How to Avoid a Pain in the Neck

OR How to Avoid a Pain in the Neck COURSE INTRODUCTION Computers are found in almost every workplace. Unfortunately, many employees suffer work related injuries from prolonged use of a computer. This CE course will describe musculoskeletal disorders associated with prolonged computer use, ergonomic principles for setting up computer workstations, and exercises that may assist in preventing employee injury. Ver 6.0 9/2012 1

X No COURSE TITLE: COMPUTER WORKSTATION ERGONOMICS Author: Lucia Johnson, MA Ed, CLS(NCA),MT(ASCP)SBB Director of Continuing Education National Center for Competency Testing Number of Clock Hours Credit: 1.0 Course # 1221206 P.A.C.E. Approved: Yes U U Course Objectives Upon completion of this CE module, the professional will be able to: 1. List the benefits of using ergonomic principles in the workplace. 2. Identify physical problems associated with prolonged computer use. 3. List four types of musculoskeletal diseases associated with prolonged computer use. 4. List seven types of tendon disorders associated with prolonged use of a computer. 5. List three types of nerve disorders associated with prolonged use of a computer. 6. Describe thoracic outlet syndrome. 7. Identify three general causes of lower back pain. 8. List occupational and non-occupational risk factors associated with musculoskeletal disorders. 9. Identify correct body positioning when sitting in a chair. 10. Describe the ergonomic setup of a computer workstation. 11. Describe stretching exercises that should be performed several times throughout the day. Disclaimer The writers for NCCT continuing education courses attempt to provide factual information based on literature review and current professional practice. However, NCCT does not guarantee that the information contained in the continuing education courses is free from all errors and omissions. 2

INTRODUCTION Ergonomics is defined as the science of designing the workplace to accommodate the worker for the purposes of avoiding physical injuries resulting from work-related tasks. Benefits of using ergonomic principles in the workplace include: increased productivity, increased job satisfaction, increased work quality, lower employee turnover, lower lost time at work, and lower worker s compensation claims. Employers should proactively evaluate the ergonomics in their workplace. However, most evaluations do not take place until an employee has reported an injury. Computers have become common in almost every workplace. Unfortunately, prolonged use of computers can lead to numerous physical problems. This CE course will focus on injuries associated with prolonged computer use, proper workstation setup, and exercises that may prevent common injuries. PHYSICAL PROBLEMS RESULTING FROM COMPUTER USE Prolonged use of computers may cause the following physical problems: back pain caused from sitting incorrectly at workstations; eye problems from looking all day at computer screens; musculoskeletal disorders from repetitive tasks such mousing, and muscle aches and nerve pains in the wrists, arms, and shoulders from prolonged use of a computer keyboard and mouse. MUSCULOSKELETAL DISORDERS AND RISK FACTORS Musculoskeletal disorders (MSDs) are also called cumulative trauma disorders (CTDs) and repetitive motion injuries (RMIs). These disorders result when muscles, joints, tendons, and nerves are overused resulting in pain. MSDs can be grouped into four types: Tendon disorders tendonitis inflammation of a tendon for computer users, usually occurs in hand, wrist, arm, shoulder tenosynovitis inflammation of the sheath that surrounds a tendon for computer users, usually occurs in hand, wrist, arm, shoulder DeQuervain s disease narrowing of the sheath that surrounds a tendon occurs in wrist and thumb 3

trigger finger finger that jerks/snaps as a result of a locked tendon; end segments of the fingers end up being flexed while the middle segments are straight fingers and hand ganglionic cyst tendon sheath swells up with synovial fluid most commonly occurs in wrist epicondylitis unsheathed tendons in elbows and shoulders become inflamed and radiate pain occurs in elbows ( tennis elbow ) and shoulders rotator cuff syndrome inflammation of the tendons in rotator cuff of the shoulder resulting in pain occurs in shoulders Nerve disorders carpal tunnel syndrome compression of the nerve on the thumb side of the wrist resulting in weakness, pain, burning, tingling, and numbness; reduced grip strength affects hands (palm to area below the ring finger, the thumb and the index, middle, and ring finger) guynon tunnel syndrome compression of the nerve on the little finger side of the hand resulting in weakness, pain, burning, tingling, and numbness affects little finger cubital tunnel syndrome compression of the nerve below the notch on the inside of the elbow resulting in tingling, numbness, or pain radiating into the ring or little finger affects ring and little fingers Neurovascular disorders thoracic outlet syndrome compression of the nerves and blood vessels between the collar bone and the first and second ribs resulting in numbness of the arms; also limits muscular activities occurs in shoulders and arms Low back disorders lower back pain resulting from problems with muscles, intervertebral discs, and nerves next to the spine resulting in pain affects the lower back 4

