First, let me say I hate the term ‘ergo injury’ because it’s not a thing — if something is truly ergonomic then the risk of injury should be very low. Instead, these should be called Non-Ergonomic injuries!
The economist Anne Case and Nobel Prize winner Angus Deaton recently published a book called Deaths of Despair and the Future of Capitalism (deaths from Alcoholism, Drug Abuse and Suicide). Their research revealed that 40 – 60% of all working class Americans, aged 45-54 have chronic Neck, Back or Joint pain!
Another recent article published in EHS today showed that, in Utah, 57% of those who died from opioid-related deaths had at least one prior workplace MSD (Cheng et al., 2013).
Injuries from poor ergonomic conditions are not a new thing. In fact, hundreds of years ago this type of condition might have been described by the type of job or worker who was involved. For example, early medical literature described conditions like;
- Butchers’ Wrists,
- Fiddler’s neck,
- Writers’ Cramp
- Milk Maids’ Hands
- Game keepers’ thumb
More recently, following the introduction of personal computers in the 80’s and 90’s, there was a minor epidemic of hand, arm, wrist injuries. And the naming of these injuries implied the supposed causes of the injury (and a couple carry-overs from the people who might get them). Examples included;
- Cumulative Trauma Disorders (CTDs)
- Repetitive Motion Disorders (RMDs)
- Repetitive Strain Injury (RSI)
- Work-related upper limb disorders (WRULDs)
- Golfers elbow
- Tennis elbow
- Nintedo thumb
- Texting neck
Now it is generally accepted to use a more general term, like Musculoskeletal Disorder or MSDs, that describes the affected tissues but doesn’t imply the cause, or the type of worker involved. And from a medical perspective, a specific diagnosis naming the affected tissue is preferred to naming the job that caused it.
Descriptions of MSDs: Computer-related injuries can be broadly termed MSD’s – which include a range of medical conditions affecting muscles, tendons, joints, or nerves. Some examples of MSD’s include muscle sprain & strain, tendonitis and carpal tunnel syndrome.
The symptoms of MSD’s may include pain, muscle fatigue, soreness, spasm, or numbness. If you have symptoms of MSD’s which don’t improve after making ergonomic changes, please seek appropriate medical advice.
Muscle disorders – These are perhaps the most common
- Muscle Spasm: A spasm is a sudden, involuntary contraction of a muscle or a group of muscles. It is sometimes accompanied by a sudden burst of pain but is usually harmless and ceases after a few minutes.
- Muscle Strain: A strain is an injury to a muscle in which the muscle fibers tear as a result of over-stretching. Strains are also known as pulled muscles.
- Myalgia: means “muscle pain” and is often caused by overuse, over-stretching of a muscle, or by stress. Cervical Myalgia, neck tension syndrome, and cervical strain, are common examples related to computer work. These can occur if the work involves chronic tension, awkward postures or repeated bending of the neck.
- Myofascial Pain Syndrome: A painful, chronic muscle condition associated with Muscle Trigger Points, or small knots, that can make symptoms worse when aggravated. Trigger points are a very common cause of persistent muscle pain and can be a result of repeated use, static muscle tension, or a sudden movement that causes muscle strain.
Tendon Disorders – The Second-most common injury I’ve seen
- Tendonitis: An inflammation of the tendons or sheaths surrounding the tendons, and causes movement to be painful. Tendonitis can occur from keying or mousing with the wrists bent, or in the shoulders from frequent reaching.
- Tenosynovitis: A painful swelling and thickening of the sheath surrounding some tendons.
Stenosing Tenosynovitis: Irritation and roughening of the tendon surface. This condition may lead to stiffness, snapping, and jerking motions when moving a finger for example.
- De Quervain’s disease: Stenosing Tenosynovitis that occurs at the base of the thumb and in the wrist.
- Trigger Finger: an example of Stenosing Tenosynovitis that occurs in the fingers.
- Epicondylitis: A tendon disorder that occurs at the elbow where the muscles controlling wrist and finger movements attach to the arm bones.
- Lateral Epicondylitis: Often called Tennis Elbow, occurs on the lateral or outer side of the elbow and is from bending the wrist to the outside, bending the wrist up/ back or from straightening the fingers out.
- Medial Epicondylitis: Often called Golfers Elbow, occurs on the medial or inner side of the elbow and is from gripping the fingers or bending the wrist down.
- Ganglion Cyst: A disorder of the tendon sheath. It occurs when the sheath swells up with too much lubricating fluid causing a bump under the skin.
- Rotator Cuff tendonitis: This occurs in the shoulder and often results from working with the arms held out away from the body or when repeatedly reaching up too high.
Ligament Disorders – Rare in the office
- Ligament Sprain:Ligaments are tough fibers that connect bone to bone. A sprain or tearing of the ligamentous fibers can occur if a ligament is over stretched. Ligament injuries are uncommon in office environments.
Nerve disorders – Not as common as Muscle and Tendon disorders, but often pretty significant
- Carpal Tunnel Syndrome: An irritation of the Median Nerve as it passes through the narrow Carpal Tunnel in the wrist. Symptoms include pain, numbness, and tingling of the first three fingers and the thumb. This nerve irritation can occur from swelling of the wrist tendons or from fluid retention and other conditions.
- Cubital Tunnel Syndrome: A pinching or compression of the Ulnar Nerve at the elbow. This nerve is often referred to as the “funny bone”. This condition can occur from working with flexed or bent elbows.
- Guyon canal stenosis: An Ulnar Nerve compression at the wrist. This can occur from working with the wrist bent to the sides when keying or mousing.
- Thoracic Outlet Syndrome: Compression and irritation of nerves and blood vessels as they exit the thorax near the upper chest and shoulder area. The symptoms can be similar to carpal tunnel syndrome and the entire arm can feel like it is going to sleep.
Other disorders related to extensive computer use
- Computer Vision Syndrome: Symptoms vary and may include; dry eyes, or red, itchy, watery eyes; fatigue & heaviness of the eyelids; and difficulty focusing the eyes. CVS does not cause eye damage, but can cause headaches, neck aches, and muscle spasms. Computers can be hard to read because the small dots that produce screen images are blurry around the edge, and are constantly being re-written. This forces the eye to continually refocus to keep images sharp. Excessively high monitor placement, wearing contact lenses, and monitor “flicker” can make symptoms worse.
- Fatigue and stress: These symptoms may be secondary to an MSD or other medical condition. It may be caused by poor job design, work organization, over-working, lack of job control on the part of the user, under utilization of skills, high speed repetitive working, or social isolation, or other psycho-social issues at the job. Many symptoms described by DSE users reflect stress arising from their task. All of these factors have been linked with stress in DSE work, although clearly they are not unique to it.
About MSDs and what to do for them
All of us have probably experienced discomfort due to overusing our arms, legs, necks and backs. Typically, these pains are a result of irritation to soft tissues of the body such as muscles, tendons or nerves. Generally, this discomfort lasts only a few days, and subsides with rest. Some discomfort from work is common and may be considered normal; however, discomfort that lasts from day to day, or discomfort that affects work or home activities needs to be addressed.
If the soreness or irritation to soft tissues continues, it may result in further discomfort or injury and a Musculoskeletal Disorders” (MSDs) may develop. For a speedy and successful recovery, it is important to identify the activities at work and at home that may be contributing to your discomfort and then modify or eliminate these activities by making ergonomic adjustments.
If making ergonomic and work-practice changes doesn’t improve the condition, please seek appropriate medical advice. It’s easier to treat minor issues and It’s important not to ignore symptoms.