When farming hurts

Early treatment of on-farm injuries can help prevent the development of more serious musculoskeletal disorders

It’s no secret that many Canadian farmers still work even when in physical pain. Unfortunately, that same work ethic that puts money in the bank can increase your risk of developing recurrent or chronic musculoskeletal disorders, say researchers with the Canadian Centre for Health and Safety in Agriculture (CCHSA) in Saskatoon.

Farming is physical, and it’s that part of the job that can lead to injuries such as broken bones, soft-tissue injuries, pulled tendons and pinched nerves, says Brenna Bath, a professor at the University of Saskatchewan’s School of Physical Therapy and a CCHSA researcher.

These types of injuries may lead to the development of some painful musculoskeletal disorders (MSDs) such as osteoarthritis, tendinitis, carpal tunnel syndrome, fibromyalgia and rheumatoid arthritis, to name a few.

Osteoarthritis — sometimes called “degenerative joint disease,” or “wear-andtear arthritis” — is one of the more common musculoskeletal disorders. It often shows up years after an injury and in the joints affected by the repetitive stresses of the work environment. (see sidebar)

MSDs can affect any area of your musculoskeletal system such as the neck, hips, knees, wrists, shoulders and back. Those that manifest in the lower back, shoulders and knees are more common in farmers than the rest of the Canadian population, says Catherine Trask, Canada research chair in ergonomics and musculoskeletal health with CCHSA.

The most common symptoms of MSDs include dull aches, swelling, stiff joints and recurrent pain.

Unfortunately for farmers, the prevention and treatment of these injuries and any associated MSDs are complicated by circumstance. CCHSA research shows:

  • Compared to other occupations, farmers start younger and work more years, putting more physical stress on their bodies over a longer period of time.
  • Seasonal stressors dictate long hours.
  • Geographic isolation restricts access to treatment.
  • Some farmers/employees lack access to funded health benefits like physiotherapy.

“Even when farmers experience an episode of increased pain, it’s ‘job first,'” says Bath. “There is a sense that taking time off is not a realistic option. And faced with the prospect of a long drive followed by a brief appointment with a health care provider, some farmers opt against seeing a health care professional,” she explains. “They may not think the time trade-off is worth it.”

“In fairness, the tendency to work through pain is not always a bad thing,” says Trask. “Pain tolerance or acceptance can be healthy when it keeps people active and engaged with life. Movement can also help with healing.” She and Bath recommend seeking advice from a health care professional when pain is constant and doesn’t change with activity or rest.

Most musculoskeletal and joint injuries tend to be self-limiting, or resolve on their own, says Marvin Fritzler, a rheumatologist and member of the McCaig Institute for Bone and Joint Health in Calgary. “If that doesn’t happen in a normal healing window, which would be a month or less, then attention is required,” he says.

But it’s not always as straightforward as it seems. “‘Arthritis’ is a catch-all label for joint disorders, but there are more than 100 different forms of arthritis,” says Fritzler.

“When an individual develops joint pain, the importance of making sure which of those 100 we’re dealing with is important.”

He says the initial cause of the disorder may be obvious if it happens after an injury, a fall or being trampled or kicked by an animal. “We now know that events like that can be a trigger for one of the inflammatory autoimmune diseases that can lead to significant disability,” he says.

Inflammatory diseases that might be triggered by a joint injury include gout and pseudo-gout, which can present as debilitating foot or knee pain. Definitely go see a doctor when an injury fails to resolve in a timely fashion, or if other joints are affected by pain, swelling, redness or limited movement.

Fritzler, who grew up on a farm southeast of Calgary, knows the culture of farming can work against seeking medical care. But it’s important to seek help because post-trauma treatments such as physiotherapy, may help slow the progression of some forms of osteoarthritis.

The bottom line is that while MSDs are a leading cause of disability, early treatment can impact long-term outcomes.