Computers and Postural Stress

I often tell patients that computers were actually invented for the sole purpose of keeping DCs busy. Think about a few of the conditions that prolonged use or improper work station ergonomics creates.

Let's start at the hand and wrist. Chiropractors see a large number of patients with carpal tunnel syndrome. While you may not remember the names of the carpal bones you are aware that adjustments, soft tissue work, physiotherapy modalities, and wrist supports are all helpful in relieving this syndrome. The cock-up wrist supports are particularly helpful when used while sleeping to prevent prolonged wrist flexion.

The elbows bring us more repetitive stress injuries including medial and lateral epicondylitis, pronator syndrome, etc.

Rounded shoulders and forward posture promote creep and hysteresis of collagenous tissues. Eventually a new set length develops changing the instantaneous axis of rotation of the various areas of the spine. Creep is the displacement in amplitude or length of collagenous structures over a prolonged period of time when a force is applied. This is measured in minutes or hours. Hysteresis is the deformation of collagenous structures due to the loss of water forced out of the compressed tissues. Set is the difference between initial and final length of the collagenous structures. Examples that would cause this would include anterior head carriage or obesity. Roofers would be vulnerable to this because they are in a flexed position for prolonged periods of time. Another example would be a factor worker who works in a slight degree of lumbar flexion on a production line. These changes lead to cervical and thoracic complaints along with cervicogenic headaches.

Sitting associated with low back pain is so common it does not need further comment. Our low backs are not designed for sitting all day. What about the lower extremities? Sitting leads to weakness of the lower extremities which leaves people more vulnerable to injury when they are active. Many DCs are very good at evaluating and treating lower extremity problems. For example, an inversion ankle injury needs immediate evaluation to rule out fracture, dislocation, etc., and proper initial care. As soon as possible, barring no contraindications, joint function needs to be restored. We often use the inversion ankle injury as discussed in our Motion Palpation classes. This may not seem to be related to computers, however I want to reinforce the point that because these people sit all day their lower extremities are weaker and less able to sustain stress with increased activity or exercise.

A great deal can be done ergonomically to reduce many of the typical problems we see in our offices: positioning of the screen to keep the neck in neutral as much as possible; using a chair that fits the person using it; a proper back support in that chair; and glasses which correct vision at the proper distance, so that the patient does not strain to see the screen, etc.

Len Goodman, PhD, wrote in a previous Dynamic Chiropractic article that the exercise craze has really caught on with approximately 10 percent of the population. Many people sit all day at a computer, drive home, and sit in front of their television. When these people try some physical activity, they are at higher risk for injury because they are usually so sedentary. Patients must be encouraged to gradually increase activity levels.

Anyway, back to the original point of this article: computers are yet another example of why DCs have such great job security. Aren't computers wonderful?