Ergonomically Yours

Archive for April, 2010

How Does Your Posture Affect Back Pain and Neck Pain?
Chiropractor, neck pain, posture, chiropractic, back pain, ergonomic
Have you ever wondered how it can be that you can sit around all day doing nothing strenuous and develop back pain or neck pain?  When you start to examine the structure of our bodies and apply some simple rules of physics, the fact that we don’t suffer from more frequent or intense back pain and neck pain is a wonder.  In my chiropractic office in San Diego, California, I see office workers on a regular basis that have significant back and neck complaints related to simple ergonomic issues.
Back pain or neck pain can affect anyone at any time.  I see patients that have injured their backs and necks from lifting, operating machinery, sports injuries, auto accidents and falls on a daily basis.  I would classify these injuries as typical or expected types of injuries.  Many non-chiropractic patients or new chiropractic patients would be surprised to find that the most common type of injury that I see in my office is not from lifting heavy sacks of concrete but from the long term consequences of postural stress.
Postural stress is the “silent killer” when it comes to our spinal health.  Postural stress occurs during both seated and standing positions.  Postural stress occurs any time that your spine looses its’ natural curves and / or moves forward beyond its neutral balance point.
An example of a posturally stressful position for your neck would be when you are sitting at the computer leaning your neck and head forward while keyboarding, mousing or viewing the screen.  Assuming a posture in which your head and neck are extended out in front of your body reverses the normal curve of your neck and shifts your head forward of its balance point.
When we assume postures that cause stress on our spines, the stability that is inherent in our structure when postural boundaries are respected is lost.  Postural stress exposes our ligaments and muscles to prolonged periods of stretching which results in fatigue, irritation, inflammation, back pain and neck pain and eventually arthritis.
Treating neck pain and back pain that has resulted from postural stress requires a multifaceted approach.  Chiropractic care combined with stretching and nutritional support will relieve the pain and stiffness and restore normal, full joint motion.  This part of your recovery may take several treatments or a lengthy treatment program based on the length of time that you have been in pain and the severity of your symptoms.
In addition to chiropractic care, you must eliminate or modify the causes of the postural stress.  A workstation analysis can reveal ergonomic issues that are instigators of postural stress.  Ice pack applications to the specific areas of neck pain and back pain in twenty minute sessions are also helpful.
The best way to begin your care is discuss your issues with your chiropractor.  Chiropractors are well trained in dealing with postural stress issues and the neck pain and back pain that result from it.  At my San Diego based chiropractic clinic we use a complete approach that utilizes chiropractic care supported by specific stretches and exercises.  We also encourage the proper nutritional support to facilitate the healing process.  Whatever approach that you take to relieve the pain of postural stress, please be aware of the importance of eliminating the source of the postural stress in addition to seeking treatment.

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Here’s To Your Health

Yours Ergonomically,

Dr. Jones

Economic Mouse Pad
San Diego Chiropractic
Pain Relief San Diego Chiropractic

(619) 280-0554

Our spines do not like sitting as a rule.  If you remain seated in the same position for a long enough period of time you will experience some level of discomfort.

Although there are many reasons that sitting eventually causes discomfort, one of these reasons cannot be avoided.  The natural center of gravity for a sitting human being is approximately 1 inch in front of the belly button.  In order to park our upper bodies over our center of gravity we have to either lean forward eliminating the support of our backrests or slide our butts downward and forward assuming a slumped position.  Often these postures are accompanied by crossed legs or feet and leaning our elbows on the desk or our armrests in order to promote stability of the spine.

Poor posture often results from chairs and work stations that are void of proper ergonomic considerations.  Postural stress causes discomfort in the neck, back and arms resulting in fatigue and fidgeting.  It comes as no surprise that these consequences of poor posture have a negative effect on your mood, your concentration and your productivity.

In the long run, poor posture can cause chronic back pain, neck pain and a host of syndromes that affect the upper extremity as a whole.

I found an excellent definition of poor posture in  a book called “Backs” by Leonard Ring in which he defined poor posture as “a faulty relationship of the various parts of the body which produces increased strain on supporting structures”.

