Dr. Vic Weatherall
Updated December 2014
Computer-related injuries are usually caused by poor sitting postures and improper workspace arrangement. Typical injuries include
- Posterior cervical dorsal syndrome (“computer back”)
- “Mouse shoulder”
- Carpal tunnel syndrome
- Tennis elbow
- Lumbar sprains and strains
- Disc injuries
To understand computer related injuries requires an introduction to some of the basic terminology of musculoskeletal injury.
Muscle spasm: excessive muscle tone; usually caused by a reaction to postural fatigue, tissue injury, or psychogenic stress.
Strain: injury to a muscle or tendon (the tissue that connect muscles to bones); usually due to repetitive overuse, fatigue, over stretching, excessive contraction, unguarded movements, postural loading, or direct blows.
Repetitive strain injury (RSI): damage to the tendons, nerves, muscles, and other soft tissues of the body caused by specific repeated movements which
overstress the tissues; another name for RSI is cumulative trauma disorder (CTD).
Tendonitis: inflammation of a tendon; usually caused by excessive repetitive or abnormal motion.
Sprain: injury to a ligament (the tissue that connects bones together); usually due to the same things which cause strains and the additional stress added when the muscles fatigue.
Myofascial trigger points: local points of severe muscle spasm caused by postural strain and repetitive use; they may be initiated or perpetuated by many physical, chemical, or psychological stresses; and trigger points can “trigger” local and referred pain when pressed or when severe they cause pain
Joint dysfunction: abnormal joint operation due to weak or lax supporting muscles or ligaments, or conversely excessively tight supporting tissues; dysfunction can result in pain, abnormal motion, and eventually degeneration and nerve interference.
Cervicogenic headaches: headaches caused by irritation of the tissues of the neck by any of the tissue dysfunctions.
Posterior cervical dorsal syndrome (“computer back”)
A very common postural syndrome in modern society involves excessive rearward curving of your lower, middle, and upper back; forward drawn head; rounded shoulders; and excessive forward curving of your upper neck. This syndrome has been given several names including sterno-symphyseal syndrome, posterior cervical-dorsal syndrome, or more commonly, computer back or student syndrome. It is a natural result of prolonged sitting work, especially with computers. These postural defects in turn can cause
- excessive muscle tension in your neck, chest, shoulders, arms and forearms, back, abdomen, hips, and thighs and legs
- strains and trigger points the above muscles
- joint dysfunction and sprains in your neck, back, and ribs
- increased loading on the intervertebral discs of your spine
- impaired function of your breathing muscle (your diaphragm), causing the muscles lifting your upper ribs and shoulders to become overactive and subject to problems
To help prevent computer back try adopting the postural relief position every 20 minutes.
“Mouse shoulder” (as good a name as any) is a syndrome arising from prolonged elevation and bracing of the shoulder to accommodate an inappropriately positioned mouse, or performing short range movements of the mouse, or (usually) both. This syndrome results in severe shoulder and shoulder blade muscle spasm (in the trapezius, deltoid, and teres muscles) and trigger points with referred pain in the arm.
If left untreated, this problem can develop into a much more serious rotator cuff injury.
Carpal tunnel syndrome
Carpal tunnel syndrome arises primarily from compression of the median nerve as it passes through the wrist. It is the most common nerve compression injury in the body and it is the most common and costly RSI. Typical symptoms include
- paresthesias (abnormal sensations) such as tingling and numbness in the thumb and index and middle fingers
- night pain
- weakness in grasping, thumb and index finger pinching, and other thumb movements
- clumsiness, such as awkward hand movements and dropping things
For more information, see Carpal tunnel syndrome.
Classic tennis elbow, or lateral epicondylitis, is another type of RSI. It is a tendonitis affecting the common extensor tendon at the lateral (outside) area of the elbow. Tennis elbow is a very common cause of elbow and forearm pain. It can cause mild to severe pain in the lateral elbow and may be aggravated by grasping and excessive finger motions. The pain may also radiate up the arm or down into the forearm.
For more information, see Tennis elbow.
Lumbar sprains and strains
Lumbar spine sprains (ligament or joint capsule tears) and strains (muscle or tendon tears) are common in office workers due to the high loads placed on the spine during sitting.
Sprains and strains may cause back and hip pain as well as muscle swelling and tightness.
For more information, see Lumbar sprains and strains.
Increased loading on the spine due to prolonged and faulty sitting postures may cause sprains of the outer (annular) fibers of the intervertebral discs. In more advanced cases the soft inner material (nucleus) of the disc may protrude into or even through the annular fibers of the disc, resulting in a herniated disc.
Herniated discs may cause back pain, leg pain and altered sensation down to the foot, weakness, walking difficulties, or combination of these symptoms.
For more information, see Disc injuries.
Eight basic steps for preventing common computer-related injuries
The key to preventing common computer-related injuries is to identify and remove the abnormal stresses acting on your body while you work. Eight ways to do this are
- Adopt proper sitting posture by changing the arrangement of your desk, chair, and computer screen and keyboard. See Ergonomics: Good for Everybody and Microsoft’s Healthy Computer Guide. Check yourself to ensure you maintain proper posture throughout the day. A good idea is to have someone else watch your posture while you work.
- Support easily compromised areas of the body. A lumbar support pillow and wrist supports for your keyboard and mouse can prevent many injuries.
- Don’t sit too long at your desk, get up and move around at least every half-hour. Also, try adopting the postural relief position every 20 minutes.
- Recognize that the psychological stress of your work could be altering your posture. Slumped shoulders and shoulders pulled upward are common self-defense postures.
- Improve your overall fitness level to make your muscles strong and flexible so that they do not fatigue as quickly. Start simple, balanced exercise program that you will continue, for example, brisk walking at lunch.
- Stretch and relax your tight (or overactive) muscles and strengthen and tone up your weak (or underactive) muscles. Periodically perform these simple stretches.
- Take a few minutes to massage your muscles to help work out the kinks. Use gentle kneading motions and strokes towards the heart.
- At the end of your long day, relax your muscles in a warm bath or shower. You deserve it!
Consider using a computer program like Workrave, a freeware program that assists in the recovery and prevention of RSIs. To quote the website: “The program frequently alerts you to take micro-pauses, rest breaks and restricts you to your daily limit.” It also provides helpful examples of stretches and exercises for you to perform during the breaks. Also consider using one of the many posture apps available for smartphones.
When to get additional help
You should seek help for
- problems different than your “usual” ones
- persistent (lasting more than 2-3 days) or worsening symptoms
- symptoms that disrupt your work or home life
Contact Dr. Weatherall if you have any questions or to see if he can help you with a problem.