Carpal tunnel syndrome began to capture the attention of insurers when, back in the late 1980s, treatment costs for repetitive stress injuries started to soar. CTS occurs when the median nerve at the wrist gets chronically irritated. The thumb and first two or three fingers become painful, numb and weak.
The computer workstation culture had been born as more and more workers performed their duties at a keyboard in front of a screen. At the time, I was working for a computer components manufacturer and charged with product development. Treatment costs for carpal tunnel syndrome were so high in the municipalities of San Francisco and Los Angeles that city councils began to enact legislation to ensure that their employees had access to ergonomic workstations. Our first wrist rest, meant to be placed in front of the keyboard, was picked up by several large office chains.
Ergonomics is dedicated to the design of environments, equipment and devices that fit the human body and its natural movements.
According to Charles Black, owner of Furniture Plus Design, "It’s all about comfort and productivity. If your back is not comfortable in your chair, you are going to get up and go away. On the other hand, an ergonomic workstation reduces the likelihood of carpal tunnel syndrome as well as back, neck and shoulder pain, eyestrain and headaches."
Recommendations for an ergonomic workstation:
» Seat height: One’s feet should be just resting flat on the ground, not dangling. The thigh slopes only slightly downward.
» Depth of the seat: There should be space for three fingers between the back of the calf and the front of the seat to avoid cutting off circulation.
» Lumbar support: Use a padded but firm support at the base of the spine.
» Keyboard: The goal is to be wrist-neutral. This often requires a one-half to one-inch lift at the base of the palm.
» Monitor: The screen should be low so that the eyes can gaze comfortably downward. The natural angle for our eyes is 22.5 degrees.
» Screen: Avoid squinting with an anti-glare screen, and, if possible, avoid having the light source behind you.
» Armrest: The height should be just above the natural position of the elbows when at rest.
» Headrest: Optional.
Even when we have all the right equipment, we can forget to use it. The key is to begin each session at the computer with the intention of caring for the body. Go through a little checklist from the information above and start work once you have optimized your body position.
Also, remember to take breaks. No matter how ergonomic the workstation is, it is still important to get up, stretch the legs, use the restroom, get some air and enjoy a moment of repose.
Working harder or longer doesn’t always mean that more will get done or that what gets done will be of superior quality. Attention to the needs of the human body and its natural movements is enjoyable and results in lower health care costs and higher productivity.
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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
