SETTING UP YOUR WORKSPACE – For the IT Professionals

Workspace ergonomics

Ergonomics

As told in our previous post, ergonomics is the study of human capabilities in line with the occupational requirements/demands.  It is very important to have the right ergonomic adjustments of your workstation (ergonomic workstation) so you can perform optimally.  Spending long hours at work, in front of the computer, slowly but gradually leads to a compromised state of health, making the human body vulnerable to various musculoskeletal disorders.  Long-standing problems can further lead to disabilities, at times beyond repair through conservative management, or even surgery.

Thus, it is very important to set up our workspace.  This is the first step towards prevention from, and even cure of, the various musculoskeletal disorders arising from the occupational hazards.  The most common problems faced due to the occupational demands involve neck pain, back pain, headaches, pain in the wrists, hands, and fingers, neurological involvement leading to radiating pain, numbness and tingling, and loss of sensation in the upper and lower extremities, and nausea/vomiting/dizziness.

 

Setting up of your Work-Space

The key points to remember while giving your workspace a makeover are

  • Choosing the right chair
  • Good posture maintenance and positioning
  • Equipment height adjustment and positioning

Taking care of these will make your work experience as comfortable as possible, and will help you cater to your job duties and responsibilities optimally.

 

Chair

The chair should support the contour of your spine.  The height of the chair should be adjusted such that the feet rest comfortably flat on the floor/footrest.  The thighs should be well supported and parallel to the floor.  The armrests should enable your forearms to gently and comfortably rest on them while maintaining relaxed shoulders.  The seat should be comfortable and firm (neither too hard on the buttocks, nor too soft making you slouch).  An ergonomic chair is very helpful in this.

 

Footrest

If the height of the chair is too high and not adjustable, or the height of the desk forces you the keep your chair high, and your feet do not rest flat on the floor, always use a footrest.  If a footrest is not available, a low stool or any object with a flat surface and a good stable flat base can be used for the same.

 

Desk

Desk height is very important to maintain a good and comfortable workspace.  It should be in accordance with the body posture mentioned above.  If the height is too low, use sturdy blocks or objects to raise the height accordingly.  If the height is too high and can’t be adjusted, the chair height can be raised as explained.  There should be enough room under the desk for the knees, thighs, and feet.  Make sure there is nothing stored under the desk making it cramped-up for the lower body.  If the edges of the top surface of the desk are hard, pad the edges.  The surface should not be rough either, smooth surface enables the forearm and wrists to glide through comfortably.  Ergonomic desktops are easily available in the markets.

 

Objects

The objects frequently used, like the stationaries, work materials, and the telephone should be kept as close to the body as possible to enable comfortable reaching without altering the body posture much.  If an object is needed to be kept away, always make sure to reach it after standing up without bending or trying too hard from sitting position.

 

Telephone

If your job requires you speak over the phone while writing/typing at the same time, make sure you use the speaker phone function than uncomfortably cradling the receiver between the head and the shoulder.

 

Keyboard and mouse

Keep the keyboard and mouse at a level that enables you to keep your wrists straight, upper arms close to the body, forearms well supported, and hands at or slightly below the level of elbows.  Focus on keeping the use of the mouse as minimal as possible by using keyboard shortcuts (enhancing your skills may prove worthy here).  Also, if possible, be as ambidextrous as possible by alternating hands for operating the mouse.

 

Monitor

Place the monitor directly in front of the level of the eyes, approximately at about an arm’s length away.  The top of the screen should be at or slightly below the eye level and should be directly behind the keyboard.  An additional lowering of the monitor for 1-2 inches helps in more comfortable viewing with use of bi-focal glasses.  The brightest source of light should be at the side of the monitor and not directly in front or behind the monitor.

 

Also, make sure you take proper rest and stretch breaks every 30 minutes.

 

NECK PAIN, Facts you must know

Neck pain causes

What is a neck pain?

Neck pain is one of the most common sign/symptom we encounter in our daily life.  Another common problem encountered is back pain, but we will talk about it in detail in another article.  So neck and back are very vulnerable when it comes to our body and may lead to severe disabilities and impairments if not taken care of well.  However, most of the times, spinal pain may not have a serious cause and effect.

