ERGONOMIC ADVICE FOR COMPUTER USE
by Joseph Ierano- Doctor of Chiropractic
Why chiropractic?
Since 1895, Chiropractors have been a leading profession in the care of neuro-musculo-skeletal disorders. This is largely due to the fact that they focus on the spine, and the spine is the central area of potential interference to body, limb and organ function. Quite simply, every area in the body is influenced by nerves which emerge from the spinal cord and through the spinal column.
Current trends
With the vast impact of computers on every field of human endeavour, we now find that chiropractors are seeing more and more human ills attributable to computer use and the seated position.
Conditions such as carpal tunnel syndrome (CTS), where the wrist bones painfully impact on the nerves going to the hand, often responds to chiropractic care because:
a) the over use of the wrist causes problems all the way up the arm and affects the neck as well
b) problems may have originated in the neck with poor posture, and the nerves going to the hand affected the structure of the arm which then causes weakness in the wrist
c) neck of problems must be addressed before many of the CTS symptoms will respond
Other problems such as:
· head aches
· stomach aches,
· chest and rib pain,
· shallow breathing and
· pain between the shoulders
· low back pain
- may also be attributable to computer use. But what can one expect a chiropractor to do? As in the above example, the origin of the irritation may be spinal. Consider that slouching, use of the arms, the tightening of the upper body with fatigue can all cause spinal irritation and misalignment. Once this misalignment is there it needs to be addressed as it creates destructive feedback to muscles, brain and organs. One may seek massage or physiotherapy, which obviously can help. But until the spinal joint is cleared of disturbance, the nerves to the stomach, lungs, ribs, muscles may all remain affected, thus prolonging disease and discomfort. Chiropractic is the profession which spends most time in diagnosing the spine and joints in order to correct poor function, of any of the professions licensed to manipulate the spine &endash; clinically and educationally.
These are but a few examples and one can understand how the chiropractic and body-working professions are facing ever increasing cases of CTS, neck pain, headache, elbow aches, indigestion, asthma and the like, caused by computer use.
Chiropractic first choice
Chiropractic is a first choice for these problems usually because:
· chiropractors are trained in diagnosis for recognition of problems that need immediate medical referral
· it is a drug free choice in many cases
· the body is dynamic in its response to spinal adjustment
· quite often the hidden spinal problem has not been diagnosed, or missed, and treatment delayed
· the spine is responsible for more childhood conditions than we give credit for. This is reflected in world-wide studies on colic, headache, and asthma. More research is needed to inform the public and other health professions.
· more and more people are going online and using the computer for study, work, games and the internet. This means children are also susceptible to increased repetitive, postural, and sedentary injury also.
What Is Ergonomics?
Ergonomics is the study of how people fit in their work or study environment. This includes how children adapt to the use of computers in daily activity.
Chiropractic addresses the issue of computer related injuries with:
1 full comprehensive history and examination
2 corrective adjustment of the spine and joints
3 prevention by advice on do's and dont's
4 exercise guidance to strengthen the body
5 referral where necessary
What Types of Disorders Are Associated with Computer Use?
* vertebral subluxation (poor spinal joint function)
* Neck/shoulder tension
* Headache
* Tendinitis of the wrist & forearm
* Carpal tunnel syndrome
* Mid back/shoulder blade pain
* Lower back pain
* Sciatica
Neuro-musculo-skeletal injuries cost Australians more money per year than cancer treatment. Most of these cases are due to "repetitive strain" from overuse syndromes. The human body was not meant to stay in one, constrained position for prolonged periods of time. It requires regular motion and activity to maintain normal circulation and to keep muscles relaxed. The result of prolonged static postural strain is fatigue in the muscles and eventually joint, nerve, or disc injury. The pain may start suddenly or gradually, but the problem was inevitably "brewing" for months, years or even decades!
The Computer Station Checklist
Chair
* Is your seat height adjustable?
* Are your feet firmly on the floor?
* Are hips at the same level as your knees?
* Is there a good lumbar support?
* Do you have arm rests?
Desk/Computer
* Is your desk or keyboard at a height where your wrists are not bent?
* are your elbows flexed 90 degrees?
* are your shoulders relaxed, not "shrugged"?
* Is the center of your monitor at nose level?
* Is there glare on your computer screen?
* Do you have a document holder?
* Do you have a headset?
What Can I Do?
Apart from seeing your chiropractor for a check up for prevention...
Micro-Breaks
It is essential to break the cycle of repetitive strain, muscle fatigue, and pain. To do this we should recharge our muscles and take strain off our joints and discs every 20 minutes. Even if just for 10-30 seconds!
Also:
* Chin tucks
* Shoulder blade squeezes & rolls
* Standing reach upwards
* Take a walk
* Take a deep breath, and let it go!
Contact the Chiropractors Association of Australia NSW on 02 4722 6811 or browse www.chiropractors.asn.au
[Adapted from Craig Liebenson, DC, published in "Dynamic Chiropractic", chiroweb.com , California.]
