Office Ergonomics

Common Office Injuries

Musculoskeletal, vision, and hearing problems are common in the workplace. By applying ergonomic solutions, you may be able to reduce physical problems and improve your comfort and ability to work effectively.

Musculoskeletal problems

Your musculoskeletal system is made up of the structures that support you and help you move, such as bones, joints, muscles, tendons, and ligaments. Examples of musculoskeletal problems that may be related to ergonomic issues are:

• Bursitis.
• Carpal tunnel syndrome.
• Muscle strains, often affecting the neck, upper back, lower back, and shoulders.
• Tendon injury.

Solutions. You can reduce your chances of musculoskeletal injuries and be more comfortable and efficient by setting up your workstation and work tools for your own personal needs.

• Your computer monitor should be directly in front of you. The height should be adjustable, with the top of the screen at about your eye level.
• A footrest can help support your legs and reduce low back strain, especially if your feet don't rest comfortably flat on the floor.
• Your chair should have adjustable seat height, back, and arm rests, and a base with five wheels for easy movement without tipping. Lumbar support for your back is helpful. When you sit in your chair, your feet should rest flat on the floor, and your thighs should be parallel to the floor. The edge of the chair should be soft and should not touch the backs of your knees. If you have arm rests, you should be able to use them without slouching or having your shoulders either hunched up or drooping down.
• Your desk should be large enough to accommodate your work area. Arrange your desk so the items you need most often are within reach, and you don't have to bend or twist frequently.
• Your keyboard tray should be big enough to hold your keyboard and mouse, and the height should be adjustable.
• Your computer mouse can be a trackball or touch pad, which may help reduce symptoms some people get from the repetitive motions of a standard computer mouse.
• The computer mouse should be placed close to the keyboard where it does not cause you to lean forward or to reach too far.
• Contoured or curved keyboards are designed to help reduce problems in the hands, wrists, and shoulders. They seem to help some people, but there is no good evidence that they reduce symptoms. Wrist pads (also called wrist supports or wrist rests) help support the arms and reduce strain during breaks from typing. The pads are not intended to be used while you are typing. But some people find the pads helpful even when they are using their keyboard or mouse. When you type or use your mouse, try raising your forearms a little so your wrists are in a neutral position and your arms and hands can move freely. If you have arm rests on your chair, you may be able to adjust them so your forearms are parallel to the floor and your wrists are neutral. A neutral position means not bent too far forward or backward. You may want to alternate between resting your wrists on the pads and raising them up. If you use a wrist pad, it's best to rest your palm or the heel of your hand on the support, rather than your wrist.

Good posture will also help prevent musculoskeletal injuries.

• Stand tall, to keep the natural curves in your back. Slouching increases stress on your back and can also make you feel less energetic. If you stand for long periods, try putting one foot up on a low stool periodically to change your position. Bring reading material up to you, rather than leaning over a low desk.
• Use good sitting posture. Relax your shoulders, keep your feet flat on the floor, and avoid leaning close to tasks on your desk.
• Turn your whole body to your task instead of twisting.

If you have to lift, do not use a back belt. Back belts do not reduce strains or other injuries. And they may even increase your chance of injury by making you overconfident, so you try to lift more than you should. To lift safely:

• Keep the object you want to lift close to you.
• Bend your knees and keep your back straight as you grasp the object, then straighten your knees to lift it up.
• Don't try to lift something by yourself that is too heavy, too awkward to carry, or that will not allow you to see where you are walking.
• Try a "golfer's lift" for very light objects such as a pen or piece of paper. Bend one knee slightly and allow your other leg to come off the floor behind you as you bend over. Hold on to a desk or stable chair for support.

To help prevent falls, keep walkways clear of cords, clutter, and spills. Close drawers completely after you use them. Use stepladders instead of chairs to reach high objects. Report any hazards such as loose carpeting or burned-out lights. And wear shoes appropriate to your job and environment.

Maintain good health through:

• Regular exercise.
• Proper nutrition.
• Not smoking.
• Following prescribed treatment for any other health conditions you have.

Good general health, including strength and flexibility, can help prevent injuries. It will also help you recover faster if you are injured.

