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.

Osteoarthritis


Related Terms

  • Arthrosis
  • Articular Disease
  • Atrophic Arthritis
  • Degenerative Joint Disease
  • Hypertrophic Arthritis
  • Noninflammatory Arthritis
  • Osteoarthrosis
  • Secondary Osteoarthritis

Differential Diagnosis

Specialists

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

Comorbid Conditions

  • Conditions that precipitate secondary osteoarthritis (e.g., hemochromatosis, gout, chondrocalcinosis, intra-articular fracture)
  • Obesity
  • Rheumatoid diseases

Factors Influencing Duration

Rest and exercise must be balanced. Too much rest will weaken muscles surrounding the affected joint. This places further stress on the joint and causes additional pain and instability. Repetitive activities at home or on the job that place stress on the affected joint or cause overuse of the affected joint may lengthen disability. The presence of comorbid illness, especially metabolic, autoimmune, or neuromuscular disorders, may increase duration. Depression or other emotional reactions possibly triggered by pain and limitation of movement and function can make it more difficult to cope or overcome symptoms of OA.

Medical Codes

ICD-9-CM:
715.00 - Osteoarthrosis, Generalized; Degenerative Joint Disease, involving Multiple Joints, Site Unspecified
715.04 - Osteoarthrosis, Generalized; Degenerative Joint Disease, involving Multiple Joints, Hand; Carpus; Metacarpus; Phalanges [Fingers]
715.09 - Osteoarthrosis, Generalized; Degenerative Joint Disease, involving Multiple Joints, Multiple Sites
715.10 - Osteoarthrosis, Localized, Primary, Site Unspecified
715.11 - Osteoarthrosis, Localized, Primary, Shoulder Region; Acromioclavicular Joint(s); Glenohumeral Joint(s); Sternoclavicular Joint(s); Clavicle; Scapula
715.12 - Osteoarthrosis, Localized, Primary, Upper Arm; Elbow Joint; Humerus
715.13 - Osteoarthrosis, Localized, Primary, Forearm; Radius; Ulna; Wrist Joint
715.14 - Osteoarthrosis, Localized, Primary, Hand; Carpus; Metacarpus; Phalanges [Fingers]
715.15 - Osteoarthrosis, Localized, Primary, Pelvic Region and Thigh; Buttock, Femur, Hip (Joint)
715.16 - Osteoarthrosis, Localized, Primary, Lower Leg; Fibula; Knee Joint; Patella; Tibia
715.17 - Osteoarthrosis, Localized, Primary, Ankle and Foot; Ankle Joint; Digits [Toes]; Metatarsus; Phalanges, Foot; Tarsus; Other Joints in Foot
715.18 - Osteoarthrosis, Localized, Primary, Other Specific Sites; Head; Neck; Ribs; Skull; Trunk; Vertebral Column
715.20 - Osteoarthrosis, Localized, Secondary, Site Unspecified
715.21 - Osteoarthrosis, Localized, Secondary, Shoulder Region; Acromioclavicular Joint(s); Glenohumeral Joint(s); Sternoclavicular Joint(s); Clavicle; Scapula
715.22 - Osteoarthrosis, Localized, Secondary, Upper Arm; Elbow Joint; Humerus
715.23 - Osteoarthrosis, Localized, Secondary, Forearm; Radius; Ulna; Wrist Joint
715.24 - Osteoarthrosis, Localized, Secondary, Hand; Carpus; Metacarpus; Phalanges [Fingers]
715.25 - Osteoarthrosis, Localized, Secondary, Pelvic Region and Thigh; Buttock, Femur, Hip (Joint)
715.26 - Osteoarthrosis, Localized, Secondary, Lower Leg; Fibula; Knee Joint; Patella; Tibia
715.27 - Osteoarthrosis, Localized, Secondary, Ankle and Foot; Ankle Joint; Digits [Toes]; Metatarsus; Phalanges, Foot; Tarsus; Other Joints in Foot
715.28 - Osteoarthrosis, Localized, Secondary, Other Specific Sites; Head; Neck; Ribs; Skull; Trunk; Vertebral Column
715.30 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Site Unspecified
715.31 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Shoulder Region; Acromioclavicular Joint(s); Glenohumeral Joint(s); Sternoclavicular Joint(s); Clavicle; Scapula
715.32 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Upper Arm; Elbow Joint; Humerus
715.33 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Forearm; Radius; Ulna; Wrist Joint
715.34 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Hand; Carpus; Metacarpus; Phalanges [Fingers]
715.35 - Osteoarthrosis, Localized, Not Specified Whether Primary or Secondary, Pelvic Region and Thigh; Buttock, Femur, Hip (Joint)
715.36 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Lower Leg; Fibula; Knee Joint; Patella; Tibia
715.37 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Ankle and Foot; Ankle Joint; Digits [Toes]; Metatarsus; Phalanges, Foot; Tarsus; Other Joints in Foot
715.38 - Osteoarthrosis, Localized, Not Specified whether Primary or Secondary, Other Specific Sites; Head; Neck; Ribs; Skull; Trunk; Vertebral Column
715.80 - Osteoarthrosis Involving, or with Mention of More than One Site, but Not Specified as Generalized, Site Unspecified
715.89 - Osteoarthrosis Involving, or With Mention of More than One Site, but Not Specified as Generalized, Multiple Sites
715.90 - Osteoarthrosis, Unspecified whether Generalized or Localized, Site Unspecified
715.91 - Osteoarthrosis, Unspecified whether Generalized or Localized, Shoulder Region; Acromioclavicular Joint(s); Glenohumeral Joint(s); Sternoclavicular Joint(s); Clavicle; Scapula
715.92 - Osteoarthrosis, Unspecified whether Generalized or Localized, Upper Arm; Elbow Joint; Humerus
715.93 - Osteoarthrosis, Unspecified whether Generalized or Localized, Forearm; Radius; Ulna; Wrist Joint
715.94 - Osteoarthrosis, Unspecified whether Generalized or Localized, Hand; Carpus; Metacarpus; Phalanges [Fingers]
715.95 - Osteoarthrosis, Unspecified whether Generalized or Localized, Pelvic Region and Thigh; Buttock, Femur, Hip (Joint)
715.96 - Osteoarthrosis, Unspecified whether Generalized or Localized, Lower Leg; Fibula; Knee Joint; Patella; Tibia
715.97 - Osteoarthrosis, Unspecified whether Generalized or Localized, Ankle and Foot; Ankle Joint; Digits [Toes]; Metatarsus; Phalanges, Foot; Tarsus; Other Joints in Foot
715.98 - Osteoarthrosis, Unspecified whether Generalized or Localized, Other Specific Sites; Head; Neck; Ribs; Skull; Trunk; Vertebral Column

