IRSST - Institut de recherche Robert-Sauvé en santé et en sécurité du travail


Evaluation, Treatment and Return to Work of Workers Suffering from Rotator Cuff Disorders

Evaluation, Treatment and Return to Work of Workers Suffering from Rotator Cuff Disorders

Musculoskeletal impairments of the shoulder affect the shoulder’s functional status and the quality of life of the individuals involved, and in the case of workers, sometimes leads to problems of absenteeism or losses of productivity. Workers who perform tasks with their arms above shoulder height or repetitive tasks are at higher risk of developing shoulder impairment, especially an impairment of the rotator cuff. The IRSST carried out an extensive literature review regarding several aspects of rotator cuff impairments.

The main objective of the review was to summarize the evidence-based data and make recommendations for diagnostic and clinical evaluation tools, therapeutic interventions, and workplace interventions for workers with rotator cuff impairment.

No treatment algorithm exists to guide professionals in treating rotator cuff tendinopathy. However, based on the results of this literature review, some interventions can be recommended for managing tendinopathy or full-thickness tears of the rotator cuff.

For rotator cuff tendinopathy, taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a short period of time appears useful for alleviating pain An exercise program has also demonstrated positive outcomes in study populations of adults and workers. Particularly in workers, a therapeutic exercise program can reduce pain, improve shoulder function, and speed up the return to work. Some studies have shown similar efficacy between an exercise program and acromioplasty-type surgery for rotator cuff tendinopathy. Conservative treatment is therefore recommended initially for adults with this condition. If it fails, surgery can then be envisaged.

The predictive factors for absenteeism and return to work (RTW) were also explored. This literature review confirmed the ambiguity surrounding the factors associated with these two issues. Numerous factors actually emerged from the review, but with no consensus. Based on the determinants explored for joints other than the shoulder, psychosocial or environmental factors as well as the employer’s role appear to be key factors in the success of the RTW.