COMPUTER RELATED DISORDERS, RECOMENDATIONS


Musculoskeletal disorders are the most common work related/occupational diseases seen among office workers using computers. The most common complaints are neck pain, low back pain, joint pain in the shoulder, elbow and wrist, paresthesia/numbness, weakness, joint stiffness in arms or hands.

Many other complaints such as eye disorders (itching, dry eye etc), fatigue, weakness, headache and psychological disorders can also accompany. Health problems can be in a wide range of severity, ranging from discomfort to disability or persistent pain.

Scientific studies show that the musculoskeletal health of office workers are effected by the work station design (desk, screen, seat, keyboard, etc), duration of computer use and break/resting intervals, sitting position/posture, work load, job satisfaction and working environment (lighting, temperature, humidity etc). Health problems increase with duration of computer use and the primary reason for pain is work load and working environment, long-duration and improper sitting position has a negative effect on the musculoskeletal system. The most important step to reduce such health problems is to have individually adjustable work stations and to have a plan for breaks.

The increase in health problems of office workers decrease job satisfaction and work efficiency which consequently have impacts on the individual, the company and society. Scientific researches are much more concerned with prevention and good health of computer users, there are developments in the designs of computer machines and equipment, law regulations are more specified for work safety and ergonomic precautions are enforced.

Common Musculoskeletal Diseases in Computer Users


• Neck and low back pain, muscle strain, disc herniation


• Nerve entrapment at the wrist (Carpal Tunnel Syndrome)


• Soft tissue disorders of the shoulder, elbow, wrist, and the thumb (joint pain, shoulder stiffness, tendonitis, tennis elbow, etc)


When should you refer a physician?

If the pain and other complaints would not subside within a few days of rest, if there were frequent repetitions and if there is numbness and/or weakness you should visit the physician.


Treatment:

Prevention is always more important!


As all other medical conditions, disorders related to computer use are evaluated by the physician at the primary step of health care systems who can be a general practitioner or occupational health physician. They can treat or refer to a specialist. The relationship and effects between the complaint and occupation should be described.

Medical doctors with Physical Therapy and Rehabilitation specialty evaluate and treat muscle-skeletal disorders. Treatment consists improving the working conditions, resting, medication, physiotherapy and medical equipment to protect or support the joints. Exercise recommendations will differ for prevention and treatment. Surgical treatment may rarely be needed.


RECOMMENDATIONS FOR WORK STATIONS

Ideal work stations should be user friendly, adjustable.

Work Desk: The height of the work surface should be adjustable for the user, average height is 70 cm. There should be enough knee clearance and leg room to allow the worker to stretch the legs. All equipment should be easy to reach, comfortably accessible.


Work Seat: Chair should be adjustable, stable and provide good back support. The recommended chair height is between 35 and 50 cm. The backrest should have a good back support, if not custom-made pillows may be used. The support should fill the gap between the patient’s low back region and the seat, and be comfortable. Chairs should have five castors for stability and swivel smoothly.


Computer: The monitor/screen should be placed in front of the worker. The top edge of the monitor should be at eye level. The devices like keyboard and mouse should be placed at the same level and allow user to have a natural hand position. The recommendation for the distance between of the screen and eye is ‘one arm length’. The keyboard buttons should be easily used and hard effort should not be necessary to type.


Working - sitting position: Sitting position should be comfortable and cause least fatigue. Slight backward recline is recommended. The hands and the wrists should be in a natural and comfortable position when using the keyboard and the mouse, the wrist could be able to remain straight and not just at the edge of the desk, and there should be sufficient desk area available. The computer user should easily lean forward with some elbows support on the desk. The feet should rest comfortably and when desired could be raised with inclined foot rests/step boards.


Rest time - Breaks: Frequent short breaks of 20-30 seconds have a positive effect when using computers. With prolonged work, once every hour a short break by standing up and every two hours a longer break like ”having a cup of tee” is recommended. The individual should definitely change the sitting position when he/she feels fatigue and must stand up, have a little walk. Stretching exercises will help to relax.


Other Recommendations:

- prefer to mix work tasks by sitting and walking, try to make variations in your position

- prefer communicating with your colleague by visiting instead of electronic mails

- prefer to stand up while you are on phone

- don’t cradle the telephone between your ear and shoulder

- to rest your eyes give frequent breaks by looking at distant objects (20 seconds resting for every 20 minutes, looking far away or to an object at a 6 meter distance)

- don’t prefer using the computer and electronic world for resting or relaxing

- demand ergonomic training and work stations and at your work place.


EXERCISE RECOMMENDATIONS:

Before planning an exercise program your health problems, body features, fitness level should be evaluated with a holistic approach. Exercise program should be personalized and for whole body health with some adds for a computer user. The effects of exercise should be monitored and changed when necessary. If you have a diagnosed disease like; heart disease, diabetes, hypertension, disc herniation, joint disease, etc you should ask your medical doctor for restrictions, precautions and advices for an exercise program. If you experience pain during or after an exercise program you should visit a physician and consider changing the program.

1- Exercises that can be done at the office:

- Short walk at every break

- Stretching exercise for neck and arm can easily be done anywhere but you may need a proper environment for low back and leg exercises. Exercise should be done comfortably and without pain, 3-5 repetitions will help.

2- Exercises outside the office:

Computer users should prefer an active life out of the office as they are mostly inactive at work. All types of exercise and sports may be preferred. You should feel good, comfortable and no pain. The exercise program should start slowly and build up gradually, should have stretching, strengthening and relaxing characteristics. You should give plenty time to warm up and cool down. Exercise 3-5 times a week, 30-60 minutes is beneficial and you can break it into shorter parts if needed. The exercise intensity should be flexible; you should not feel tired afterward. You should listen to your body and change your program when necessary, especially if you feel pain, dizziness or nausea you should not push hard and consult a doctor if it repeats.

The most frequently recommended exercises are walking, swimming and stretching exercises. Fitness, aerobics, yoga, Pilates and dance are the most popular programs. You should try to learn the benefits and possible harms of any program before starting.


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