Solving "White Collar" Pain Problems

Solving "White Collar" Pain Problems


When applied properly, ergonomic analysis, design, and applications have been proven effective in the corporate battle against white collar pain.
                                    by Ian Chong, CPE


Most professionals have heard of the dreaded carpal tunnel syndrome from computer "keyboarding." But did you know there is a whole host of additional problems lurking in the white-collar environment? When workers twist, reach, flex and otherwise contort themselves they are actually suffering micro-traumas. When repeated over time, micro-traumas cause the kind of biomechanical breakdown that makes headlines. Many cases result in continuous and costly medical care.


Office Culprits

  • Poor work station layouts cause serious back and neck strains from undue twisting and turning. (Often "L" shaped type)
  • Improper chairs (even some touted as ergonomically correct) are the cause of upper/lower back pain and nerve pinching that may result in sciatica (pinching of the large nerve in the lower back).
  • The improper chair for a work station can also cause various forms of thoracic outlet syndrome, the constriction of blood vessels and nerves that exit the body (thorax) into the arms. This constriction causes a myriad of symptoms, including numbness, pain, tingling and a heaviness sensation in various parts of the hands and arms. Sometimes radicular pain (pain radiating to other parts of the body) occurs in the upper back and the upper chest areas. Analysis often places the blame on high arm rests.
  • Improper height relationships of the work surfaces are responsible for various forms of tendonitis, tenosynovitis and shoulder problems.
  • Seemingly innoucous chair arms can cause upper shoulder pain in the levator scapula muscle (top of the shoulder directly between the arm and neck—the muscle everyone likes to have massaged). Improper chair arm use and height forces this pair (left and right sides) to be in tension all day holding up the shoulder, eventually leading to pain. The trouble is that arm rests are frequently perceived as adequate in supporting arms and causing less pain.
  •  Workers with diabetes or other circulatory ailments require additional medical attention due to circulation constriction in the legs from poor chair or footrest configurations.
  • Shoulder and neck discomfort occur when scientists or researchers read highly technical journals for hours with the head bent forward and the shoulders "hunched".


These examples are only the beginning. At worst, the worker can't perform required work tasks and must be relocated. Usually, though, the more minor symptoms are nagging enough to influence the worker's overall psychological and physiological well-being. As with an ongoing toothache, it is difficult to perform optimally until the pain is removed.


Keyboarding is one of the most notorious culprits of occupational injuries. Carpal tunnel syndrome has become synonymous with "power keyboarding" and "Flying fingers" is viewed as potentially crippling. Indeed, many cases involve innumerable finger, hand, wrist and arm pain, tingling, numbness, cramping and surgery (sometimes multiple at the same site). The result is always the same, inability to continue keyboarding tasks--a tough situation if your job description and livelihood depend on it. Engineers, architects, graphic artists and administrative support, all intensive keyboarders, are at risk.
In court cases, where intensive keyboarding was at issue, one ruling indicated that similar to wrist rests, no one special keyboard will impact all the keyboarding associated with anatomical breakdowns.

Proper application is necessary.


Some solutions include building up keys with foam or spacers. These allow the activation of keys with less movement from anatomical neutral positioning. This type of correction is required when older mainframe computers in large organizations are used and virtually nothing (short of spending thousands of dollars) can be done to modify the keyboards.
The solutions may not look sleek, some people laugh at the sight, but they work. The reduce pain. They allow workers to recover. They allow workers to return to normal work tasks—then everyone stops laughing.


One Worker's Pain Becomes that of Many: A Case in Point


In a recent consultation, a clerk complained of severe back pain from a bad chair. (The employee was so surly no one in her office wanted to be anywhere near her.) The problem was her task chair, which supported too little of her girth. Her bosses unsuccessfully ordered chairs from various manufacturers, and the worker became more irritable, She felt management let her down and was not trying to help. Management tried several things but eventually just concluded that she was a pathological complainer.


By the time ergonomic advice was sought, the situation was as close to a crisis as any office problem. After performing a workstation analysis, the causes and locations of her pain were identified. Data was accumulated that revealed how the pain shifted during the work day.


