Illustration: Kevin Wong

Snap out of it

Injuries caused by lazy habits while working on computers have become a widespread problem

Technology: can’t live without it, can’t quite live pain-free with it. In this modern age, this seems to be the norm. According to Dr Grace Pui-yuk Szeto, a professor in the department of rehabilitation sciences at Hong Kong Polytechnic University, work-related musculoskeletal symptoms are such a major health issue that extensive global research has been carried out on workers in many occupations, including office workers, bus drivers, cleaners, sewing machine operators and health care professionals.

Two recent papers by Cornell University ergonomics professor Alan Hedge concluded that as US health care goes hi-tech, spurred by US$20 billion in federal stimulus incentives, the widespread adoption of electronic medical records and related digital technologies is predicted to reduce errors and lower costs – but it is also likely to significantly boost musculoskeletal injuries among doctors and nurses.

The repetitive strain injuries, says Hedge, will stem from poor office layouts and improper use of computer devices. “Many hospitals are investing heavily in new technology with almost no consideration for principles of ergonomics design for computer workplaces. We saw a similar pattern starting in the 1980s when commercial workplaces computerised, and there was an explosion of musculoskeletal injuries for more than a decade afterward.”

In one paper, Hedge asked 179 physicians about the frequency and severity of their musculoskeletal discomfort, computer use in their clinic, knowledge of ergonomics and typing skills. The most commonly reported repetitive strain injuries were neck, shoulder and upper and lower back pain – with a majority of female doctors and more than 40 per cent of male doctors reporting such ailments on at least a weekly basis. About 40 per cent of women and 30 per cent of men reported right wrist injuries at a similar frequency.

Szeto’s latest study reveals that Hong Kong surgeons have injuries “due to their static posture in the operating theatre, but part of it is due to their daily work on a computer, as well”. But it’s not only the medical profession that’s suffering, Szeto says. Those most at risk of ergonomic injuries are anybody who works in an office or uses computers.

Ergonomics expert Justine Chim, whose company, Chim’s Ergonomics and Safety Limited, has advised employees of many large Hong Kong firms in the past decade, says her team completed 661 individual ergonomics workstation assessments in the past year and that many of those employees complained of musculoskeletal symptoms.

Says Chim: “More than 80 per cent of [those] office computer users reported musculoskeletal symptoms in at least one body region and more than half had received treatment in the past or are currently receiving treatment. Of those 661 office employees, about 75 per cent were required to use a computer for a prolonged period, cumulatively, for at least six hours a day for almost every day at work.”

The responsibility lies with employers to keep their employees safe and healthy during working hours
Justine Chim, ergonomics expert

Common problems include neck pain from stiff joints and tight muscles, which can also cause pain down the arms – especially the right arm for those who are right-handed and use a mouse. Other problems faced by computer users are carpal tunnel syndrome, tendonitis and bursitis. The main cause is from maintaining a static posture with a bent neck – excessive neck flexion – for a long time.

“You don’t even notice you’re doing it,” says Szeto, who has been studying this problem for more than 10 years and whose research includes the effects of cumulative exposure to IT in people using iPhones and iPads for leisure as well as using computers at work.

She says: “The newest problem is the younger generation developing pain in the thumb. They may use a computer in the office, look at their phone on the MTR or bus, then go home and play games – for some people, especially the younger generation, it’s non-stop, almost all their waking hours are spent using technology.” There’s even a new term for people on the MTR or on the streets of Hong Kong who can be seen bent over their mobile phones or iPads: the “head down tribe”.

“If you have a lot of static  tension you can suffer muscle fatigue and [therefore] be prone to injury and pain,” Szeto says. “This kind of static tension is usually concentrated in just one or two muscles especially those which connect the neck to the shoulder. People will often have more tension on the right side. That muscle becomes overloaded and the muscle fibre changes, which contributes to the pain.”

Frequent use of the mouse can make one vulnerable to forearm injury, says Szeto, because when a muscle is in a contracted position for a long time, it compresses the blood vessels, cutting off the flow of oxygen. This leads to inflammation of the muscles in the forearm, causing tendonitis or tenosynovitis.

Szeto advises regular breaks of at least two to three minutes every hour to avoid injury and to cure or ease pain. Make time for exercise, to strengthen and stretch the muscles of the whole body, and to loosen the tension of static muscles that have stayed in the same position for prolonged periods of time.

Dr Richard So, general secretary of the Hong Kong Ergonomics Society, says sitting continuously for hours on end causes numbness, discomfort and spine misalignment. “Studies show that lying down for half an hour, or doing some exercises on the gym ball, will pump the spinal fluid to keep the intervertebral discs even.”

Chim says the responsibility lies with employers to keep their employees safe and healthy during working hours. She suggests that there are many employers who are not aware of the legislative requirements that have been put in place to protect prolonged computer users, “even though the regulation has been enacted for about 10 years”.

This ignorance or oversight by employers is costing them money, she says, because they are “not calculating the cost of medical insurance, the time taken off work for treatment, lowering employee morale, productivity reduction, sick leave and absenteeism, increased labour conflict and psychosocial issues which correlate to the prolonged use of computers”.

Chim’s company has developed an office ergonomics programme with the objective of providing “a systematic solution to manage the potential risk of musculoskeletal disorders among computer users in an office setting”, which she says can eliminate or minimise the risk of musculoskeletal disorders among computer users but which must be based on an individual assessment by an experienced ergonomist.

Szeto’s and So’s advice is to ensure your workstation is set up correctly and to try to relax your muscles when you’re working (see graphic above). “Some people tense their muscles when they are concentrating, they form the habit of using too much force – be aware of this and try to avoid it. Try a light touch,” says Szeto. If you have already developed symptoms of repetitive strain injuries, Szeto says your doctor may prescribe anti-inflammation medication or physiotherapy, or you might want to see a chiropractor, osteopath or a Chinese bone setter. Acupuncture is also said to help.

“Anything that helps to stretch or release the muscles can help relieve the pain,” she says. “But if you return to the same habits you will never solve the problem.”

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This article appeared in the South China Morning Post print edition as: Snap out of it