Ergonomics studies the relationship between workers and their environment. The goal is to design products and procedures that take into account the characteristics and limitations of the human body. Ergonomic desk chairs, head rests, keyboards and more help prevent MSD, musculoskeletal disease, and considering the number of hours we Americans work, that is a workplace essential!
[our aching backs]
Linda Wheatland Smith, doctor of chiropractic, Hands on Health:
Most ergonomic back pain in business results from computer use. It’s the way one’s computer is set up, the type of chair used and the length of time people sit in front of it. These all have a profound impact on the neck and back. Posture also comes into play, especially when the head and shoulders are slumped forward. Factor in repetitive thumb and finger use with a mouse, and you have a perfect storm conducive to triggering a line of pain in the back, by the shoulder blade.
To interrupt pain, alternate the mouse position from one side of the keyboard to the other and train your non-dominant hand to use it. Use a lumbar roll. It arches your lower back and helps change the spine’s dynamics. Manual therapy, including massage, spinal manipulation and acupuncture, can counteract muscular patterns that cause back pain. Be aware that weight-training programs that strengthen forward-facing muscles, such as the chest, can aggravate poor posture associated with computer use.
Dr. Howard Place, SLUCare orthopedic surgeon:
Many people move poorly, resulting in back pain. Blame it on poor education about how to move and bad habits, such as improper lifting. Some people lift and twist at the same time. Lift first, then twist.
Most of the ergonomic back pain I see is associated with recreational activities and work, but genetics also are involved. People who report a high incidence of back pain include helicopter pilots and truck drivers. These persons lean forward for hours on vibrating seats. People need to appreciate that recurrent episodes of back pain may be related to poor ergonomics, and that it would behoove them to have a medical professional observe them and train them on the proper way to perform certain activities. Bending, lifting and prolonged sitting—these all require appropriate biomechanics.
Barring trauma, treatment for back pain is similar regardless if it stems from poor ergonomics or other issues. What differs is follow-up care. Back pain from poor ergonomics concentrates on patient education and, in some instance, patient retraining.
[mouse management]
Ann Kammien, physical therapist, Rehab1Network:
The repetitive motion associated with mouse use can be bad for you. It can stress the joints and tendons, and cause pain. Although it appears counterintuitive, get a portable keyboard and mouse for your laptop. If your desk has a pull-out shelf, place the mouse and keyboard on it. The ‘tilt’ function of many pull-outs allow the hands and elbows to rest in a neutral or slightly extended position. This means the elbows are flexed less than 90 degrees. A flat surface can cause the wrists to cock up too far, putting the median nerve in a vulnerable position and creating pressure. If the pressure continues and increases, carpal tunnel can result. Similarly, if the elbow is bent too much, you can irritate the ulnar nerve and develop symptoms in your hands. Basically, you want to keystroke close to your lap. Alternate mouse use between both hands and position the device by the hand you are using. Take breaks. Stretch your arms horizontal to sides of your body, make a fist and roll your wrists up and down.
Dr. Donald Bassman, orthopedic surgeon:
Long-term and repetitive use of a computer mouse can lead to carpal tunnel syndrome, tendinitis in the wrist and elbow, and tennis elbow-like symptoms. Tendinitis is an irritation of part of the muscle-tendon unit. First-line treatment for wrist pain is to cure the cause. A wrist splint can take some of the tension off the tendons and joints. A padded wrist rest can also help reduce stress. It’s a device with a gel-like substance that supports your wrists while you’re typing on a keyboard or using a computer mouse. Take Tylenol for pain and inflammation or non-steroidal anti-inflammatory medications, like Advil or Aleve. If you improve the ergonomics and take medications, you should have symptom relief within three to four days. If that doesn’t work, switch mouse use between both hands and make sure the mouse ergonomically fits you. Physical therapy may also be recommended. Surgery is rare unless long-standing carpal tunnel syndrome has been documented.