Vision problems

Typical workplace vision problems include:

• Eye problems from either too little or too much lighting. Poor lighting can lead to:
  • Eyestrain and irritation.
  • Watery eyes and red, swollen eyelids.
  • Double vision.
  • Decrease in the ability to focus the eyes and see clearly.
• Headaches from straining to see clearly.
• Neck and back pains due to hunching over to see small items.
• Accidents due to poor lighting, glare, shadows from lighting, or moving from a well-lighted area to a dark area.

Solutions. You can reduce your risk of vision problems from improper lighting with:

• Full-spectrum lights, which may help reduce eyestrain.
• Task lighting (such as lights above your workstation or on your desk), which can increase the level of light in your office and allow you the flexibility to position the light where it is needed most.
• Monitor screens that reduce glare, such as plasma screens or removable glare guards.
• Proper placement of computer screens. Do not place a computer screen in front of or next to a window. This creates a contrast problem and visual stress. If you do sit next to a window, the best placement for your monitor is at a right (90-degree) angle to the window.
• Window blinds or tinted glass, to reduce sun glare while still allowing filtered light into your office.

It's also a good idea to have an eye exam every 1 or 2 years. If you wear bifocals or reading glasses, you may want to adjust your monitor so that you don't have to tilt your head back to see clearly. Or consider full-frame reading glasses for computer use. There are also progressive lenses available that have a reading prescription at the bottom, a mid-distance prescription that is good for computer use in the middle of the lens, and a long-distance prescription at the top of the lens. The lens has these three types of prescriptions in different areas of the glass and smooth transitions between types of prescriptions.

Noise problems

Noise can produce tension and stress and interfere with your ability to concentrate. And it can damage your hearing.

• Common office noise sources may include:
  • Equipment, including telephones, computers, and printers.
  • Many people working close together, which leads to more voices and foot traffic around work areas.
  • Noise outside the building that comes through office windows.
• Even low-level noise can reduce your productivity and increase stress levels, leading to problems with muscles and joints.
• High-level noise is regulated by the U.S. Occupational Safety and Health Administration (OSHA), as this type of noise can lead to significant hearing loss.

Solutions. You and your company can reduce your risk for hearing loss or other problems associated with noise levels with:

• Earplugs, to reduce background noise.
• Acoustic ceiling tiles, to absorb some noise.
• Relocation of noisy equipment.
• Window glass, to block out excessive noise.
• Carpets, to help absorb foot-traffic and conversational noise.
• Noise-reducing partitions, to reduce noise around workstations.

Using Ergonomics to Prevent Injury

Ergonomics may prevent musculoskeletal injuries (such as back strain or carpal tunnel syndrome) by reducing physical and mental stress caused by the workstation setup. By focusing on the physical setup of your workstation and the tools you use, you can reduce your chances of injuries. It also is important to evaluate the work process, including job organization, worker rotation, task variety, and demands for speed and quality.

Working intensely over long periods of time without taking breaks can greatly increase your risk for musculoskeletal injuries. Taking regular breaks from your work and doing stretching exercises may reduce the risk of repetitive motion injuries. Try taking 3- to 5-minute breaks-or changing tasks-every 20 to 40 minutes.

To improve your workstation:

• Arrange your work so you can sit or stand comfortably in a position that does not put stress on any specific area of your body. You should be able to keep your neck in a neutral position and minimize the need to look up or to the sides continuously while you are working.
• Eliminate most movement from your waist. Keep the workstation and workstation tools within reach without having to lean, bend, or twist at the waist frequently.
• Vary postures if possible.
• Take 10- to 15-second breaks frequently throughout your task. For example, look away from your computer monitor, stand up, or stretch your arms. Short breaks reduce eyestrain and buildup of muscle tension.
• Stretch your body by getting up out of your chair and stretching your arms, shoulders, back, and legs. When you are sitting, shrug and relax your shoulders.

If you do similar work or activities at home, be sure to apply these principles there as well to avoid the cumulative effect of repetitive motions.