As important as proper sitting posture is for a younger person with an otherwise healthy back, it is of much greater importance to those who are older and may have some level of arthritis in their spines or a history of injury.  Arthritis weakens the joints in the back and makes it more sensitive to the stresses of prolonged sitting when using good posture and much more likely to suffer consequences in situations that involve poor posture.  A history of back injuries is also detrimental to the spine during sitting positions especially when it is exposed to the stress of poor posture.   All of those old gymnastics, football, hockey and general horseplay falls and jolts have a cumulative effect that decreases our ability to endure stressful postures.

The bottom line is that there are many good sources on the Internet that describe the characteristics of proper sitting positions.  The more stress that you can eliminate from your sitting postures the happier your back will be.

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Here’s To Your Health

Yours Ergonomically,

Dr. Jones

Economic Mouse Pad
San Diego Chiropractic
Pain Relief San Diego Chiropractic

(619) 280-0554

Better Ergonomics

Ergonomics, ergonomics, ergonomics – it is all that we hear.  For good reason too!

Today’s workers spend more and more time sitting at computer terminals.  We try to find comfortable positions at our home and work office stations but these positions are deceitful.

Regardless of my chiropractic education, without the help of a few ergonomic devices, I end up slouching over my computer.

Approximately ten years ago, I started working on the development of an ergonomic apparatus that eventually would be known as the Ergo Nav.  This device was 100% inspired by my treatment of patients who were suffering from computer related ailments and syndromes.

I began to notice a pattern amongst my patients who complained of computer related neck pain, shoulder pain, elbow pain, wrist pain and hand pain.

First of all, they typically carried worse symptoms on their dominant sides.  Right handed folks had more severe symptoms on the right and lefties were worse on the left.

A second prevalent characteristic among these patients was the intense and often unbearable increase in their symptoms when they were using the computer mouse.

Almost all of my patients who suffered from some sort of neck, back or upper extremity complaint that was secondary to computer use complained that reaching to the desk for the mouse greatly exacerbated their pain!

One of the things that I tell my patients is that when they are in pain, regardless if it is neck pain, back pain or pain in some other joint, to pay attention to the activities that make the pain worse.  This is good information to know because barring some significant injury; most of the time pain is the end result of some ongoing low level aggravation that more often than not goes un-noticed.    Once you are in pain, the activities that have silently contributed to your current symptoms will be the activities that now noticeably cause your current symptoms to worsen.

The ongoing painful stress of reaching for the mouse is what led to the idea behind the Ergo Nav.  The Ergo Nav was designed to be an inexpensive, adjustable and functional mouse platform that would allow a computer operator to operate the mouse in a comfortable, ergonomically friendly position.

By eliminating the need to reach for the mouse a large amount of stress can be eliminated reducing the chances of injury.

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Here’s To Your Health

Yours Ergonomically,

Dr. Jones

Economic Mouse Pad
San Diego Chiropractic
Pain Relief San Diego Chiropractic

(619) 280-0554

Is computer work making you miserable?

If it is, you are not alone. National statistics point to the computer as a major contributor to lost days at work due to injury. I see the same thing in my San Diego Chiropractic office. Neck pain, shoulder pain, wrist pain, hand pain and back pain are common among those who don’t have the proper ergonomic set-up of their computer stations. That being said, some people get these symptoms regardless of their ergonomic set-up.
Computer ergonomics is the study and / or implementation of workstation design with the purpose of reducing or eliminating physical stress.
My interest in repetitive stress syndromes began approximately 10 years ago when my practice started seeing a much greater number of people suffering from the effects of computer / keyboard work. Despite all of my training and continuing education related to these types of injuries, I quickly realized that traditional treatment for this type of injury was marginally successful at best.
Any type of therapy was going to have to include the application of basic ergonomic principals to the patient’s work environment.
I am of the opinion that treatment alone or application of ergonomic principals by themselves was not going to resolve a repetitive stress injury.
Over the next several weeks I will write a series of articles that will address the implication of workstation ergonomics and injury resulting from postural stress secondary to use of the computer mouse.
Specifically, the following will be addressed:
1) What repetitive stress injuries are
2) What role do work station ergonomics play in injury
3) How reaching for the mouse sets the stage for injury
4) What are the symptoms of repetitive stress injury
5) How you can avoid mouse reaching injuries

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Here’s To Your Health

Yours Ergonomically,

Dr. Jones

Economic Mouse Pad
San Diego Chiropractic
Pain Relief San Diego Chiropractic

(619) 280-0554

Computer ergonomics is the study and / or implementation of work station design with the purpose of reducing or eliminating physical stress.

