May 18, 2010
How You Work Can Affect How You Feel
By Dr. Jennifer Yang, Physical Medicine and Rehabilitation Specialist
Walton Rehabilitation Health System
Augusta, GA—As more and more people use computers in their everyday lives, it is important that we become more aware of the injuries that can occur in those who spend most of their workday in front of the computer. Computer work may appear to be a low-effort activity when viewed from a total body perspective, but maintaining postures or performing highly repetitive tasks for extended periods can lead to problems in specific areas of the body.
Unlike falls, lifting injuries and many other work-related injuries that occur suddenly at a specific time, musculoskeletal disorders from ergonomic problems usually arise from frequent or repetitive movements. Known as cumulative trauma disorders (CTDs), these may also be referred to as repetitive overuse disorders, repetitive motion disorders, repetitive strain injuries or occupation overuse injuries. A CTD is a condition that develops because of repeated tissue microtrauma that exceeds the tissue’s ability to heal itself.
That’s where ergonomics can help. Ergonomics is the study of fitting the job to the worker and the worker to the job by understanding how human anatomy interacts with the physical environment during functional tasks. By ensuring proper “fit” between the worker, the job tasks, the tools and equipment used, and the work environment, an ergonomically correct workstation can help lessen the incidence of work injuries and errors, reduce the worker’s fatigue and physical stress, and enhance overall productivity. An understanding of human anatomy, physiology and psychology can promote design that will improve both worker well-being and workplace efficiency.
Typical symptoms of work-related musculoskeletal disorders include numbness, tingling, pain, stiffness, cramping and weakness. The most common CTDs related to computer use include:
- Cervical myofascial pain syndrome, neck and shoulder pain that can be caused by poor posture and muscle overuse when sitting at a computer workstation for prolonged periods of time.
- Rotator cuff disease, affecting the muscles and tendons that hold the shoulder joint in place (the “rotator cuff”). Shoulder pain and weakness limit movement and are typically caused by frequent performance of overhead activities and reaching.
- DeQuervain’s tenosynovitis, an inflammation of the tendons of the muscles moving the thumb, caused by repetitive pinching motions of the thumb and fingers (such as from using joysticks or scissors).
- Ulnar neuropathy at the elbow, which manifests as numbness in the pinkie and ring fingers, hand clumsiness and weakness, and pain from the elbow down the forearm. Symptoms are due to damage to the ulnar nerve that stretches across the elbow joint, and are associated with repetitive elbow movements or prolonged and frequent placement of the elbows on a desk or armrests.
- Carpal tunnel syndrome, the most widely recognized of all CTDs, resulting in pain, tingling and numbness from the heel of the hand through the middle finger and sometimes includes the wrist; in severe cases, hand grip weakness and clumsiness are also common. Repetitive strain and overuse of the wrist joint causes inflammation of the tendons, which in turn crowd around the median nerve that runs alongside the tendons. Any repetitive motions involving the wrist such as excessive keyboard typing and computer mouse use are common causes of carpal tunnel syndrome.
The Ergonomic Workstation
Good ergonomic design is the solution to prevent musculoskeletal injuries. A neutral body position - a comfortable working posture in which your joints are naturally aligned - reduces stress and strain on the muscles, tendons, bones and joints. This in turn reduces your risk of developing a musculoskeletal disorder.
Neutral body position guidelines at the computer workstation from the Occupational Safety and Health Administration include:
- Hands, wrists, and forearms are straight, in-line and roughly parallel to the floor.
- Head is level, or bent slightly forward, forward facing, and balanced. Generally it is in-line with the torso.
- Shoulders are relaxed and upper arms hang normally at the side of the body.
- Elbows stay in close to the body and are bent between 90 and 120 degrees.
- Feet are fully supported by floor or footrest.
- Back is fully supported with appropriate lumbar support when sitting vertical or leaning back slightly.
- Thighs and hips are supported by a well-padded seat and generally parallel to the floor.
- Knees are about the same height as the hips with the feet slightly forward.
Although a good working posture is ideal, working in the same posture or sitting still for prolonged periods can also be unhealthy. Making small adjustments to the chair or backrest; stretching fingers, hands, arms and torso; standing up and walking around for a few minutes periodically are ways one can use to change working positions frequently throughout the day.
Treating Overuse Injuries
Should you experience an overuse injury, visiting a physician familiar with musculoskeletal anatomy, kinesiology and neuromuscular physiology would be a good way to begin treatment. Evaluation will include a thorough history (to help identify any underlying disorders that may be contributing to your injury or pain), a physical examination and diagnostic tests, if needed.
Non-operative treatments that your physician may recommend include medications, selective injections, modalities such as ice, heat or ultrasound, splinting and therapeutic exercise. You can perform these exercises by yourself at home and work, or with the specialized supervision of physical or occupational therapists. Surgery may also be an option as a last resort in certain cases.
But the most important treatment begins at your computer workstation: configuring it to fit you better is the first step in eliminating the root cause of CTDs. Continuing work-related repetitive tasks that cause CTDs are likely to cause symptoms to worsen, and if the disorder is not treated or inadequately treated, pain symptoms may spread to other body regions or even occur at rest. By making ergonomics a priority, you can help keep these work-related problems from becoming an issue.
Media Contact: Danielle Wong Moores, Public Relations Specialist, 706-434-0150
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