To improve your workstation, choose workstation tools that fit your personal physical and comfort needs, such as:

• A desk or work surface:
  • Large enough to accommodate papers, reference manuals, and other workstation tools, but arranged properly to access items easily.
  • At a height that allows enough space for your knees and thighs to comfortably fit under the desk.
  • That is not shiny.
• A computer monitor that is:
  • Clear and easy for you to see without leaning forward or looking up or to one side.
  • At a height where the top of the screen is at eye level or within 15 degrees below eye level.
  • Less than an arm's length away from you.
  • Protective against eyestrain, which may lead to vision problems and headaches. For example, glare guards are available either as part of the monitor or to be placed over the monitor screen. Plasma screens also have less glare than other monitors.
• A chair that maintains normal spinal curvature. A supportive chair:
  • Is adjustable, so that you can set the height to rest your feet flat on the floor. Keep your feet supported on the floor or on a footrest to reduce pressure on your lower back. Some people like to sit in a slightly reclined position because it puts less stress on the back, although this may increase stress on the shoulders and neck when you reach for items.
  • Supports your lower back.
  • Has adjustable armrests that allow your elbows to stay close to your sides. If you are not comfortable with armrests, move them out of your way. It is still important to keep your arms close to your sides even if you choose not to use armrests.
  • Has a breathable, padded seat.
  • Rolls on five wheels for easy movement without tipping.
• A computer keyboard and keyboard tray that allow comfortable typing or keying.
  • Your keyboard should be at a height that allows your elbows to be bent about 90 degrees and close to your sides.
  • There are many variations for keyboard design, including split, curved, or rotated keyboards. Studies have not proved that these reduce injuries. But some people find them to be more comfortable. If you notice hand, arm, or neck discomfort, your employer may have different keyboard styles for you to try. Different people find different styles work best for them.
  • Many keyboards and keyboard trays have wrist supports to help keep your wrists in a neutral, almost straight position. But wrist pads are just there for brief rests. They are not meant to be used while you are typing. But some people find they help even during keying. When you type, try raising your wrists from the support so your wrists are in a neutral position. You may want to alternate between resting your wrists on the supports and raising them up.
  • You can adjust the tilt of the keyboard. Some people find it more comfortable if the keyboard is flat or tilted slightly down at the top. Try different tilt angles to see what is most comfortable for you.
• A computer mouse or pointing device that does not require a lot of forearm movement or force, such as a trackball mouse or touch pad, is more comfortable than a standard mouse for some people. Other types of pointing devices are also available. See a picture of proper hand and wrist position for mouse and trackball use for examples.
• A document holder that holds your papers level with your computer monitor, so that as you look back and forth between paper and monitor, your eyes do not need to continually refocus.
• A comfortable room temperature, a relatively quiet area, and sufficient lighting without glare from office lights, sunlight, or the computer screen.
• A telephone headset or speaker phone, so you avoid awkward positions while talking and doing other tasks, such as typing.
• A location for any reference manuals that is close to the center of your workstation, for easy access.

Many people use laptop computers as secondary workstations. You should not use a laptop as your primary computer. Using a docking station that provides an adjustable keyboard can help keep your wrists in a neutral position to reduce stress and strain. If you use a laptop often, try the following to improve ergonomic factors:

• Take 10- to 15-second breaks often throughout your task. For example, look away from your computer monitor, stand up, or stretch your arms. Short breaks reduce eyestrain and the buildup of muscle tension.
• Keep your head and neck in a neutral position and about 18 to 30 inches away from the monitor screen.
• Position the keyboard so that it is at elbow height, and try to keep your wrists relatively straight and your fingers slightly curved while you are working. You may need to use a pillow under your elbows to support your arms if you are sitting on a couch or chair while keying.
• Use an external mouse instead of the small touch pad or trackball that is on the laptop keyboard.
• When you have to carry your laptop with you:
  • Carry only what you need with you.
  • Use a carrying case with a padded strap and handle. Backpacks with two straps are the best. If you use a case with one strap, it's best to put the strap over the opposite shoulder to help distribute the load you are carrying, or to switch hands regularly.
  • Use a luggage cart with wheels when possible.

Parents can apply all these ideas when children use a computer. To adjust a workstation for a child, you may want to:

• Make sure the seat is high enough so your child can see the monitor without looking up and so your child's shoulders are relaxed when he or she types. You may want to have your child sit on a thick book, a firm pillow, or a booster seat.
• Use a footstool (or a thick book or a backpack) to support your child's feet if they don't rest comfortably on the floor.
• Use a firm pillow behind your child's back to scoot him or her toward the front of the chair.
• Adjust the keyboard and mouse or other input device to keep your child's wrists straight.
• Avoid glare on the monitor screen.