My interest in repetitive stress syndromes began approximately 10 years ago when my practice started seeing a much greater number of people suffering from the effects of computer / keyboard work. Despite all of my training and continuing education related to these types of injuries, I quickly realized that traditional treatment for this type of injury was marginally successful at best.

Any type of therapy was going to have to include the application of basic ergonomic principals to the patient’s work environment.

I am of the opinion that treatment alone or application of ergonomic principals by themselves was not going to resolve a repetitive stress injury.

This article will address the implication of work station ergonomics and injury resulting from postural stress secondary to use of the computer mouse.

Specifically, the following will be addressed:

1) What repetitive stress injuries are

2) What role do work station ergonomics play in injury

3) How reaching for the mouse sets the stage for injury

4) What are the symptoms of repetitive stress injury

5) How one can avoid mouse reaching injuries

What Exactly is a Repetitive Stress Injury?

Repetitive Stress Injury is a kind of catch all phrase for many conditions. Carpal Tunnel Syndrome, Tenosynovitis / DeQuervain’s Syndrome, Tendonitis, Thoracic Outlet Syndrome, Trigger Finger, Myofascial Pain Syndrome and Chronic Sprain / Strain are some of the actual diagnosis that are rendered in my office. All of these conditions are serious and in many cases can cause great pain, permanent disability and sometimes loss of employment.

Repetitive Stress Injuries occur from repetitive movements involving a specific set of muscles and joints. RSI injuries are the result of an accumulation of stress and strain that causes irritation, inflammation, and eventually pain or other disability. A good analogy used to characterize the onset of RSI would be the “straws on the camels back” saying.

Initially, RSI affects the soft tissues of the involved joint(s). Soft tissues include muscles, nerves, ligaments and tendons. However, if left untreated for long periods of time, the involved joint can become arthritic and form bone spurs resulting in permanent damage to the joint.

While various occupations ranging from meat cutters to construction workers develop RSIs that result from the typical duties of their professions, the most frequent cause of these injuries involve computer work. The constant demand of keyboarding and mousing combined with the postural stress of confinement in an office chair with one’s neck and back held in prolonged fixed positions has resulted in an epidemic of injuries that includes hand pain, wrist pain, arm pain, neck pain, back pain and shoulder pain.

Work Station Ergonomics

The study of workstation ergonomics tells us that the objects that are used most often should be located closest to your body and accessed easily, without awkward body positions. Repeated reaching or prolonged postures that involve leaning forward from your chair are particularly stressful and fatiguing.
Many people are aware of computer ergonomics and thus have an ergonomic mouse. An ergonomic mouse is of little use if it is positioned in an area that requires reaching and stretching in order to operate it. Limiting reaching and stretching for desk items is essential to maintaining a healthy ergonomic environment.

The most frequent complaint that I have seen in my office is due to computer work is the combination of mousing and its’ inherent postural stress.

Most computer stations are designed in a way that involves the worker operating the computer mouse on a pad on the desk. Reaching to the desk for the mouse places direct stress on the joints and soft tissues of the neck, shoulder, elbow, wrist and hand. Additionally, reaching forward for the mouse stresses the lower and middle back.

So How Does Reaching for the Mouse Set the Stage for Injury?
Reaching for the mouse causes you to lean forward in your chair, extend your arm and support the weight of your body through your extended arm. The following section will discuss the particulars of each of these positions.

The stresses placed on the human frame when reaching for the mouse are easily explained. Contrary to popular belief, sitting, which most people believe is relaxing, is hard on the back. Sitting for long periods of time can cause increased pressure on the intervertebral discs of the spine.

In recent years, ergonomisist have told us that proper sitting posture would have us sitting upright with our hips flexed at 90 degrees. As it turns out, the most up to date studies show that a slightly reclined sitting posture with the hips flexed at 100 to 115 degrees is ideal if you have to sit at a desk. If your mouse is not positioned close enough to your body, you will have to reach for it. Reaching for your mouse stresses your back by reducing the angle of your hips.

Next, we have to look at the effects of reaching on the neck and shoulder. When the mouse is being operated at a distance that makes the operator reach, the shoulder extends forward and the shoulder blade abducts (rotates forward). This position stretches the muscle groups that connect the medial portion of your shoulder blade to your spine and the superior portion of your shoulder blade to your neck.

