10.DEC.2020 7 MIN READ | 7 MIN READ

Working from home (WFH) has its ups and downs. One particular downside is that it may create conditions triggering neck and back pains. Here are some reasons why and what to do about them.

Where once WFH was unrelatable to many of us, the current COVID-19 pandemic has forced us to convert parts of our home into make-shift working spaces.

One of the challenges in creating a working space at home is, that our homes were never set up to support an ergonomic work environment. Cooking, meals, lounging and hanging with family and friends, yes, but work rarely features in space planning.

An ergonomic working environment is one that is designed to provide maximum comfort and optimise the effectiveness of work. A poorly set-up home office/space can lead to various injuries such as backaches, neck pain and strain, and wrist strains. Additionally, working in this sort of environment for long hours (typically 7 – 8 hours a day, at a stretch) may further aggravate the situation.

WFH injuries related to backaches and sprains have increased significantly in Singapore since the circuit breaker period, with neck and backaches up chief among the chief complaints. But what exactly is causing these aches and pains?

A less than ideal desk set-up

Too high or too low


Desk height
A kitchen table may be too high whilst the coffee table is definitely too low to serve as a desk. The couch and bed, similarly, are hardly ideal as they do not provide proper back support and can lead to problematic postures.

When the workstation is high, the shoulders tend to shrug, elbows are bent incorrectly, and the wrists can overextend. All these can lead to tension in the shoulders, neck, and the wrist, causing discomfort and injury.

Working on a surface that is too low would, in addition, cause you to hunch over, further aggravating poor posture. Therefore, if you do not have an actual work desk, the dining table may be the better option.

A supportive chair


The height of the chair should match the height of the work surface. Most chairs in our home may be too low for the chosen workspace and do not have lumbar (lower back) support which, causes further change in the alignment of the spine as we sit for long hours at our makeshift work stations.

The laptop


Originally created for convenience and use during travel, the laptop is less than ideal to be used for long hours at a desk. Even when the screen is at the right level, the keyboard may be too low. Get that right, and the screen becomes too high. Therefore, it becomes a trade-off between stressing your neck or, hand and wrist posture.

Aches and pains that lead to chronic problems

WFH aches
A less than ideal workspace will affect you.

It may start with discomfort and tightness that progress to pains in areas such as, the upper and lower back, hands, and wrists. If these are not addressed either by preventive measures or seeing a healthcare provider, such as an orthopaedic specialist, it may progress to chronic conditions affecting your muscles, tendons, and bones.

Common conditions that may come up include:

Muscle and tendon strains


Muscle and tendon strains can occur when there is a sudden twist, pull or tear movements cause injury to the muscles or tendons. With back pain due to strains, the muscles and tendons that support the spine are affected.

When an individual adopts poor posture due to a less than ideal workstation, it causes undue stress to these muscles, leading to a strain.

Some of the signs that you may have strained your back are:

  • the pain/discomfort gets worse with movement
  • there may be cramping or spasms of the back muscles
  • there may be difficulty in walking, bending forward or sideways

If the stress to these muscles and tendons are prolonged or become worse, you may develop additional signs such as:

  • severe pain that restricts any movement or interferes with sleep
  • numbness of your legs

Carpal tunnel syndrome


The carpal tunnel is a narrow tube in the wrist that contains tendons to the fingers and a nerve (median nerve). Repeated movements, or stress to the wrist, causes this narrow tube to get inflamed and narrow, compressing on the structures and nerves within it.

The resulting symptoms triggered by the narrowing of the carpal tunnel is known as carpal tunnel syndrome.

Some of the signs that you may have developed carpal tunnel syndrome are:

  • numbness and tingling sensations of the fingers/fingertips
  • discomfort, pain or tightness at the wrist

If not managed early, this may become a chronic issue, leading to weakness in the hand and the inability to perform basic tasks such as buttoning a shirt, handling small objects, grasping a steering wheel, or holding a book to read.

Tendonitis


This occurs when there is an inflammation in the tendons. Tendonitis can also affect the tendons in the neck due to strain from poor posture, sitting at the computer and also, sleeping in an awkward position.

Some of the signs of tendonitis in the neck are:

  • pain in your neck that may radiate to your shoulder blades
  • stiffness of the neck that limits your movement
  • tenderness in the neck area

Because the neck and shoulders are connected, neck tendonitis can also cause pain in the shoulder and the arm.