[pain in the neck]
Dr. Chi-Tsai Tang, orthopedic physiatrist, Washington University:
Anytime there’s lots of motion and a lot of moving parts — which the neck has — you’re going to have wear-and-tear issues and occasional pain. But neck pain can also result from poor posture, particularly while working with a computer. Keep your monitor at eye level. If you constantly look up or down, you create neck tension. If your arms lie unsupported while you keystroke, you put weight and tension on the trapezius muscle, which spans the neck, shoulders and back. Many people also develop a head-forward posture. This too can strain neck muscles. Sit straighter. Do chin-tuck exercises: Tuck your chin towards your neck, look down and hold for a few seconds. Repeat.
Neck pain has many causes, and deciphering its exact etiology can be difficult. Potential causes of pain include arthritis, bulging discs, cervical radiculopathy (pinched nerve), myofascial (muscle-related) pain and myelopathy (spinal cord injury). A physical exam, health history and imaging test bring together the information needed to make a diagnosis. For persistent neck pain, see a physician.
Brenda Kingen, owner, Kingen Chiropractic Wellness Center:
I’m seeing more arthritis in progressively younger people due to the loss of the cervical curve in their spine. A normal spine curves slightly inward. Blame poor ergonomics — and technology. Increasingly, kids and young adults lounge in a chair or a couch for hours with their laptops, tablets and cell phones. They often lean with their heads tilting forward. That forward carriage of the head creates a rounding of the upper back. Most of us aren’t aware of this posture because we don’t see ourselves from the side. Over time, the muscles in the front of the neck can shorten. That’s when I start to see changes in the spine, which affects the nervous system and brings about chronic neck pain and, sometimes, arthritis. From a chiropractic point of view, we work on restoring good mobility in the spine and associated structures, such as the neck. Besides administering spinal adjustments, we give these patients stretches to open up the front muscles in the neck and the chest, and exercises to strengthen their back.
[the perfect perch]
Not all chairs are created equal, says Laurie Wall, owner of Advanced Ergonomic Concepts, an office industrial workstation company. “You need the right fit for the right use.” And just like the shoes you buy, you need to try out several chairs for size. Some companies let customers ‘demo’ a chair for a day, Wall says.
What to look for? “An office chair should have lots of adjustable features you can control with ease,” she says. You should be able to adjust the height and angle of the seat and the chair back, she explains. “The back of the chair should come up to the shoulder blades or higher, which is the thoracic part of the spine. Some people with back problems may need adjustable lumbar support.”
A good-fitting chair allows you to sit with feet on the floor, shoulders relaxed and forearms resting comfortably on armrests. Wall recommends padded armrests; wheels are optional. “Don’t rush and buy the first chair,” she says. “Compare options, and opt for one that offers firm support, preferably one made from molded foam. A chair isn’t just a piece of furniture. It’s an investment in your health.”
[sitting can be hazardous to your health]
Too much of anything is unwise. Even sitting. Some medical experts now say ‘sitting is the new smoking’ and that prolonged sitting can damage your health. Signature Medical Group orthopedic surgeon Dr. Coles L’Hommedieu agrees prolonged sitting is a major problem. “There’s been lots of research on it, including a recent study of 60,000 Australian men between the ages of 45 and 65,” he says. The men were divided into groups based on the amount of time they sat each day: less than four hours of sitting, four to six hours, six to eight hours. and more than eight hours. “While men who sat eight or more hours had the highest risk, those who routinely sat four hours still had significant risk for disease development, including cardiovascular disease, cancer, obesity and Type 2 diabetes,” he says.
So what are we to do if our job requires us to sit for extended periods of time? “Stand,” L’Hommedieu says. “Take micro-breaks to stretch. Do chair-based exercises, and be diligent about minimizing sitting during leisure activities. Small steps, including short walks, can make a difference. Any activity is better than none. The body is designed to move.”
[stats]
33% of all worker injury and illness cases were related to musculoskeletal disorders, according to the 2011 numbers from Bureau of Labor Statistics.
