Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Impingement Syndrome


Related Terms

  • Internal Derangement of the Shoulder
  • Internal Impingement
  • Painful Shoulder
  • Rotator Cuff Impingement Syndrome
  • Subacromial Impingement Syndrome
  • Subcoracoid Impingement

Differential Diagnosis

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Rheumatologist

Comorbid Conditions

  • Biceps tendon rupture
  • Musculoskeletal disorders
  • Rheumatologic disorders
  • Shoulder instability
  • Tear in the contralateral shoulder

Medical Codes

ICD-9-CM:
718.81 - Other Joint Derangement, Not Elsewhere Classified; Flail Joint (Paralytic); Instability of Joint, Shoulder Region; Acromioclavicular Joint(s); Glenohumeral Joint(s); Sternoclavicular Joint(s); Clavicle; Scapula
726 - Peripheral Enthesopathies and Allied Syndromes
726.2 - Other Affections of Shoulder Region, Not Elsewhere Classified; Periarthritis of Shoulder; Scapulohumeral Fibrositis
840 - Sprains and Strains of Shoulder and Upper Arm
840.9 - Sprains and Strains of Shoulder and Upper Arm, Unspecified Site of Shoulder and Upper Arm; Arm NOS; Shoulder NOS

Diagnosis

History: The hallmark symptom of impingement syndrome is shoulder pain that is most often gradual and progressive over time. This type of shoulder impingement is commonly due to degenerative changes. Acute onset of pain is often linked to a traumatic event. In the early stages, individuals will experience pain only when the arm is held out from the side or in front of the body with the elbow at or above shoulder level, and the pain will be relieved with rest. There may be a "catching" sensation when the arm is lowered. As the impingement syndrome becomes more chronic, pain is felt most with shoulder activity but will not be relieved with positional change or rest. Night pain, often disturbing sleep, particularly when the patient lies on the affected shoulder is common. Shoulder pain may be so severe that it prevents the individual from moving his or her shoulder, which can lead to adhesive capsulitis. Pain is also frequently felt at night and may be severe enough to interfere with sleep, particularly when the individual rolls onto the affected shoulder. There may be a clicking or popping sensation felt with arm motion. The individual may have an occupation that requires repetitive arm motions. Complaints of weakness or the inability to raise the arm may indicate that the rotator cuff tendons are actually torn.

Physical exam: Pain will be evident in individuals as the physician elevates the arm and positions the shoulder in a 90-degree forward-flexed with 90-degees of elbow flexion and then internally rotated the arm (Hawkins impingement sign), or in maximal forward flexion (Neer impingement sign). Pain may occur at a particular point in the arc of motion but disappear as motion proceeds (called "painful arc"). Pain may also be elicited by resisted arm elevation during muscle strength testing. Range of motion testing will reveal limitations, most commonly in abduction and internal rotation. Individuals may exhibit total relief of symptoms after injection of a local anesthetic into the subacromial space (injection test). Pressure on the subacromial region produces pain (Marx).

Tests: Routine shoulder x-rays, including special views of the acromial arch, are used to evaluate the shape of the arch and rule out other diagnoses. For most individuals, MRI is the imaging study of choice for shoulder pathology (DeBerardino). It is noninvasive and can be used to measure the amount of room for the rotator cuff, determine whether tendinitis is present in the cuff tendons (increased signal), determine whether osteophytes or acromioclavicular joint hypertrophy are producing impingement, detect rotator cuff tears, and detect other pathology (such as biceps tendinitis, biceps rupture, or labrum tear). Diagnostic ultrasound or shoulder joint arthrography (x-rays obtained after injecting a contrast medium, such as iodine solution) are alternatives that examine the integrity of the rotator cuff.

Source: Medical Disability Advisor






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