RESEARCH AND COMPUTER USE PROBLEMS....
Some of the major problems that arise from computer use are:
1. back pain
2. headache / migraine
3. carpal tunnel syndrome
Chiropractic can help all of these. No matter how good the chair is, the key is to move around and avoid prolonged postures.
Back Pain and Work.
Work-related factors have long been implicated
as potential contributors to back pain, a hypothesis supported by
recent research in the journal Spine. Four hundred and eighty-four
men and women participated in a 24-year study to determine specific
occupational factors related to low back pain (LBP). The study also
evaluated whether interactions between psychosocial and physical
factors, and between work-related and leisure-related factors,
affected LBP. Results showed that:
-Heavy physical workload and sedentary work (i.e.,
jobs involving prolonged sitting or limited movement)
increased the risk of LBP among men and women.
-Among women, smoking and the combination of
"whole-body vibrations" (a phrase used by researchers
to designate jobs involving driving, operating
machinery, etc.) and low influence over work
conditions increased risk of LBP.
-Among men, high perceived load outside work (i.e.,
exercising, household responsibilities and/or repair,
etc.) and the combination of poor social relations and
overtime increased risk of LBP.
School Computers Up Kids' Risk of musculoskeltal disorders
Computers in schools are putting children at risk for musculoskeletal disorders (MSD), say researchers from Cornell University in Ithaca, New York. In fact, none of the students met "acceptable levels" for postural comfort in regard to computer workstation ergonomics, and 40% of youngsters used computer workstations deemed detrimental to their postural health. The remaining subjects worked at stations with questionable ergonomics. In general, monitors and keyboards were positioned higher than recommended. Workstations also lacked wrist and palm rests. The study looked at 95 third-to-fifth grade students.
from: Computers in Schools 1998;14(3/4):55-63
Carpal Tunnel Syndrome
This can develop with computer use where the nerve through the wrist gets trapped. What people dont realise is that the spine and neck has to be checked also because that is the origin of the nerves to the arms/hands.
Study:
Comparative Efficacy of Conservative Medical and Chiropractic Treatments for Carpal Tunnel Syndrome: A Randomized Clinical Trail
P. Thomas Davis, DC1, James R. Hulbert, PhD1, Kassem M. Kassak, PhD2, John J. Meyer, DC1
Objective: To compare the efficacy of conservative medical care and chiropractic care in the treatment of carpal tunnel syndrome.
Design: Two group, randomized, single blind trial with nine weeks treatment and a one-month follow-up interview.
Setting: Wolfe-Harris Center for Clinical Studies at Northwestern College of Chiropractic in Bloomington, MN.
Patients: Ninety-one subjects of 96 eligible who reported symptoms, confirmed by clinical exam and nerve conduction studies.
Interventions: Interventions included anti inflammatory drugs (800 mg. t.i.d. for one week, 800 mg. b.i.d. for one week, and 800 mg. p.r.n. to a maximum daily dosage of 2400 mg. for seven weeks) and nocturnal wrist supports for medical treatment.
Chiropractic treatment included manipulation of the soft tissues and bony joints of the upper extremities and spine (three treatments/week for two weeks and two treatments/week for three weeks, and one treatment/week for four weeks), ultrasound over the carpal tunnel, and nocturnal wrist supports.
Results: There was significant improvement in perceived comfort and function, nerve conduction, and finger sensation overall, but no significant differences between groups in the efficacy of either treatment.
Therefore, the non drug treatment (chiropractic care) was just as effective, without the dangerous side effects.
Headache
This can develop with use of keyboard, seating problems, and tight shoulders after long term computer use. This study compared drugs with chiropractic care for migraines.
Study:
The efficacy of spinal manipulation, Amitriptyline, and the combination of both therapies for the prophylaxis of migraine headache
Background: Migraine headache affects approximately 11 million adults in the United States. Spinal manipulation is a common alternative therapy for headaches, but its efficacy compared to standard medical therapies is unknown.
Objective: To measure the relative efficacy of amitriptyline, spinal manipulation, and the combination of both therapies for the prophylaxis of migraine headache.
Participants: A total of 218 patients with the diagnosis of migraine headache.
Interventions: An eight-week course of therapy with spinal manipulation, amitriptyline, or a combination of the two treatments.
Conclusion: There was no advantage to combining amitriptyline and spinal manipulation for the treatment of migraine headache. Spinal manipulation appeared to be as effective as a well-established and efficacious treatment (amitriptyline), and on the basis of a benign side effects profile, should be considered a treatment option for patients with frequent migraine headaches.
(J Manipulative Physiol Ther 1998; 21:511-519)
- Finally, the best advice I can give you on posture for computer use: USE TWO Mouse controllers; one on the left, one on the right - preferably one mouse, the other a trackball. You will be amazed !
Doctor of Chiropractic
Formerly: Secretary & Public Education Officer, Chiropractors Association of Australia (NSW)
Office: 02 4655 4010
Fax: 02 4655 4710
Cell: 0418 435392
