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Abstract

Background Piriformis syndrome (PS) is a neuromuscular disorder with significant impact on workforce productivity. This case report presents a comprehensive evaluation of fitness for work and job modification strategies for a patient with PS in a combined physical and sedentary working environment. A 44-year-old male medical facility supervisor presented with left buttock pain, radiating to the left leg, diagnosed with left gluteal piriformis syndrome. Despite undergoing multiple conservative therapies by Physical Medicine and Rehabilitation Specialist, the patient showed minimal improvement.

Methods A seven-step fitness for work assessment approach was implemented following Indonesian Association of Occupational Medicine Specialists guidelines. The evaluation encompassed detailed job analysis, physical demands assessment, medical condition evaluation, impairment assessment, risk analysis, tolerance determination, and final fitness for work determination.

Result The patient was declared fit with restrictions, particularly regarding oxygen cylinder handling activities. Workplace ergonomic risk factors were identified, including non-adjustable workstation equipment and manual lifting requirements. Job modifications and ergonomic interventions were recommended, including implementation of lifting aids, surface modifications, and structured break schedules with stretching exercises.

Discussion This case highlights the importance of comprehensive occupational health assessment in managing PS patients with combined physical-sedentary work demands. Success of return-to-work programs depends on workplace ergonomic modifications, employer support, and regular occupational medicine specialist follow-up.

Conclusion The case emphasizes the need for collaborative approaches between healthcare providers, employers, and coworkers in facilitating optimal recovery and successful workplace reintegration.

References

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