Repetitive Strain and the Computer

Much has been written about the problems associated with the overuse of the computer. Computer professionals and enthusiasts often suffer from a particular combination of symptoms. First of all, because of the length of time in a seated position, compression of the lower back is common. Most people do not engage their deep abdominal muscles or their psoas muscles when seated, resulting in an increased lordosis and lumbar disk compression. Even with the most expensive and ergonomically designed chair, the strain of remaining in a seated position takes its toll. What can be done? After an ergonomic evaluation and postural analysis are performed, there needs to be some change in the way the person works so that they are not seated for long periods of time. My suggestion is to work standing up part of the day. This can be accomplished by using a desk that converts to standing or by using a device called the “Kangaroo Pro”. This is a very clever and inexpensive desktop device that fits on any desk. For more information please go to I have many clients currently using the Kangaroo Pro, and they report that their low back pain has improved significantly. Of course releasing the lower back muscles followed by strengthening the weak abdominal muscles is crucial in any rehabilitation program.

Aside from the problems with the elbow, wrist, and fingers (which we will cover at a later date), the next greatest complaint is of pain in the upper back and neck. We must remember that the neck muscles start at the bottom of the shoulder blades and end at the base of the skull. Our heads weigh between 15 and 20 pounds. People who use laptops generally speaking do not use laptop stands and thus are constantly looking down at their computers. The muscles in the back of the neck are then stretched and are straining to keep the head from falling further forward. This posture also inhibits the muscles in the front of the neck creating a further imbalance. What can be done? First of all, make sure you are at eye level with your monitor. If you have a laptop get a laptop stand. If you’re using bifocals get special computer glasses. This will prevent you from looking up and down which strains the muscles at the base of the skull. Working standing up can also greatly alleviate this problem. Testing the strength of the neck flexors in relation to the neck extensors will often reveal a significant weakness in the neck flexors. Start by releasing the muscles as far down as the bottom of the shoulder blades and up to the occiput. Then retest the neck flexors. If they test strong, mission accomplished. If they still test weak, continue releasing the neck extensors. Teach your client how to release the muscles in the back and how to strengthen the muscles in the front of the neck.

We will continue to see musculoskeletal problems associated with the overuse of the computer. As professionals we must educate our clients about posture, sitting for prolonged periods of time, and the proper use of a laptop. Employers must also be educated about ergonomic devices and exercises that can benefit their employees and reduce their workers compensation payments. Lower back pain and neck pain are the leading causes of missed work. There is certainly an opportunity for the manual therapist to benefit his or her clients and impact the workplace.