Background: This is an account of a patient working in an ophthalmology clinic in a tertiary care hospital, Riyadh, who initially presented with work-related musculoskeletal disorder of the upper limb. The primary complaint was pain in the right shoulder and arm for the past 6 months. She was diagnosed with tenosynovitis of the upper limb on the first presentation, but later investigations revealed cervical stenosis. Case Presentation: A 42-year-old Indian female nurse, working in ophthalmology outpatient clinic at a university hospital in Riyadh, Saudi Arabia, presented with the complaints of pain in the right shoulder and arm for the past 6 months. She was transferred to another area with less work load and reduced exposure to occupational work manual exertion and sustained awkward exposure. The symptoms improved after 6 months of her transfer to the current unit. Conclusion: Although the initial symptoms were in favor of work-related upper limb musculoskeletal disorder, the nature of symptoms led to extensive workup, magnetic resonance imaging, diagnosis of cervical stenosis, and referral to orthopedics and neurology for further management.

Keywords: Work-related musculoskeletal injury, cervical stenosis, disc herniation, upper limb pain, case report