The Occupational Safety and Health Administration (OSHA) has identified the following occupational and non-occupational risk factors associated with MSDs: Occupational repetition forceful exertions awkward postures contact stress vibration Non-Occupational hobbies such as tennis, gardening, bowling, golfing, knitting, etc. gender (females are much more likely to get MSDs) age (persons over 40 have a higher incidence of MSDs) previous trauma to an area that worsens due to overuse of the same muscle, tendon, or nerve. Musculoskeletal disorders do not improve with time. All employees should be aware of symptoms of MSDs and they should report them immediately to their supervisor. Depending on the place of business, the employee may be referred to an employee health program or asked to contact his/her personal employee. GENERAL ERGONOMIC TIPS Watch Your Posture! Maintain the three normal curves of the spine as much as possible, especially when maintaining static positions or when bending or lifting. Wear shoes with good support and cushioning if your work requires a lot of standing or walking. If standing in one spot for long periods, use special anti-fatigue mats that redistribute pressure on the legs. Sit back in your chair to keep the back supported. If you sit back and your feet no longer reach the floor, adjust the chair. If your chair lacks good back support, tilt the seat forward or use a seat wedge to position the back and the pelvis in a better position. 5

Minimize Upper Back Discomfort! Maintain neutral wrist/arm postures as much as possible. Keep the elbows to the side of the body. This keeps the shoulders in a neutral position. Sit close to your work area, hold objects in close to the body, and adjust your chair to the height of the desk. Keep supplies that are used most frequently in closest reach as possible. Avoid Static Positions! When standing for long periods, make sure you shift your weight shift often. Use a stool or shelf to raise one foot off the floor to relieve pressure on your back. Avoid long sessions of repetitive motion by varying your activities. COMPUTER ERGONOMIC TIPS Seating Adjust the height of your chair so that your: feet rest comfortably on the floor or a footrest, knees bend at 90º or slightly greater, and thighs rest parallel to the floor. Adjust the seat back so that your: hips bend at 90º or slightly greater, and lower back is adequately supported. Adjust the seat depth to allow for a 2 4 gap between the front edge of the seat and the back of your knees. Mouse and keyboard height Adjust your mouse and keyboard height so that your: hands are at elbow height or slightly lower, forearms and hands form straight lines, and shoulders are relaxed, with elbows hanging close to your body. Monitor placement Adjust your monitor position so that: the top of the screen lines up at or slightly below your eye level, the monitor is straight in front of you, the distance from your eyes to the monitor is between 16 28, and you can look at the monitor with an upright head position with your chin tucked in. 6

Posture and positioning Avoid twisting or bending your trunk or neck when working. Frequently used items should be positioned directly in front of you. Document holders should be angled upward when typing from a printed document. Your wrists should be in a neutral or straight position when keying, typing, or using a mouse. Wrist pads can assist you in maintaining a neutral position when used properly during pauses. Float your arms above the keyboard and wrist pad when keying. Avoid planting your wrists on the table or wrist pad. This can result in bending the wrists either up and down or side to side. Work pace Work at a reasonable pace. Take frequent rest breaks during the day. These breaks can be brief and should include stretches for optimal results. If possible, take a 1 or 2 minute break every 15-20 minutes. Every one or two hours, get up, move around, and do an alternate activity. Work technique Keep your fingers and knuckles relaxed when working at the keyboard. Avoid hitting the keyboard with excessive force. Avoid holding your mouse tightly. Your hand should be relaxed. Rest your eyes by refocusing on distant objects intermittently when working. Alternate tasks to make changes in your working position to avoid making the same movements for prolonged periods. Never hold a pen or pencil in your hand when typing. Work environment Avoid excessive reaching when working at the computer. Your keyboard, mouse, files, and telephone should be within easy reach. Position your monitor to eliminate excessive glare. Avoid reflections from windows or overhead lighting. When writing at the computer, avoid excessive reaching over the keyboard or work materials. Avoid direct or overly bright lighting but make sure you have enough light to see comfortably. 7

