If you work on a computer at all, chances are you may have experienced some neck or back pain while toiling away at that keyboard. If you work in a large organisation or for the government, you’ve also probably had a workstation assessment done at some point. Occupational pain is a massive problem – studies show about 1/3 of all computer workers experience neck or back pain every year. In Australia alone that’s millions of people suffering because of their computer work!
Companies are trying their best (and rightly so) to look after their employees and this often involves ergonomics assessments of the workstation and appropriate adjustments. The main aim of this is simple – reduce the workload and effort required to do the work, so you reduce the strain the worker’s body is under. Easier work = less pain, right?
BUT, there’s one big problem with this – the evidence that ergonomics interventions work is inconsistent and contradictory. Just as many people DON’T get better with workstation adjustment as those that do. Chances are some of you out there are in this exact situation. You’ve got the perfect chair and the perfect computer and workstation setup, you’re sitting in the perfect position – but you’re STILL getting headaches, or neck pain, or back pain.
And in my opinion, here’s why:
“We spend so much time and money modifying the work environment and task to suit the individual, but we put zero effort into modifying the individual to suit the task.”
Now I’m not saying that ergonomic intervention isn’t important – it definitely is. Providing a safe and appropriate work environment is very important to keep workers safe and reduce the risk of injury. Ergonomic changes reduce the total workload that the worker is under (hopefully). My gripe with ergonomics is that this seems to be the only intervention. The assumption that once we place the worker in a “perfect” position and ensure they don’t deviate from that, then everything should be fine. The problem is it’s not.
Here’s a few other reasons why you might be in pain even if you’ve already had the perfect workstation set-up:
You don’t have adequate physical capacity to perform the tasks.
This is the biggest contributing factor that we see in practice daily. You don’t have the strength, or postural endurance to manage the tasks you are doing all day. As the days wears on, (and the days and weeks) you get more and more fatigued with the workload – which can lead to a whole range of pain issues. This can even include just sitting in one position for long periods of time.
As an experiment try holding your arms out in front of you (like a zombie) and not moving for five minutes. Chances are after 1 minutes you’ll be starting to fatigue, and not many of you out there will last a full five minutes. It’s too tiring and too sore. Now this was only holding one position for 5 minutes. If you’re working on a computer, you’re in the one position for up to 8 hours per day. If you don’t adequate postural endurance for your muscles to hold you in these positions all day, no wonder you’ll be getting sore.
A recent study even showed that strength training was the most effective form of treatment to reduce neck pain in office and computer workers. More effective than adjusting workstation setups, more effective than fancy chairs, even more effective than standing desks! Improving muscle capacity was the best way to reduce pain. By INCREASING the worker’s endurance and strength, their muscles fatigued less and they experienced less pain!
Now I know that if I was working as a roof carpenter (for example), I wouldn’t last one day without back pain. The main reason for this is I’m not conditioned to that type of work. Conditioning for the required tasks is imperative for all physical activities. We know that poor conditioning is a massive risk factor for injuries on the sporting field, and the workplace is no different. You need to have the physical capacity to do the required tasks, for the required duration and to back that up every day.
Your work posture isn’t your biggest risk factor for developing pain.
Studies looking into causes of occupational pain due to computing found the biggest risk factors for pain were:
- Working more than 7 hours per day at the computer
- Poor job satisfaction/sense of control
- Never or infrequent breaks
- Poor sleep (less than 6 hours per night)
So, what this tells us is how long you do the tasks (in particular how long at one go without a break) is a strong predictor for pain. This also relates back to my first point regarding muscle fatigue. Frequent breaks mean you get a chance to recover and perform different movements and positions, reducing fatigue and sustained postural load. It also tells us (which has also been shown with mountains of research) is that people who are happy/satisfied at work are less likely to experience pain.
Poor sleep means more fatigue. It also increases injury rates across sports and in the workplace. Unfortunately, sleep isn’t a work issue, but a personal one. If you’re struggling with pain at work and you average less than 6-7 hours sleep a night, you should probably get to bed a little earlier.
Changing behaviours is more important than changing workstation setup.