In the short term, this stretch aggravates the affected muscle groups causing spasm, fatigue, headaches and stiffness in the neck and shoulder. In the long term, this position creates a condition called a “stretch weakness” resulting in muscular imbalance, trigger points and chronic variations of the conditions listed in the prior sentence.

Lastly, placing the mouse too far away, too low, or too much on one side can cause shoulder, wrist, elbow, and forearm discomfort. When the operator is forced to reach for the mouse, his / her body weight shifts forward and ultimately results in weight bearing stress on the extended arm. Spending prolonged periods of time leaning on an extended arm is an unnatural and destructive posture that will eventually lead to the development of a repetitive stress syndrome; likely resulting disorders would include tendonitis of the wrist, elbow or shoulder.

What are the Common Symptoms?

” Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows

” Tingling, coldness, night pain or numbness in the hands, especially around the base of the thumb

” Clumsiness or loss of strength in the hands

” Pain in the neck, shoulders, wrists, hands or back that is associated with using the computer

How Can You Avoid Injuries Related to Reaching for the Mouse?

The following recommendations are applicable to both home office ergonomics as well as ergonomics in the office.

1) Placing the input device directly in your immediate reach zone offers natural comfort and maximum hand-eye coordination. The use of a platform for the mouse is preferable. Some models of mouse platforms attach directly to your chair.

2) Your chair should have arm rests that are adjustable.

3) Your wrist should be either in a neutral position or flexed slightly downward when operating both your mouse and your keyboard. For this reason, if you select a mouse platform that attaches to your chair, adjustability of the platform is of primary importance.

4) Consider using a high quality office chair with adjustable armrests and lumbar supports. It should also allow some degree of recline.

5) Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use – avoid overreaching.

6) Hold the mouse lightly, don’t grip it hard or squeeze it. Place the pointing device where you don’t have to reach up or over very far to use it. The closer you can place it to your body the better.

More Coming Soon

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Yours Ergonomically,
Steve Jones

Ergonomic Office Supplies

San Diego Chiropractor

(619) 280-0554

Setting up your office space correctly definitely requires some expert input.  That being said, many aspects of setting up your office space are based on common sense.

We all have specific items at work that we handle more frequently than others.  In my work environment for instance, I use the mouse and keyboard more than any other object on my desk.  At this point I will inject a shameless plug for my Ergo Nav.  Since I use my mouse most frequently, I have it perched right at the end of my chairs’ armrest.  My Ergo Nav positions my mouse close enough to my body to avoid any reaching for the mouse at all.  From an ergonomic standpoint, this positioning is ideal.
Visit the Ergo Nav site to see a demo of how it Reduces Wrist, Arm and Neck Pain For Computer Users
http://www.ergonav.com/

My keyboard is also within my immediate reach as are my writing instruments such as pens and pencils.  All of the items that I have discussed so far are within my immediate reach area, which is also known as the “usual work space”.

Most people only have a handful of objects that truly belong in their “usual work space”.  The actual dimensions of this space vary with the size of the worker, therefore, you have to keep the principals of good ergonomics in mind when determining the actual size of your “usual work space”.   As far as placement of mice, keyboards, pens, phones etc., within your “usual work space” you have to position these items in a way that avoids or limits hunching of the shoulders, flaring out of the elbows or forward flexion of the shoulders.

The area beyond the “usual work space” is considered the “occasional work space” and should contain objects that are only occasionally used.  In my circumstances, the “occasional work space” contains my cpu, monitor, printer and my phone.  Most of the time I have an assistant to answer my phone and I may only make a handful of calls each day.  My monitor only requires that I turn it on and off once a day – the same being the case with my printer and the computer itself.  My desk space is limited so the items that I have covered are the only items in my space.  Staplers, files and paper are needed infrequently enough to not deserve the chance to clutter my work area.

Visit my San Diego Chiropractic Website to read more about workplace injuries and Repetitive Stress Syndrome and how I can help you set up your workspace and work with any pain you may already have

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Here’s To Your Health

Yours Ergonomically,

Dr. Jones

Economic Mouse Pad
San Diego Chiropractic
Pain Relief San Diego Chiropractic

(619) 280-0554