treatment for severe symptoms
If you have severe symptoms, in particular wasting of the muscles at the base of the thumb, then
you will probably need surgery. This is to decompress the trapped nerve quickly which aims to
prevent any permanent long-term damage to the nerve.
Carpal tunnel syndrome during pregnancy
Symptoms commonly go after the baby is born. Therefore, a nonsurgical treatment, such as a
splint, is usually advised at first. Surgery is an option if symptoms persist.
http://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/expert-answers/carpaltunnel-exercises/faq-20058125
Macrobreak defined