Everyday Office Ergonomics

Posted on October 30th, 2009

Nearly anyone who has used a computer has experienced discomfort in the neck at some point. The most common cause is overuse of the neck musculature to hold the head up, instead of letting the spine do the job. This occurs when the worker juts the head forward while viewing the screen. People are rarely conscious they are doing this. When a screen is too far away for the eyes to see properly our heads move closer to the screen to fix the problem. Unfortunately, this creates other problems such as neck strain.

Adjusting the Monitor

In general the screen should be about an arm’s length away; it can be moved within a six-inch range, either way, depending on the worker’s vision. Monitors should always be placed where the user can look straight at them. Constantly looking off to one side to view the screen creates static load in the neck musculature, as well as muscle imbalances that can add up to significant injury. Adjustable monitor arms allow the screen to be placed in front of the worker and then slid out of the way for other tasks.

For users without glasses or for those who use single-vision lenses, the top of the glass screen should be at eye height. This position will let the eyes gaze down on the screen at the preferred angle. Workers who have bifocals will often tilt the head up to view the screen through the lower part of the lenses. The best solution is to discuss single-vision computer glasses with an optometrist. Otherwise, workers should lower the screen a few inches, so they can view the monitor with the head in a straight forward position, without the chin pointing up or down.

Positioning the Chair

A properly adjusted office chair is the most important tool that allows an office worker to work efficiently and safely. If there is insufficient lumbar support, patients can compensate with a back support, rolled towel or small pillow. If the seat is too deep—keeping the workers from being supported—they can use a back support or full-length pillow to take up the extra room.

In addition, educate your patients about how to adjust their chairs:

*Lower the chair until feet are well supported on the ground. If they are not firmly planted, use a footrest to provide support.
*Adjust the seat depth so there is one-to-three-fingers’ space between the front of the chair and the back of the knee.

*Adjust the armrests so they are one inch below the forearms. If the patient has any neck issues, bring the armrests up to provide support, without reaching down or up to use them.

Choosing a Keyboard

Design
Most keyboards have a standard design copied from typewriters with a number pad thrown on the right side for increased efficiency. Users typically plop down in front of the computer and center themselves between the side of the keyboard on the left and the mouse on the right. Now the right arm is externally rotated and reaching to use the mouse and then reaching across the mid-line of the body to type, so it is never in a good position.

The best solutions are to move the mouse to the left or use a keyboard that has the number pad on the left side. Workers can then center themselves by lining the bellybutton up with the “B” key.

Angle
Due to the variability of people’s shoulder widths and forearm lengths, many workers cannot use a standard keyboard without sustained ulnar deviation at the wrists. This causes static use and overload of the forearm muscles. A keyboard that allows angle and pitch adjustments is the solution to this problem.

Reach
Reaching to use a keyboard that is too high forces the upper traps to fire continuously, creating tension, fatigue and pain. A keyboard tray is the most helpful of the ergonomic tools, as it can fix problems ranging from excessive reach for the keyboard and mouse to improper wrist angles when typing. Since the proper writing height is several inches higher than the proper typing height, the tray will allow both functions to be performed safely.

Rest Breaks and Task Rotation

To work properly over time, muscles need a break to rid themselves of lactic acid and waste products while delivering oxygen to the tissues to prevent overuse and damage.

Teach patients to take a 15-second micro-break each hour. This is an easy solution for employers to accept, which helps gain compliance. During the micro-breaks, the office workers should shake their arms out or do simple stretches you can provide for them. Computer users should also frequently look away from their screen to focus on something about 20 feet away. This allows a break for the eye muscles. If they can’t seem to remember to take breaks, an egg timer can serve as a reminder. A software program such as RSI Guard can also help workers tailor breaks to the amount of work.

People are always concerned about how it will look if they seem to be taking too many breaks or are unproductive. By spreading tasks, like going to the fax and copier, returning phone calls and meeting with co-workers throughout the day, they can still be productive while giving their body a break from the computer.

Starting with these simple adjustments, your patients who work in an office should feel happier and healthier at their jobs in no time.

This article was in the magazine:
ACAnews: The Official Publication of the American Chiropractic Association
October 2009 edition pp 28-29 by Chris Sorrells

Tags: Back Injury, Chronic Pain, Ergonomics, Neck Pain, Treatment
Filed under Chronic Pain, Ergonomics, Neck Pain, Relief for Aching Back | No Comments »

Relief for Aching Backs

Posted on September 16th, 2009

Relief for aching backs

Hands-on therapies were top-rated by 14,000 consumers

About 80 percent of U.S. adults have at some point been bothered by back pain. The Consumer Reports Health Ratings Center recently surveyed more than 14,000 subscribers who had lower-back pain in the past year but had never had back surgery. More than half said pain severely limited their daily routine for a week or longer, and 88 percent said it recurred through the year. Many said the pain interfered with sleep, sex, and efforts to maintain a healthy weight.

photo is from photobucket.com

Back pain can be tough to treat. Most of our respondents tried five or six different treatments. They rated the helpfulness of the treatments tried and their satisfaction with the health-care professionals visited.

Hands-on therapies were among the top-rated. Fifty-eight percent of those who tried chiropractic manipulation said it helped a lot, and 59 percent were “completely” or “very” satisfied with their chiropractor. Massage and physical therapy were close runners-up.

