The occurrence of work related musculoskeletal disorders (WRMD) has been a focus of much research and the prevalence of upper extremity disorders (UED) has also been explored. Most of the studies addressing WRMD among hairstylists considered the biomechanical demands of the industry, with a few studies acknowledging the psychosocial risk factors as precipitators of the upper extremity pain. This qualitative study contributes to an understanding of the biopsychosocial factors linked to the experience of pain, and how the process of adjustment to pain impacted the performance of roles at work and home of female hairstylists. The PEO model (Law et al., 1996) was used to describe the impact of pain on roles and the adjustment process in the management of roles, and facilitated an understanding of the occupational performance issues face by the stylists experiencing upper extremity pain.

The occurrence of work related musculoskeletal disorders (WRMD) has been a focus of much research and the prevalence of upper extremity disorders (UED) has also been explored. Most of the studies addressing WRMD among hairstylists considered the biomechanical demands of the industry, with a few studies acknowledging the psychosocial risk factors as precipitators of the upper extremity pain. This qualitative study contributes to an understanding of the biopsychosocial factors linked to the experience of pain, and how the process of adjustment to pain impacted the performance of roles at work and home of female hairstylists. The PEO model (Law et al., 1996) was used to describe the impact of pain on roles and the adjustment process in the management of roles, and facilitated an understanding of the occupational performance issues face by the stylists experiencing upper extremity pain.

The outputs that form the basis of this PhD submission include a web site that summarises a unique collection of over 200 Court Judgments in personal injury claims for work-related upper limb disorders heard in the UK, together with a number of more conventional publications. Individually, these outputs all address upper limb disorders associated with work although they each had slightly different objectives and the audiences for which they were produced significantly influenced the type of publication in which they appeared. Together, they help illustrate when, how and, to some extent, why upper limb disorders associated with keyboard use became the issue it did in the UK in the late 1980s and 1990s. While many might now regard keyboard or computer use as an innocuous task, in the late 1980s and 1990s upper limb disorders associated with keyboard use, particularly computer use, became the subject of litigation, legislation, industrial disputes and widespread publicity. The outputs on which this submission is based, together, suggest that following the importation of the concept of repetitive strain injuries (RSI) from Australia in the later 1980s, the activities of trades unions and journalists in the UK promoted work-relevant upper limb symptoms and disorders associated with keyboard use as work-induced injuries. Subsequently, a small number of successful, union-backed, personal injury claims, which involved contentious medical evidence and perhaps an element of iatrogenesis, were widely promoted as proof that computer use causes injury. Around the same time, the government chose to implement flawed Regulations relating to the design and use of computer workstations, which failed to distinguish between that which might give rise to discomfort, fatigue and frustration and that which might give rise to injury. The existence of these Regulations, which among other things require regular, individual risk assessments of computer users, unlike any other type of work, could be interpreted as further 'proof' that computer use causes injury. The approach to the prevention and management of musculoskeletal disorders advocated in current HSE guidance, including the risk assessment strategy, remain capable of generating distorted perceptions of the risks arising from keyboard and computer use.