Home Treatment

If you have a musculoskeletal injury such as back or neck strain or carpal tunnel syndrome, try home treatment for a few days when you first notice symptoms. These steps are usually helpful in relieving discomfort caused by stress and overuse. Home treatment includes:

• Resting the painful area and avoiding or modifying activities that make your pain or discomfort worse. Return to some daily activities as soon as possible to help maintain flexibility and general well-being. Be aware of any tingling, numbness, weakness, or pain that may indicate an injury.
• Using ice to reduce pain and inflammation. Place an ice pack or cold pack over the painful area for 10 to 20 minutes at a time, as often as once an hour. This will help decrease any pain, muscle spasm, or swelling. You can try heat, or alternating heat and ice, after about 3 days or when there is no swelling.
• Using nonprescription pain relievers. Acetaminophen (such as Tylenol) can help relieve pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve), can also help relieve pain and reduce inflammation. People younger than age 20 should not take aspirin because of the risk of Reye syndrome (a central nervous system complication in children). Be safe with medicines. Read and follow all instructions on the label.
• Doing gentle stretching exercises to keep flexible and prevent stiffness. These exercises include:
  • Stretches for your neck.
  • Stretches for your back.
  • Stretches for your shoulders.
  • Stretches for your wrists and arms.
• Examining your workstation setup and workstation tools. Apply the ideas of ergonomics to make sure your workstation and tools fit you and the activity you are doing. Then try making changes that will limit any injury.
• Keeping good health habits. Exercise regularly (including aerobic, muscle strengthening, and flexibility exercises), eat a balanced diet, don't smoke, get enough sleep, and lose weight if needed. If possible, reduce stress and tension at work and at home.

Home activities may contribute to workplace injury. For example, doing an activity at home that requires the same repetitive movements as at work may not allow your body time to recover. Also, driving long distances to and from work may contribute to workplace injury. Using special seat covers for added comfort (such as those made of wool or beads), carpooling, or using public transportation may help reduce this added stress.

Other Treatment

Other treatments to relieve pain, prevent further injury, and return to normal activities include:

• Physical therapy, to relieve pain and keep or improve strength and flexibility.
• Spinal manipulation, which ranges from massage and slow pressing to a quick thrust. It's used to increase movement in the joint, relax the muscles, and reduce pain.
• Orthotic devices, such as wrist splints or a neck (cervical) collar, which may be worn at home to relieve stress and provide temporary support.
  • Wrist splints should not be worn while you work, because they can increase strain on your tendons.
  • A cervical collar is not to be used on a continuous basis at the workplace. Follow your doctor's instructions for wearing the collar. And if you find it to be uncomfortable, talk to your doctor. Cervical collars are not usually used for long periods of time.
• Complementary therapies are health care practices that may be used along with standard medical treatment. They include:
  • Acupuncture, which is used to relieve pain and treat certain health conditions. It is done by sticking thin needles through the skin at certain points of the body to reduce pain.
  • Massage, which involves applying pressure to the soft tissues of the body, such as the muscles, to reduce tension and pain, improve circulation, and encourage relaxation.
  • Yoga, which is a program of exercises to help improve flexibility and breathing, decrease stress, and maintain health. The basic components of yoga are proper breathing and posture.

Surgery usually is not needed for injuries related to workstation design.

Where to Go for Help

If you have tried the home treatment suggestions but your pain and discomfort have lasted for several days (for example, 7 continuous days), call your doctor. Health professionals who can diagnose and treat work-related injuries include:

• Chiropractors.
• Family medicine physicians.
• General practitioners.
• Neurologists.
• Nurse practitioners.
• Occupational medicine specialists.
• Occupational therapists.
• Orthopedic doctors.
• Osteopathic doctors.
• Physiatrists.
• Physical therapists.

You may be able to get help or information through:

• Your human resources department at work.
• Your state's Labor Department.
• Occupational Safety and Health Administration (OSHA), for information on treating and preventing injury.
• National Institute for Occupational Health and Safety (NIOSH), a division of the Centers for Disease Control and Prevention (CDC). NIOSH is the federal agency responsible for conducting research and making recommendations for the prevention of work-related disease and injury.