Computer Ergonomics: Work Pain Free

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This is the second in a series of posts about [tag]computer headaches[/tag], causes and solutions.

2. Monitor too high results in the head being extended back from the neutral posture.

RISKS
This posture causes prolonged contraction of neck muscles. Prolonged contraction or repetitive contraction without sufficient rest between exertions results in shortened, hyper tonic [in a state of mild constant contraction, even when at rest] muscles, neck and upper back ache, pinched nerves in the neck, pain traveling into the arm, headache, fatigue, the head feeling heavy, and a tendency to injury from an otherwise innocent activity.

SOLUTION

A] Lower monitor by removing appropriate amount of whatever is underneath monitor. This is often the CPU, which is then placed on the floor or a stand without crowding the operator’s legs.
B] If the monitor is too high and on a tabletop so it cannot be lowered, raise the seat height of the operator.
(Keep in mind that this will then result in other ergonomic changes such as a foot stool to keep your feet flat on the floor, and a keyboard adjustment so your arms stay relaxed at your side, there is an open angle at the elbow, and your wrists are straight.)
C] Tilting the monitor down will have the same effect on your head position as lowering the monitor

==>> This is a part of a 6 part series of short articles on the causes and solutions to headaches related to working on computers. View them all under computer headaches.

For a complete online audio/visual training of how to customize your entire workstation to eliminate pain, check out the workpainfree program. The Neck and Shoulder section will show you the exercises that you can do to reduce the tension in your neck. It shows how to self diagnose exactly where your tension is, and how to give yourself therapy in the form of a 5 second stretch to instantly reduce the neck tension and headaches from computer usage.

This is the first in a series of posts regarding computer headaches, causes and solutions. One of the most common causes is the monitor being too low. Anything that causes you to look down, even very subtly, will cause the muscles in the upper back and neck to constantly contract

Monitor too low, no document holder so you must look down at papers lying on the desktop, or working with a lap top on the desk results in prolonged or repetitive forward head posture, rounded shoulders, and upper back bent forward while working.

RISKS

This posture causes a stretching of neck and upper back ligaments, and a tension in associated muscles. This then results in muscle contracture and weakness, joint irritation, headache, fatigue, neck and upper back pain.

In addition, the chronic tension results in significant muscle weakness making the worker prone to neck sprains and strains from otherwise innocent activities.

SOLUTION

A] Raise monitor so top of standard size screen or top third of large monitor is 1 - 2 inches below operator’s eyes. This is done with an adjustable monitor arm, a monitor riser (which has desk top storage), or placing the monitor on items such as reams of paper.
B] Install a document holder. Ideally, the document will be close to and at the same level as the monitor. This can be placed on the desk top or attached to the monitor and can swing to be placed right or left. OPTION: The document holder is a slant board between the keyboard and monitor. This is especially good for 3 - ring binders and books.
The document holder should be periodically moved between the right and left to reduce neck stress from prolonged turning in one direction.
C] Raise laptop so screen is appropriately placed as described above, and install a standard keyboard.
D] Place laptop keyboard in appropriate ergonomic position. Install a standard monitor at the proper height as described above.
E] Tilting the monitor up will have the same effect as raising the monitor.

==>> This is a part of a 6 part series of short articles on the causes and solutions to headaches related to working on computers. View them all under computer headaches.

For a complete online audio/visual training of how to customize your entire workstation to eliminate pain, check out the workpainfree program. The Neck and Shoulder section will show you the exercises that you can do to reduce the tension in your neck. It shows how to self diagnose exactly where your tension is, and how to give yourself therapy in the form of a 5 second stretch to instantly reduce the neck tension and headaches from computer usage.

The back of my legs (thigh area) get very painful after sitting for a while. Do you have some advice as to what will take the pressure off my legs while I’m sitting?

There are 3 things that commonly can cause pain in the back of your legs when sitting.

You can try making one change only per day. The one that takes away or reduces your discomfort is the one that is most important for you.
They are:

1. When the seat pan pushes against the back of your knee. This causes muscle tension in the back of your leg.

Solution: If the seat pan presses on the back of your knees, this will cause leg stress and tension. It will cause you to be fatigued and that leg tension over a period of months will travel up your legs and cause low back discomfort, eventually going all the way to your neck. The solution is simple. Either get a chair with a shorter seat pan so it’s not pressing on the back of your knees or place a pillow or a piece of foam behind you. This will bring you forward and will keep the seat pan from pressing against the back of your knees.

2. When the seat height has your heels off the ground. This causes you to constantly contract leg muscles to hold the position leading to leg tension

Solution: Adjust the chair height so you feet are flat on the floor with your knees slightly lower than the hips. When your legs are in the posture in this position there is minimal stress, tension and fatigue. If the seat is too low and the knees are higher than the hips that will cause a closed angle at the knees which will then result in decreased blood flow to the lower leg.

The decreased blood flow to the lower leg will then result in leg tension. This tension can travel as pain over a period of months up the legs to the hips, to the low back causing low back discomfort, and can even eventually travel up the back all the way to the neck.

Now if the seat is too high the toes or balls of the feet are on the floor and the heels are up off the floor. Unconsciously you are going to be contracting muscles to hold you in an uncomfortable posture and this can cause leg tension and pain.