WORKSTATION EXERCISES Exercises performed throughout the day may help in preventing injuries. Individuals with any previous injury should check with their personal physician before performing these exercises on a routine basis. Head rotations to relieve neck tension Drop your head forward and rotate it in a circle to the left three times. Repeat the motion to the right. Perform this exercise slowly and avoid bending your head backwards. Stretching exercises to reduce the chance of carpal tunnel syndrome Tightly clench your hands and release. Fan out your fingers. Repeat five times. Rest your forearm on the edge of the table. Grasp the fingers of one hand and gently bend back your wrist for five seconds. Repeat with the other forearm. Elbow presses to reduce the tension between your shoulder blades Fold your arms at shoulder height in front of you and then push elbows back. Hold for a few seconds, repeat as necessary. Leg pulls to help stretch out your lower back and upper leg muscles From a sitting position, grasp the knee shin of one leg and slowly pull it toward your chest. Hold for the count of three and then release. Repeat the movement on the other leg. Vision breaks to relax your eyes and reduce eyestrain Form shallow cups with the palms of your hands. Place them directly over your closed eyes. Keep them there for about one minute. Do not place direct pressure on your eyeballs. Take a deep wink by closing your eyes tightly for several seconds. Then open them wide and hold open for a few seconds. Repeat several times. Shoulder rolls to loosen tight neck and upper arm muscles Roll shoulders in a wide circular motion to the front. Repeat several times. Then perform the same movement to the back. Body bend to stretch out the lower back From a sitting position, slowly bend your upper body down toward your knees. Hold for a count of three then slowly raise your upper body. Repeat several times. 8

Deep breathing to promote breathing from the diaphragm the key to relaxation! On the count of one, inhale. Hold your breath for counts of two and three. Count to four and exhale. Repeat several times. CONCLUSION Computers have become necessary items in almost every workplace, and yet prolonged use can result in employee injury. Knowing the correct way to set up computer workstations, symptoms of musculoskeletal disorders, and exercises to minimize injuries is important to assure that employees work safely. Taking time for all employees to ergonomically adjust their computer workstations is well worth the effort happier employees and less injuries! 9

\\ REFERENCES Stanford University Environmental Health and Safety. Keys to Safe Computer Use. HTwww.stanford.edu/dept/EHSTH The EyeCare Connection. Computers and Eyestrain. HTwww.eyecarecontacts.comTH National Association of Convenience Stores. Ergonomics 101-The Basics: What Retailers Need to Know. HTwww.nbacsonline.comTH Computer Ergonomics. Living with Computers. HTwww.klis.com/computers+health/TH 10

TEST QUESTIONS Computer Workstation Ergonomics Course # 1221206 Directions: Please answer these questions from the information in the article presented. 1. Working all day at a computer may result in all of the following EXCEPT. a. ankle pain b. cumulative trauma disorder c. eyestrain d. inflammation of nerves in the hand 2. Carpal tunnel syndrome is a disorder. a. lower back b. nerve c. neurovascular d. tendon 3. The musculoskeletal disorder that involves both nerves and veins is. a. carpal tunnel syndrome b. epicondylitis c. DeQuervain s disease d. thoracic outlet syndrome 4. Lower back disorders may result from problems with all of the following EXCEPT. a. blood vessels surrounding the spinal column b. intervertebral discs c. muscles surrounding the spinal column d. nerves surrounding the spinal column 5. Musculoskeletal disorders may result from prolonged occupational tasks involving. a. awkward positions b. repetition c. vibration d. all answers are correct 6. When sitting in a chair, your knees should be bent at a 40º angle. a. True b. False 11

7. When using a mouse, your hands should be higher than your elbows. a. True b. False 8. The top of the monitor screen should line up at or slightly below eye level. a. True b. False 9. When using a mouse, you should grip it firmly in your hand. a. True b. False 10. Performing stretching exercises periodically throughout the day may help prevent musculoskeletal disorders. a. True b. False *end of test* 12