Role of Workplace Adjustments in Preventing Musculoskeletal Disorders (MSDs)

Musculoskeletal Disorders (MSDs) affect the hands, wrists, elbows, neck, shoulders, legs, hips, ankles and upper and lower back. Most MSDs are work-related and result from repetitive stress injuries (RSIs). The work patterns that result in MSDs include:

• Fixed body positions (sitting hunched in front of the computer)
• Repeated movements (using the computer mouse continuously)
• Long hours in fixed positions like standing or sitting for too long

Workplace and MSDs

So far there has been little debate on the best methodology to prevent MSDs at work. Workstation adjustments alone have limited role in reducing MSD-related pain and injuries. However, certain prevention strategies can work in groups which are at risk and groups where members already exhibit symptoms of MSDs.

Researchers Eerd, Munhall, Irvin, Rempel, Brewer et al. from the Institute of Work and Health conducted a systematic review of workplace interventions for preventing and managing upper extremity MSD (UEMSD). They searched 6 electronic databases from January 2008 to April 2013 and found that evidence on 30 intervention categories which included resistance training and exercise programs to manage and alleviate symptoms. The peer-reviewed literature describes some interventions and adjustments. However, there is little evidence on positive outcomes related to symptoms and disabling results. What was surprising was the weak evidence of electromyographic (EMG) biofeedback and office workstation adjustments. In conclusion, the study and evidence point out that resistance training and exercise work best in handling UEMSD and preventing painful injuries and disability.

Types of MSDs

Muscle Injury

Muscle contractions use chemical energy from sugars and produce by-products like lactic acid which is removed by the blood. Muscle contractions which last a long time reduce the blood flow. The substances produced by the muscle are not removed on time and accumulate in the muscles causing irritation and pain which can be quite severe.

Tendon Injury

Tendons are bundles of fibers which attach muscles to bones. Tendon injuries occur due to repetitive activities and strain.

Nerve Injury

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Nerves carry signals from the brain and control all muscle activities. Nerves are surrounded by muscles, tendons and ligaments. Repetitive strain causes the tissues around the nerves to swell and this compresses the nerves leading to pain.

Preventing UEMSDs and lower back injuries are important in preventing disabilities. UEMSDs and lower back pain if ignored can result in permanent disabilities and debilitation. Since workplace interventions have little value in effecting positive outcomes, it is important to look at other preventive options. So far, evidence-based research has indicated workplace interventions like ergonomic seating, adjustments in armrests, alternative keyboards or pointing devices have had little effect on preventing MSDs. However, as pointed out by researchers Eerd, Munhall, Irvin, Rempel, Brewer et al. it is important to include a regimen of exercise and resistance training if one is engaged in sedentary workplace habits.

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People who are constantly using the computer are at a risk of repetitive strain injuries which can result in muscle, tendon and nerve issues. Common disorders include spondylitis, chronic upper and lower back pain, lumbar disorders, hip and spinal issues, knee cap injuries, carpal tunnel and other wrist injuries and shoulder injuries. Some of these can be chronic and permanent. Total avoidance of such injuries may not be totally possible due to shifting workplace environments. Computer usage is ubiquitous and cannot be avoided completely. However, it is possible to minimize damage by following a regimen of resistance training, weight-bearing exercises and whole body exercises which keep the muscles and tendons supple.

References:

1. http://oem.bmj.com/content/early/2015/11/12/oemed-2015-102992.full

2. http://www.cdc.gov/niosh/topics/ergonomics/

3. http://www.nap.edu/read/10032/chapter/12

4. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=SPEECHES&p_id=206

Source-Medindia