The solution was a very large and adjustable ergonomic chair that specifically addressed her unique needs. Training was required, since pain symptoms would increase with the routine adjustments. The clerk is now more content with her work environment, and co-workers commend on the difference. The cost of the chair was about $1000, This is not much, considering the disruption it eliminated, both in the clerk's life and in the office.
Even "soft" issues such as worker's attitudes (towards work, each other and clients) affect the bottom line. In this case we measured substantial cost savings in the following areas:

 

  • Specific performance and productivity improvement (task performance per time increment)
  • Improved quality control of tasks
  • Overall departmental functioning
  • Backlog reduction
  • Elimination of continued medical costs
  • Saved management time (not spent addressing her problems)
  • Saved personnel department time
  • Eliminated potential law suit (including management time required)


For minimal consultant time and a $1000 purchase cost, many nagging departmental headaches were eliminated, and the department could return to normal functioning.  Office disruption was almost as severe in the case of a graphic artist. This employee worked with a computer mouse for hours. She handled it as if she was reaching out on the table to pick up a ball—with her elbow elevated and her arm extended. The result was a severe shoulder rotation-cuff problem.  The artist requested a new mouse. Supervisors responded with trackballs and other contraptions that were either difficult to use, worsened the problem, or did not address the physical problems. It was a real hit-and-miss scenario.
The artist, a good performer and employee, was caught in a deteriorating situation. Her bosses were beginning to think she was a complainer.


The solution was to provide a specific pointing/input device, minimizing all of the reaching and hand movement, yet allowing he precise control of the screen cursor. The electronic input device only required an inch of movement for full screen cursor control. The new device resolved most of the biomechanical problems. She is much happier in her work.
Blinding Glare


Computers were also to blame when a well-known stock brokerage firm set up a large customer service room. Almost 50 brokers in this department were fielding calls from customers. The phone room was intended to improve customer service. However, when it began operations, the company started to lose business. Nobody knew why.
One of the problems was the glare on the computer monitors. The glare obscured information and caused severe headaches and eye strain.


The in-house solution? The brokers were using pain killers. Meanwhile, they were still short-tempered with clients. Even worse, they were misplacing decimal points in account balances, stock quotations, etc. The mistakes were so frequent that significant numbers of customers were abandoning the firm. The firm's performance, productivity and quality was influenced by inadequate office ergonomics.


Specialized anti-glare screens and monitor visors were placed on the terminals. The work stations were rearranged to reduce the main source of screen wash-out from window light (yet still taking advantage of the view). In addition, we noticed that during visits to the phone room, most of the workers were walking around their desks instead of sitting at them. It didn’t take long to figure out that their backs were also bothering them from sitting in bad chairs. Many also had shoulder ailments due to frequent lifting of heavy reference books. Complete workstation and methods analysis, along with subsequent office layout adjustments solved their problems.


Invisible Enemy


When businesses confront these types of office problems, many fear they are chasing an invisible enemy in a battle with unproven weapons, undefined goals and uncontrollable costs.


This is a false assumption.


Trained ergonomists can identify the "enemies". With proper product knowledge, design skills, and applications experience the cost-benefit ratios are often astounding.


A good example is the use of a (properly applied) ergonomic chair. Research by pioneer ergonomist, Dr. E.R. Tichauer, indicates such a chair recaptures about 40 minutes of lost time per day for seated workers, especially at the professional level. That's about 3.5 hours (nearly half a day) per week. What is an additional half day per week worth to you?


Does this mean that to regain that half-a-man day (and associated dollars), all you have to do is sit in appropriate ergonomic chairs? Not quite—training in these chairs is still needed for proper anatomical fit (remember the surly clerk?).
Past experience shows that complete intervention by trained ergonomists ranges from $1,500 to $200 per workstation type. We have already described the cost of a unique chair to be about $1000. Many chairs designed for the average desk worker (without extensive symptomology) cost considerably less.


Costs for developing special tools, methods and processes are likewise minimal when applied to workers, workstation type or specific tasks performed.
Quality control is a direct indicator of how the tasks are performed, When quality goes down, costs go up. When proper ergonomic applications help workers perform, improved quality and cost savings follow.


Priorities


Many business are prioritizing the ergonomic problems in their workplaces to keep a lid on costs while they consider a more comprehensive program.


Prioritizing, in fact, is fairly straightforward. It is easy to identify the worst injuries (they are the cases already receiving medical attention) and to take care of them first. The identification of the remaining workforce needing ergonomic attention is more subtle and requires a little more thought and programming (preventative medicine).


An ergonomic program can be established easily. The program can include an ergonomics committee, consisting of a group of employees charged with monitoring the workplaces and addressing current and potential problems. The committee should have access to a qualified ergonomist for specialized help in difficult situations. "White collar" workplace problems can be solved with current technology and expertise.