Cumulative trauma disorder, commonly referred to only as CTD, refers to a variety of disorders or health issues centered on the wear and tear of the body, specifically the tendons, muscles, and nerve tissue.1 CTD occurs most often in the neck or shoulders, knees, and wrists where micro-trauma is most common, and it can originate as the result of a variety of causes.
Some of the disorders and syndromes CTD can manifest as include:
Repetitive strain injuries, which are one form of repetitive trauma, occur when a certain area of the body is overused, such as elbows, wrists, or knees. They can cause protective membranes, such as synovial fluid or cartilage, to wear away over time. It may lead to soreness, numbness, and other symptoms.
Like repetitive strain injuries which focus on the wear and tear as a result of overusing one part of the body, repetitive motion disorders are a type of repetitive trauma that can occur when one motion, such as typing, is done repetitively and causes musculoskeletal issues.
Overuse syndromes are the third form of repetitive trauma and are common in modern pathology. They are also one of the leading forms of CTD. One of the most common is carpal tunnel syndrome, which occurs when overuse harms the nerves in the wrist and forearm.
Cumulative trauma disorders can be caused by any activity that puts excessive strain on the body. One of the most common professions to incite CTD is office work due to the repetitive nature of tasks such as typing. However, the risk for developing CTD can be increased when tasks are completed poorly and without ergonomic consideration, such as not utilizing the proper posture at the desk.
Repetitive motion is one of the most common causes of CTD. When the body performs the same task many times, it’s utilizing the same area of the body, whether it be a tendon, a muscle, or both. Over time, if the task continues to be repeated, it can cause that specific area of the body to experience increased wear, which can lead to the tenderness and pain associated with CTD.
Some of the most common manifestations of CTD as a result of repetitive motion include lateral epicondylitis, also known as “tennis elbow,” and carpal tunnel syndrome.
However, it does not have to be repetitive use alone to cause CTD in an area. Any time a part of the body is overused, it can increase wear and tear. For example, while running and walking are separate tasks that utilize different muscles and tendons, they can both contribute to the overuse of areas such as knees.
Muscle tension, usually caused by stress, results when the muscles are engaged despite not being in motion. As a result, while there is no action being performed, they are still acting as if there is.
Muscle tension can lead to overuse and with chronic stress can become a repetitive motion that wears away at the muscles, leading to the development of CTD.
With incorrect posture, pressure is applied to muscles in the back that are not designed to bear the weight of the upper body alone for long periods. As a result, your posterior muscles become sore easily.
However, over time, soreness can lead to increased wear and tear and even degenerative issues or musculoskeletal disorders in the spine and rest of the back.
There are several different forms of cumulative trauma disorder. These are different disorders, conditions, and syndrome that occur as a result of cumulative physical trauma, such as repetitive strain, and can include:
Because CTD can manifest in several different forms and conditions, the symptoms experienced can vary. However, there are a few symptoms that are often shared among types of CTD, including:
Often, CTD can be diagnosed through a verbal patient analysis discussing symptoms. However, testing and imaging can also locate and identify areas of inflammation, aiding in the diagnosis of CTD.
Treating CTD usually involves rest and reducing the amount of time spent on the activity causing inflammation. However, for more severe cases, there are other treatment options available as well.2
Carpal tunnel release is the recommended surgical procedure for treating carpal tunnel syndrome, a form of Cumulative trauma disorder. This surgery can either be done an open incision or through the aid of a small camera inserted into the wrist.
Ergonomics is the study of anatomy efficiency and is centered around the idea of designing everyday objects, such as keyboards, to reduce the strain on the body. Investing in ergonomic items can help reverse minor CTD by alleviating discomfort and the level of wear and tear occurring daily.
Like with ergonomics, body mechanics focuses on correct posture and movements to minimize strain and reduce inflammation to aid in treating, reversing, and preventing CTD.
Dual-diagnosis between CTD and addiction are common, and there are several reasons why.
One of the leading symptoms of CTD is chronic pain.3 Often, patients may find that the treatments prescribed for chronic pain do not completely remove their pain. For some people, it may not even reduce it to a tolerable level, hampering a high quality of life. As a result, this may lead to self-treatment through addiction and substance use disorders, which can produce dangerous side effects.4 This is especially true when CTD is paired with other co-occurring conditions, especially additional musculoskeletal disorders which can increase paise.
However, when prescription drugs are prescribed for the treatment of chronic pain as a result of CTD, there is also a tendency to misuse them. Since the effects of prescription drugs may be mild or don’t last for a significant amount of time for some patients, prescription medication misuse is common to reduce the level of pain.
Prescription medication misuses greatly increases the chance of addiction and dependency.
Ultimately, drug use can lead to dependency or addiction, as the body adapts to the presence of the substance and experienced pain tolerance when the substance is active in the body, causing negative effects when the substance is removed. As such, CTD plays a significant role in the development of addiction and substance use disorders.
While cumulative trauma disorder and addiction can increase the risk for different health issues as well as decreased quality of life, addiction treatment can help prevent further symptoms and even reverse some harmful effects. Some of the addiction treatments available for substance use disorders, including those for those who have co-occurring conditions with CTD and substance use disorders.
Therapy focuses on addressing the cognitive side of substance abuse disorders in a medical setting. Often, several forms of psychotherapy are utilized, with one of the most common being Cognitive-Behavioral Therapy.
Counseling, like therapy, is focused on the connection between attitude and addiction, but it is more focused on self-guidance through each session and self-discovery than medical therapy. Counseling can be beneficial in learning healthy coping mechanisms that can help prevent relapse.
When a substance no longer enters the body after addiction has developed, it can lead to withdrawal. Withdrawal is not only a prime source of discomfort during the recovery period, but it can also lead to cravings that can cause relapse.
As such, inpatient treatments provide constant care and maintenance for those with a substance abuse disorder.
It can include several other forms of treatment, such as therapy or counseling, in a single comprehensive program directed in a medical/rehabilitation setting.
Outpatient care is designed in a way similar to inpatient – having a foundation of providing care through different treatments through a program – but it is conducted outside of a medical setting. Thus, patients meet with their health practitioners throughout the month to update progress and attending meetings, but there is an increased degree of self-advising.