Treatment

Treatment is aimed at controlling pain and inflammation while maintaining mobility. Primary treatment options include exercise and medication. The treatment plan is based on several factors including the extent of joint involvement, the number and sites of involved joints, the nature of the individual's pain symptoms, presence of other health problems, the individual's age, and lifestyle issues such as occupation and typical activities of daily living.

Nonpharmacologic intervention is the mainstay of therapy for OA. The goal of exercise in treating and managing OA is to keep the cartilage healthy, maintain range of motion, and strengthen tendons and muscles to enable them to absorb stress placed on the joints. Exercises may include range of motion, strengthening (isotonic, isokinetic, and isometric), postural, and stretching exercises.

Physical therapy may also include heat treatments (warm baths, dipping the hand into hot paraffin mixed with mineral oil), massage, and traction. Especially when the neck is affected, deep heat treatment using high-frequency current (diathermy) or ultrasound may be helpful.

Because they provide only short-term relief, drugs are the least important aspect of the total treatment plan. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain and inflammation. In addition, local corticosteroid injection occasionally may be given to reduce inflammation, but may provide only temporary relief of symptoms (Bellamy). Injections of sodium hyaluronate (viscosupplementation), a natural ingredient of joint fluid, may be given to lubricate the joint. This may help reduce pain and improve function, particularly of the knee joint; however, studies examining treatment efficacy are conflicting (Bellamy; Lo). Topical analgesic creams may also be used. Muscle relaxants may be given if muscles are strained or show evidence of spasm while compensating for the affected joint. While these treatments help to control the symptoms, they do not affect the progression of the disease.

With progression to severe disease, supportive devices such as canes, braces, or shoe inserts may be needed to lessen stress on the joint and assist mobility. Exercise should be continued but may need to be modified during periods when supportive devices are required.

Surgical options should be considered in cases of advanced OA or when all other treatments have failed to bring relief. Arthroscopic débridement with or without surgical lavage is not recommended for individuals with knee OA without accompanying meniscal or cruciate ligament pathology (Kirkley; Laupattarakasem; Moseley). Surgical cutting and realignment of bone (osteotomy) increases movement and helps redistribute weight evenly on the joint. This may be done at the knee or hip and is most often used to treat younger individuals with OA. The hip or knee joint often is replaced with an artificial joint (arthroplasty). Joint replacement is usually very successful in improving motion and function and dramatically decreasing the pain. Arthrodesis (fusion) surgically fixes the joint in a permanent position.

Source: Medical Disability Advisor



ACOEM

ACOEM's Practice Guidelines, the gold standard in effective medical treatment of occupational injuries and illnesses, are provided in this section to complement the disability duration guidelines.*
 
Chronic Pain
Hand/Finger Osteoarthritis
 
* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before assuming an equivalence.

Source: ACOEM Practice Guidelines






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.