Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, March 31, 1992 TAG: 9203310149
SECTION: EXTRA PAGE: E-3 EDITION: METRO
SOURCE:
DATELINE: LENGTH: Long
Now, with workplace safeguards largely in place to control such risks, it is the white-collar workers' turn to suffer.
In offices, newsrooms and at switchboards, growing numbers of people who work hour after hour on computer keyboards are developing sometimes crippling symptoms in their hands.
Some try to ignore the symptoms until they can no longer hold a coffee cup, let alone type. Others, frightened by the disabilities of co-workers, seek professional help before it is too late.
Still others are banding together to seek changes in their computer equipment or office environment, sometimes by suing their employers, computer makers or both.
Unions and employers have also begun to hire companies that specialize in ergonomics, the science of fitting the workplace to the worker, to redesign office equipment and train workers to use their bodies in less risky ways.
It may be difficult to understand how working with something so seemingly innocuous, efficient and simple to use as a computer keyboard could damage the body.
The problems are thought to stem from this very simplicity: workers in many businesses do almost nothing the entire day except press keys, making many thousands of strokes every hour.
Many become "keyboard athletes," typing fast and furiously all day. Yet few have trained, as athletes must, to perform their task with the proper technique, and many are relying on equipment - keyboards, monitors, tables, chairs - that are designed for someone else's body, if for any body at all.
The result is often a form of overuse syndrome, an injury that can be hard to diagnose but nonetheless painful and incapacitating to the delicate structures within the wrist that make it possible to use the hands.
For example, there is carpal tunnel syndrome, in which the nerve passing through the wrist becomes pinched by swollen tissues. The syndrome causes numbness and tingling in the fingers at first, then crippling pain, permanent nerve damage and loss of muscle control that can render the hand almost useless. The disorder is but one of several hand-wrist problems that beset computer operators.
Researchers who have analyzed the conditions that seem to lead up to hand-wrist problems and clinicians who treat them have identified factors both within and outside the workplace that when properly adjusted can help prevent hand-wrist injuries.
Dr. Marvin Dainoff, director of the Center for Ergonomic Research and a professor of psychology at Miami University in Oxford, Ohio, insists that physiologically sensible use of the computer starts with the user's chair.
A well-designed chair not only helps protect your back but also reduces strain on your shoulders, neck and arms and ultimately your hands.
Most experts recommend a chair that allows you to adjust the height of the seat and the tilt of the back and possibly also of the seat. An adjustable table may also be necessary for people who are very tall or very short.
You should be able to sit with your feet flat on the floor (or on a footrest), your thighs at right angles to your torso, your arms and hands parallel to the floor or perhaps slightly elevated, your head erect and your eyes looking slightly down (about 15 degrees below the horizontal) to see the screen.
To minimize stress, the chair should support your lower back and should swivel and roll on casters. To allow for relaxation of muscles and shifts in working postures, the seat back should be able to tilt backward to an angle of 15 degrees or more from the vertical.
The desirability of arm rests is a matter of debate. Some experts suggest they can aggravate wrist problems and encourage poor posture if the arms are rested on them while typing. Others laud their usefulness as a resting place when not typing.
Next comes the surface on which the computer keyboard rests. When sitting properly in your chair, you should be able to type with a flat wrist. Avoid bending your wrist up or down or twisting it sideways when you type.
If the keyboard is very wide or deep, learn to lift your hand to reach outlying keys instead of trying to stretch your fingers to them, which distorts your wrist position.
While typing, avoid resting your wrists on the edge of the work surface; to reduce pressure on the wrists, consider using a padded wrist and palm rest in front of the keyboard. Keep fingernails trimmed; long nails force you to extend your fingers to hit the keys.
Try to avoid other potentially wrist-damaging activities when you are not typing. Dainoff cautions against moves that bend the wrist, especially if force is involved, like pushing a heavy door, opening jars, holding a telephone handset at an angle or resting your head in your hand.
Also think about home and recreational activities that might aggravate a sore wrist, including excessive use of a kitchen knife, playing a musical instrument with a distorted wrist, skating with the hand bent up at the wrist or pushing a power mower.
Use your whole hand (not just thumb and forefinger) and minimal force when gripping, grasping or lifting an object.
Take frequent brief rests while typing. Switch to another activity that uses the hands differently. Do not use more force than necessary to hit the keys. When taking notes or writing an original work, avoid holding your hands in a tensed "ready" position when waiting to type.
Do exercises that strengthen hand and arm muscles and improve circulation in the upper extremities, such as squeezing a handgripper and swimming. When typing, try to rely more on the larger, stronger muscles of the arms and shoulders to reduce strain on the wrists and hands.
When detected and intercepted in their early stages, hand and wrist problems are relatively easy to reverse. Experts caution against trying to work through pain, because that will only make the injury worse and could result in irreversible damage to the nerve that passes through the wrist into the hand.
Therapy may involve analysis of your typing technique and retraining, adjustments in your office furniture and keyboard, physical conditioning and the use of wrist splints at night to prevent abnormal wrist positions during sleep.
Dr. Emil Pascarelli, director of ambulatory care at St. Luke's-Roosevelt Medical Center in New York, who established a hand clinic to treat injured keyboard users, said that anti-inflammatory drugs, like ibuprofen, do not seem to work well in treating work-related injuries to the wrists and hands.
He also maintains that surgery, which has become a very popular remedy nationwide, should be considered a treatment of last resort, when more conservative measures seem unable to relieve the problem or when the nerve is becoming scarred or is degenerating.
Jane Brody writes about health issues for The New York Times.
by CNB