If you have a proper seat height there’s going to be minimal stress in your legs, you’ll be less fatigued at the end of a work day and there will be less chance of having injury and discomfort in your legs, back and neck.

3. Not supporting your low back curve. This can cause a nerve irritation which causes a pain in the back of your legs. This is actually the most common cause of pain in the back of your legs from sitting.

Solution: To determine where to place the pillow to support the low back curve, this is what you do. Sit up straight and arch your back by sticking out your belly. Put your hand behind you and run your hand up and down your back and feel where the deepest part of your curve is. It’s usually higher than you think with most people.

This is where you need to have your low back support. You are supporting your natural curve. So arch your back as I’ve described. Put you hand back there and feel where the deepest part of your curve is, and that’s where your low back support is going to go. Now what should you use for low back support? Many chairs have built into them a low back support. You simply adjust the height so it’s exactly in this curve.

Other options are you can buy a lumbar pillow, and there are three or four different styles. You want to have access to several of them and try the one which feels most comfortable to you.

Finally, the one that most commonly is used, simply roll up a towel and place rubber bands around it to hold it in place and use that as a pillow for your low back.

Now whether you are using the support build into the chair, a commercial pillow or a rolled up towel, you now know where to place it. But how big should it be?

It’s as simple as this. It should be the most comfortable size. So try using different-sized pillows or different-sized rolled up towels. The correct size for you will obviously feel better as soon as you sit with it.

Do the 2 low back stretches every 15-20 when sitting at your computer. Both will take a combined 10 seconds to perform and you can do them without getting up from your workstation. They are the seated low back extension and the knee pull.

I am confidant this will reduce or eliminate the pain. If it does not, you may have a condition that requires treatment and you will need to see a doctor to get appropriate evaluation and treatment. Then the techniques in www.WorkPainFree.com will keep it from returning.

Question From Letitia: After years of heavy computer usage, I developed hand, wrist, and arm pain. Despite quitting my job, seeking various forms of therapy and minimizing time on the computer, I still experience pain three years later. Is there hope for me to recover, or is it too late?

Dear Letitia,

First of all, every musculoskeletal problem can be cured. The problem is, once hand-wrist-arm [tag]pain from computer work[/tag] is an advanced condition, such as yours obviously is, it is hard to fix, there are several possible components of the cure that works for you, and it takes a long time. You must be patient and continue with the treatment path even though there is little improvement in the beginning.

You mentioned you have tried various forms of therapy. A common problem is someone in your condition may try physical therapy for a while, then a chiropractor, then an MD for medication and rest, then an acupuncturist, etc. The problem here is your condition probably has several components, and you need to see several different practitioners at the same time. They must be in contact with each other and all be contributing to your cure. It is worth it because as you have discovered, it affects your entire life.

Treatment is difficult, and prevention is simple. That prevention is what the work pain free program is about. You will need to learn the lessons of work pain free because you mentioned that you still do some computer work, so you must stop the stress from that activity in order to get better.

There are several issues that you must explore.

1. You need to find health care providers that are secure enough and have relationships with other health care providers to refer you to if they cannot cure you.
2. Despite pain location, is the problem caused by hand, wrist, arm or neck dysfunction?
3. Other conditions to explore as possible contributory causes of the condition are: Pinched nerve in Neck, Brachial Plexus, Thoracic Outlet, Elbow, or Wrist; Muscular imbalance and spasm in forearm, Muscular trigger Point, Chronic Dehydration from not drinking enough water, True Carpel Tunnel, A bony distortion (Subluxation) in the hand, wrist or elbow, Neck Disc Pathology, TMJ Dysfunction,
4. Have you truly customized your computer workstation and technique to eliminate physical stress? (these are the lessons of “Work Pain Free”)
5. You will need to be evaluated for imbalances in your posture due to muscular strength imbalances. These will need to be corrected through a customized stretching and strengthening Rehabilitative exercise program.

Please feel free to contact me with what city you are in. I will help you find you a quality health care referral to help solve your problem.

Good luck.

Regards,

Dr. Barry Carlin

When I work on the computer, I usually have a constant hot sensation in my shoulders and lower neck. It only happens when I work on the computer. It is coming faster and feels stronger. Is this serious and how can I stop it?

Dear Rani,

Your report of a constant [tag]hot sensation in the shoulders and lower neck[/tag] is most likely from your monitor or document position causing a forward position of the head. Even a subtle forward position will cause the muscles where you feel discomfort to constantly contract to hold up your head (which can weigh 8-15 pounds. The constant contraction causes the hot sensation, or it can cause tension, ache, your head feeling heavy and pain

The solution is covered in the full version of Work Pain Free. What you must do is alter the monitor and/or document position so when looking at them your head is relaxed above your body without having to think about it.

The monitor should be directly in front of you. The top of a standard monitor screen or the upper third of an oversized screen should be just below your eyes, or in the middle of the bridge of your nose.

A test to fine tune the position to be exactly correct for you is after you set the correct monitor height, have a fried hold a paper in front of the monitor. Have them slowly raise it until it feels too high. Then have them lower it until it feels too low. Go up and down until you feel the exact most comfortable position for you. That is the exact best monitor height for you. Adjust it to that height. For most people it will be at the bridge of your nose as was described earlier in this article.

Place any papers you must look at on a document holder which will hold them up close to the monitor.