Many of those who tried spinal injections found them to be very helpful, although the techniques their doctors used varied. Most respondents had used some type of medication. Forty-five percent of those who took prescription drugs said they helped a lot, double the percentage of those who said they were helped by over-the-counter medications.

Where to go for treatment

“Everyone seems to be selling some kind of gimmick, treatment, or pill for low-back pain,” says neurologist Scott Haldeman, M.D., who co-edited the January/February 2008 issue of The Spine Journal, which reviewed ways of treating low-back pain. But when treatments abound, it’s usually because there’s no clear winner.

A visit to a primary-care doctor is a smart first step when back pain is severe. A doctor can help rule out disease, such as infection or cancer. Although many of our respondents who saw a primary-care doctor left dissatisfied, doctors can write referrals for hands-on treatments that might be covered by health insurance.

Enduring the pain or seeing a chiropractor or physical therapist as a first step might be OK for a recurrent, familiar back problem. Most of the 35 percent of our respondents who didn’t see a health professional had severely limiting pain for less than a week. Many of those with more prolonged pain who didn’t see a healthcare professional said it was because of cost concerns or because they did not believe professional care could help.

Research suggests that chiropractic manipulation can reduce acute low-back pain, and many, though certainly not all, of the respondents who tried it said it helped. Albert McCann, 54, a respondent from Lakeland, Fla., has kept working as a petroleum transport engineer, driving a semi truck and using 20-foot-long hoses several times a day. By following a chiropractor’s recommendations and getting treatment every few weeks—including manual adjustments, electric stimulation, and a spinalator (roller-massage table)—he is able to keep his back pain to a minimum.

Massage and physical therapy were other treatments rated very helpful by 48 and 46 percent of consumers, respectively. “My back pain was unrelenting,” says survey respondent Charlene Mower of Fayetteville, Ark. “Before physical therapy, I thought I was done for.” Mower, 51, hurt her back while trying to lift her bedridden mother. She credits the training in lifting and bending techniques that a therapist gave her and continued exercise for her long-term success in staving off pain.

Lifestyle changes can help .

Cindy Pickett developed low-back pain at age 22, when she was building a bookcase and suffered two slipped disks. Over the years back pain and other factors led to a 100-pound weight gain. At 59, Pickett, a schoolteacher from Flagstaff, Ariz., retired and decided to make weight loss and exercise her full-time job. She credits her improvement to the combination of weight loss and abdominal-strengthening exercises that reduced pressure on her lower back. Pickett reports that she has not had to take pain relievers for months.

Forty-four percent of our survey respondents found exercise helpful, making it the top self-help measure. And a surprising 58 percent of respondents wished that they had done more exercises to strengthen their backs in the past year. That is more than twice the number who told us they wished that they had reduced or avoided activities that might make the pain worse.

Use caution with surgery

Your doctor might suggest you see a surgeon if back pain is unrelenting and no other treatment seems to work. We conducted a separate survey of almost 1,000 consumers who have had back surgery in the past five years.

Those who had back surgery had tried nine to 10 treatments and described themselves as much more impaired by their pain than people with back problems who did not have surgery. Just 60 percent of the back-surgery respondents were completely or very satisfied with the results, compared with 82 percent of respondents who were satisfied after hip- or knee-replacement surgery in our 2006 survey.

But satisfaction depended on the diagnosis and the type of surgery. Those with degenerative disk disease (arthritis of the spine) were far less likely to be highly satisfied with surgery (54 percent) than those with a herniated disk (73 percent) or spinal stenosis (71 percent).

Alfonso Sanchez, 38, a state senatorial aide from Sacramento, Calif., was highly satisfied with his lumbar discectomy. His back pain turned excruciating when he was canvassing door-to-door in the hills of San Francisco last June. After failing to improve with acupuncture, physical therapy, and chiropractic treatments, Sanchez underwent a microdiscectomy last August. Remarkably, as soon as he woke up from the anesthesia, his pain was gone. He is now back to gardening and riding a bike to work.

But not everyone does so well. More than 50 percent of respondents reported at least one problem with recovery, finding it lengthier and more painful than they had expected. Indeed, 16 percent of back-surgery respondents said that their back pain did not improve, and half of those said it became worse after surgery. The most common regret was that more post-surgery rehabilitation was not planned.

If you’re told you need surgery, get a second opinion from another practitioner, preferably one who is not a surgeon. If you decide that surgery is the best approach, ask whether the surgeon is board-certified and find out how many operations he or she has done.

For more guidance, see our free diagnostic tool for back pain at www.ConsumerReportsHealth.org. More detailed information is available to subscribers to that site, including consumer ratings and the medical evidence for 23 back remedies

Who helped the most?

The percent of people highly (completely or very) satisfied with their back-pain treatments and advice varied by practitioner visited.

Professional - Highly satisfied
Chiropractor 59%
Physical therapist 55%
Acupuncturist 53%
Physician, specialist 44%
Physician, primary care 34%

Differences in Ratings for physical therapists and acupuncturists were not statistically significant.

Article is from “Contents: Consumer Reports” Magazine
May 2009 pages 12-13

Tags: Anti Inflammatories, Back Injury, Chronic Pain, Spinal Decompression, Sports Injury, Treatment
Filed under Back Pain, Chronic Pain, Relief for Aching Back | No Comments »