Improper postures maintained over long hours every day can also cause problems in your spine due to chronic muscle tension and compression. Long-term effects of this compression to the spin can result in the compression of the joints between the vertebral bones and its discs which may lead to degenerative disc disease, osteoarthritis, and pinched nerves.

Other than discomfort or muscle stiffness/tightness, look out for other symptoms such as numbness and tingling. These are usually the earliest signs that you might want to address with your doctor.

Tips to reduce the aches and pain of WFH

Proper posture
The key is to keep your body in a neutral, relaxed position.

  • The ideal desk height should allow your elbows to bend at greater than 90 degrees to maintain the wrists at a neutral position. This also prevents strain which, can result in carpal tunnel syndrome.

  • Consider investing in a work station that is height adjustable. This will allow you the flexibility to adjust the height of your desk to your exact needs.

  • A comfortable chair with a back support is ideal. If you need to, add pillows for extra support or even height. As most working surfaces (other than a desk specifically bought for work) are higher than ideal, ensure that the chair you use is at an appropriate height and not too low.

  • When sitting, recline your back by 15 – 20 degrees and not sit straight like a rod.

  • Keep your feet on the floor. If the chair and desk are too high, use a stool instead.

  • Keep your arms rested on a wrist pad (use a folded towel if you don’t have one), so that your hands are relaxed when using the keyboard.

  • The computer monitor should be at eye level when looking straight ahead. If using a laptop, get an external keyboard and mouse and place the laptop on a stand to meet your eye level. Your head and neck should be relaxed with your chin parallel to the floor.

  • When typing, do not lean forward as this can put a strain on your lower back.

  • If you have no choice but to use a coffee table, then sit on the floor with your back supported by for example, the sofa.

  • Keep frequently used items within easy reach to prevent overstretching.

  • Move and change your posture often. Spend 1 – 2 minutes standing, or walking, break every 45 – 60 minutes before tension builds up. Prolonged continuous sitting also puts stress on the intervertebral discs in the spine, which can lead to back pain.

What should you do?

Preventing an injury should always be a priority. Here are some tips to help you do so.

  • Figure out the one or two suitable areas that you can do your work and apply some of the preventive tips above.

  • Maintaining a healthy lifestyle with exercise also helps as it strengthens the core and muscles.

  • If you experience pain, moderate-to-severe muscle tightness, numbness, or tingling, do not delay making an appointment to seek medical help to address the Injury early.

If you display any of the signs of WFH injuries, make an appointment with an orthopaedic specialist so that it can be diagnosed and managed effectively.

 

Article reviewed by Dr Yue Wai Mun, orthopaedic specialist at Gleneagles Hospital

References

VerHelst M. How to avoid body aches and pains while working at home. Retrieved 9th November 2020 from https://patch.com/us/across-america/how-avoid-body-aches-pains-while-working-home.

Huffpost. This is what happens to your body when you work from home. Retrieved 9th November 2020 from https://www.huffpost.com/entry/what-happens-body-work-from-home_l_5e84bfb5c5b6a1bb765185df.

Khoo BK. Working from home is taking its toll on our bodies: How to deal with backache and sprains. Retrieved 9th November 2020 from https://cnalifestyle.channelnewsasia.com/wellness/working-from-home-backpain-aches-solution-12982448.

Dorsey J. Tips and suggestions for improving the ergonomics of your home work setup. Retrieved 9th November 2020 from https://www.ithaca.edu/information-technology/working-remote/home-office-ergonomic-tips.

Cleveland Clinic. Back strains and sprains. Retrieved 25th November 2020 from https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains.

Cleveland Clinic. Carpal tunnel syndrome. Retrieved 25th November 2020 from https://my.clevelandclinic.org/health/diseases/4005-carpal-tunnel-syndrome.

Allen E. Neck tendonitis. Jacksonville Orthopedic Institute. Retrieved 25th November 2020 from https://www.joionline.net/trending/content/neck-tendonitis.

10.DEC.2020
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Yue Wai Mun
Orthopaedic Surgeon
Gleneagles Hospital

Dr Yue Wai Mun is an orthopaedic surgeon practising in Gleneagles Hospital, Singapore. His clinical interests include treating complex spinal problems, ranging from the cervical to the lumbar spine, especially with the use of minimally invasive spine surgery and computer navigated spine surgery.