Shoulder, Arm or Hand Impairments Overview

Shoulder, arm or hand impairments can include any condition which limits full use of these parts of the body. These could range from arthritis (inflammation of the joints) to paralysis, such as monoplegia (paralysis in one arm). Impairments of this nature also include amputations. Ten million people in the UK have arthritis, of whom the majority are affected in their upper limbs. About 50,000 people in the UK have some form of paralysis, including upper limb paralysis. Upper limb amputation is roughly five times less common than lower limb amputation.

What are the types of shoulder, arm or hand impairments?

Types of upper limb impairments affecting these body parts can include:

  • Arthritis
  • Tendinitis (irritation of the tendons)
  • Bursitis (causing inflammation in the elbow as a result of overuse)
  • Carpal tunnel syndrome (compression of a nerve through the wrist, resulting in numbness)
  • Paralysis (as a result of another condition such as a stroke or multiple sclerosis)
  • Amputations (of fingers, the hand, lower arm and whole arm).

Fractures and dislocations are classed as a disability under the Equality Act 2010 if their effects last 12 months or longer.

Ex-Military personnel are among the most likely to suffer from upper limb impairments.

How are shoulder, arm or hand impairments treated?

Depending on the nature of the impairment, medication may help, such as in the case of arthritis, for which a person can take anti-inflammatory and pain relief drugs.

For paralysis or numbness resulting from multiple sclerosis or other related conditions, steroids can be used to treat relapses in upper limb symptoms.

Physiotherapy can also help to mobilise joints and limbs in the case of a variety of shoulder, arm or hand impairments. For example, after a stroke which has caused the person in question to lose movement in one arm (monoplegia).

In the case of amputations, prosthetic hands and arms can be fitted so that the amputee can regain use of this body part. 

Since 2012, hand transplants have also been available to a small number of hand amputees, giving them full use of a hand again.

There are a few ways to determine whether an employee has shoulder, arm or hand impairments, or to confirm a shoulder, arm or hand impairment which requires reasonable adjustments:

  • The employee will likely raise the issue of their impairment upfront, particularly in the case of more severe impairments, such as monoplegia or amputations.
  • Even if the employee does not wish to disclose their shoulder, arm or hand impairments, an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
  • Given that shoulder, arm or hand impairments can evolve over time, with certain symptoms worsening as the person ages, it is important to maintain regular communication with the employee who has shoulder, arm or hand impairments so that the reasonable adjustments remain appropriate.

What reasonable adjustments are possible with shoulder, arm or hand impairments?

Employers have a legal duty to make reasonable adjustments for employees with shoulder, arm or hand impairments if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has one of these impairments. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of shoulder, arm or hand impairments:

  • Accommodating home or remote working: this can help if the employee has significant mobility issues which affect their ability to commute or get into the office.
  • Making assistive technology available and training on how to use it: such as expanded keyboards and forearm supports, as well as dictation devices, to enable easier use of a computer for employees with upper limb impairments.
  • Making sure there is a flexible break schedule: to accommodate employees whose tasks may exacerbate upper limb pain, or whose medication may decrease their productivity at the time of administration.
  • Adjusting deadlines: to accommodate any extra time that someone with an impairment might require to complete their work tasks.
  • Emphasising the employee’s skills, rather than the difficulties they have as a result of their shoulder, arm or hand impairments: many people with shoulder, arm or hand impairments have the same cognitive function as people without it, and so their intellectual abilities will be unaffected by their disability. It is important not to make assumptions about what the employee with the impairment can and cannot do.
  • Raise awareness: for the employees with shoulder, arm or hand impairments to be better understood in the workplace, and to make employees feel comfortable with asking for help related to their impairments.

Shoulder, arm or hand impairments Signposting

Limbless Association – organisation supporting amputees pre and post-amputation by providing advice and guidance to help in recovery and rehabilitation, including legal advice and advocacy (0800 644 0185).

Spinal Research – charity helping those living with paralysis as a result of spinal injury and funding worldwide research into treatments for paralysis (020 7653 8935).

https://blesma.org – charity campaigning for the better treatment and care of limbless veterans in the UK and helping veterans with limb amputations live full lives (020 8590 1124). 

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