Everybody who works in an office has heard that they should be taking regular breaks, stretching and moving around more to reduce the risk of pain. Unfortunately, the large majority of people just don’t do it. Now I know you’re busy, and it’s annoying to stop what you’re doing in the middle of something. However, it’s a lot more inconvenient to miss work because your headaches are getting too much. In a lot of companies, the culture is to tough it out and work hard – which doesn’t look after employees’ health at all.
Some larger organisations have computer programs that stop the worker every hour to remind them to have a break, but you can over-ride them. Most people I talk to with these programs find them annoying too, and turn them off whenever they can. It’s great to have these tools, but if they are not used properly they are really no good to anyone.
Unfortunately, people do need to take some responsibility for themselves (yes, even when they are at work). If you aren’t following OHS procedures (like pre-start/warm-ups, or regular breaks as prescribed) then maybe this is the place to start with addressing your issues. If you are up all night watching Netflix, and you’re tired and sore at work, then you should probably go to bed earlier. If you don’t have the physical capacity to do your job, then no amount of fancy chairs and keyboards are going to improve that. You need to go out and exercise, or get to the gym, or start doing Pilates, or get some expert advice on what you need to improve to stop your issues.
Take away messages
- Despite my ranting, ergonomic assessment is a very useful tool and changing workstation setup can go a long way to reducing the load and strain on your body. If you have a shocking workstation, and your posture while working is terrible, then maybe changing the ergonomics of your work setup is a good idea. Just remember that this is only one part of the solution.
- If your workstation isn’t too bad, you really should look at your behaviours. Are you taking regular breaks? Do you spend more than 7 hours per day stuck in front of the screen? Are you getting enough sleep? Do you do anything else to counteract all that sitting in front of the computer?
- If you are having problems (particularly is it gets worse as the day progresses) you should really look at implementing some strengthening into your life. 2-3 times a week for 12 weeks will do you a lot of good (focusing on your neck and shoulder of course).
- If you keep having problems despite proper OHS (and a lot of you are) you probably need to look at improving your physical capacity for your work. If you struggle with maintaining your posture during the day, or you are getting tired or sore, you probably need to start improving your strength, endurance (and maybe mobility). Improving your body’s tolerance to work mean the work you do is easier in comparison. Being stronger is one of the best injury prevention strategies. Being stronger makes life easier.
Julian is a Director and Senior Physiotherapist at EMC Physiotherapy. He has spent over a decade working exclusively in private physiotherapy practice, and estimates he has performed close to 40,000 individual treatments in that time. He has worked with everyone from Paralympians, elite athletes, WAFL Footballers, the Defence Forces and weekend warriors, to thousands of everyday people with all manner of issues. He is passionate about injury prevention and has a special interest in the treatment of headaches, shoulder issues, hypermobility management and exercise rehabilitation for the prevention and treatment of injuries.
- Kari Babski-Reeves, Jennifer Stanfield, Laura Hughes, Assessment of video display workstation set up on risk factors associated with the development of low back and neck discomfort, International Journal of Industrial Ergonomics, Volume 35, Issue 7, 2005, Pages 593-604, ISSN 0169-8141.
- Brewer, S., Eerd, D.V., Amick III, B.C. et al. J Occup Rehabil (2006) 16: 317. Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: A systematic review. doi:10.1007/s10926-006-9031-6
- Demure, Bernard MD; Luippold, Rose S. MS; Bigelow, Carol PhD; Ali, Danielle RN; Mundt, Kenneth A. PhD; Liese, Bernhard MD. Journal of Occupational & Environmental Medicine: August 2000 – Volume 42 – Issue 8 – pp 783-791 Video Display Terminal Workstation Improvement Program: I. Baseline Associations Between Musculoskeletal Discomfort and Ergonomic Features of Workstations
- Xiaoqi Chen, Brooke K Coombes, Gisela Sjøgaard, Deokhoon Jun, Shaun O’Leary, Venerina Johnston; Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis, Physical Therapy, Volume 98, Issue 1, 1 January 2018, Pages 40–62, https://doi.org/10.1093/ptj/pzx101