• Painful debilitating condition refers to damage to the muscles, tendons, ligaments, blood vessels, nerves & other soft tissues of the upper extremity & back.

• 20-25% computer users
• 60% of all occupational illnesses (since
1991, in US)
• Cost of compensation in US: over $20 billion/ per year

• Improper use & lack of knowledge about safe computing techniques
• Results from repeated force on soft tissues over a prolonged period
• Repeated trauma causes micro-tears to the affected part, hence leading to inflammation & subsequently to the disorder

• Any one using computers more than 2hrs/ day:
-software professionals
-secretaries, clerks
-cashiers, bank officers
-students
-journalists

• Parts affected : fingers, upper arm, shoulders, neck, lower back. legs etc
• Symptoms : ache or pains,numbness or hypersensitivity, tingling, coldness or burning, weakness, feeling of heaviness, stiffness or tightness, a constant need to stretch or massage, difficulty in day to day activities, e.g, shaking hands, opening doors, dressing, holding newspapers, using a comb, or even holding a teacup etc.

• Carpal Tunnel Syndrome
• Tendinitis, Tenosynovitis
• Thoracic Outlet Syndrome
• Epicondylitis (tennis elbow)
• Ganglion cysts
• Cervical & Lumbar spondylosis

: a) Primary: ergonomics intervention b) Secondary: minimise the development of impairment c) Tertiary: rehabilitation & disability management

• Correct posture and body mechanics
• Workstation design and modifications
• Correct keyboard / mouse / trackball techniques
• Exercise instruction for stretching and warm ups
• Individual chair fitting
• Visual ergonomics
• Stress management
• Knowledge of early warning signs of CRI
• Early and appropriate medical intervention

• Take a one- min “micro-break” every 5 minutes, and at least a 5- minute break every 30-40 minutes
“macro-break”
• Correct typing technique and posture, the right equipment setup, and good work habits.
• Don’t pound on the keys.
• Hold the mouse lightly.
• Keep your arms and hands warm.
• Keep the monitor as far away as you can read comfortably .

• Proper lighting for your work area is important.
Lighting should be indirect and even.
• The brightness and contrast control of the monitor should be set properly for comfortable viewing.
• Blink frequently and perform visual exercises.

Adopt keyboarding techniques that emphasize the use of large muscles, such as the shoulders and upper arms instead of small muscles such as those that drive the fingers.
• Emphasize diaphragmatic (abdominal) breathing to reduce pressure on your chest.

• Neutral position means sitting up, with the back supported, head straight with eyes looking forward.

The top of the monitor should be just below eye level.
• When typing from reports, etc., use paper holders for keeping papers at eye level.
• Sit with feet flat on floor, some weight on the feet.
• Hips slightly higher than knees
• Neutral spine and neck posture
• Shoulders down and back

• Chin tuck
• Elbows held loosely against the sides of the chest
• Do not rest any part of the body on arm rests of wrist rests when typing
• Wrists even with or slightly lower than elbows
• Wrists straight or slightly drooped palms parallel to the keyboard
• Forearm horizontal to the floor
• Relaxed, curved fingers
• Type with the tip of fingers
• Frequent changes of position of the hands, arms, and trunk

- Favorably affect posture, circulation and the amount of strain on the spine
- Allow you to place your feet firmly on the floor or a footrest, with your hips slightly flexed and your knees at a 60-90 degree angle
- Seat should be comfortably wide, and the backrest 6 to 9 inches high and 12 inches or more wide in the lumbar region
-Most of the chairs used by computer users have adjustments to make it comfortable to sit on, but few people bother to adjust it. Spending a little time to learn how to adjust the chair and set it correctly can go a long way in preventing back pain.

• Goals of management :
Patient education
Reduction of pain
Home exercise program
Lifestyle changes

• Break the hidden muscle spasms
• Eliminate trigger points
• Reduce your workload (short term)
• Adjust your workstation (long term)
• Active stretching
• Strengthening exercises
• Restore flexibility
• Perform motion exercises called “glides”
• Establish workstation ergonomics

• CRI is common
• Industry is likely to face heavy losses
(litigation, absenteeism, lower productivity etc)
• Work ergonomics is important
• Prevention is better than cure
• Early diagnosis & treatment is essential