The Causes

Neck pain usually has a very trivial or common cause attached to it, but we land up worrying more, as we do not understand the causes well.  The more serious causes usually have other red flags attached to it and can be easily identified.  So stop worrying, keep calm, and observe the signs/symptoms carefully.  Let’s now discuss some of the red flags:

  • Neck pain bothering for more than 6-8 weeks
  • Pain not easing up, and rather becoming severe and worsening

and

Any of the below-mentioned sign/symptom:

  • Inability to forward-bend head (nuchal rigidity), and/or a fierce headache, fever and altered mental state can be a cause of meningitis
  • Severe headache associated with/without nausea/vomiting/dizziness
  • Throbbing pain in the neck, sometimes associated with pain in temples/occiput (behind the skull), usually on one side, can be caused by a tear in the artery supplying the brain, and can cause a “stroke”. This is usually acute, and should immediately be checked in the ER
  • Light tapping on the spinal cord causing increased pain/exaggerated symptoms
  • Fevers or chills with idiopathic cause
  • Spinal cord distress leading to manifestations in the limbs causing numbness, tingling, heaviness, loss of sensation, loss of coordination, and/or shooting pain
  • Gradual progressive symptoms or marked stiffness of other joints can be causes of auto-immune diseases and likely have a pre-existing family history.

There can be other causes as well which warrant immediate attention in an ER.  This includes an accident or other injuries directly involving the neck, or an indirect cause leading to sudden strain to the neck (a whiplash injury).

Also, chronic steroid use, drug abuse, and/or HIV can cause neck pain and should be dealt with immediately.

 

Understanding the false alarms, rationalizing and treating it right!!

The usual sharp, shooting or stabbing neck pains usually not a reason to worry most of the times.  Sharp or stabbing pains usually indicate the absence of more severe causes.  These usually have a minor source of irritation that typically resolves in a few days to several weeks, with minimal self-help measures and care.  Any minor nerve irritation in the complex mesh of nerves around our neck can lead to shooting pains and usually do not indicate a more severe neurological problem.  These minor factors can cause discomfort, but with proper care, and proper use of body mechanics and exercises, they can heal in a few weeks.

Another problem that raises false alarms is neck stiffness.  Neck stiffness is rarely dangerous, unless it is due to meningitis as discussed above, which will present with other signs and symptoms as well.  Neck stiffness is usually just a diffuse pain of the musculoskeletal system.  It is caused by irritated structures surrounding the neck, adding up to discomfort.  This can also be caused due to protective muscle spasm, which is the brain’s reflexogenic attempt to prevent further strain to the injured tissues.  This can be caused due to improper positioning and posture and can be acute or chronic.  Icing, stretching, exercises and massage often relax the stiff/spasmodic muscles.

 

The worst thing we usually do when we have neck pain is over-worry.  This leads to a dent in our mental well-being along the pain altering the physical well-being, thus affecting our overall health.  We need to first observe and understand the signs and symptoms carefully and then decide on the further steps towards a healthy pain-free life.

 

-In another post, we will get back to you with the common exercises, stretches and remedies you can try as the first line of treatment without panicking at the first place, so keep reading.

I’m Starting Gym from Monday for sure

We all must have spoken these words to motivate ourselves, not once, but probably many a times.  But how many times have we succeeded in keeping this promise of good health to ourselves, may be very few times or none.  True this Monday Motivation is hard to come by.  After a relaxing weekend, it is hard to respond to the early morning alarm on Mondays.  We can think of a million excuses to stop from dragging ourselves out of the bed, freshening up, get into the gym gear and lace up our sneakers.  But if we understand its benefits, we will surely avoid missing our workout regime.  Here’s how it will be rewarding…

 

  1. You’ll feel happy and smile more

Got a meeting early morning on Monday? You’re among the majority of office working population who go through this.  Research shows an average office worker does not smile until 11:16 am.  However, exercising could help in overcoming Monday blues.  Physical activities and exercises release Endorphins (hormones behind your feeling of happiness).  A completed workout makes you feel great…is not it? There is this scientific reason behind it.  A research quoted improved self-esteem in children and young adults after exercising.  If you ever noticed, a simple stroll outdoors for 15 minutes refreshes your mind.

 

 

  1. You will most probably work out the rest of the week

If you finally succeed in getting out of bed and land up in the gym on a Monday morning, with all due possibility, you will work out for the rest of the week as well.  There is something about a Monday morning exercise that motivates you to the right direction.

 

 

 

 

 

  1. You will have better self-control

It may be very difficult to motivate your lazy self in putting on that gym gear resting in your closet.  But once you have done that, it is easier to maintain discipline in other areas of your life.  A study has proved that moving around for just 15 minutes may help in managing withdrawal symptoms/cigarette cravings.  This is because GABA, a neurotransmitter, is released by exercise the helps in controlling those pangs and calms down anxiety

 

 

 

 

  1. You will have reduced anxiety

Anxious about what the coming week holds for you, or about a new case/project that starts on Monday? Hop on a treadmill or do some exercises on the beats of your favorite energetic music number.  It will help you in energizing your body and MIND.  Aerobic exercises reduce general anxiety/anxious thoughts.  Also, high-intensity exercising not only reduces those extra-ounces, but also reduces anxiety sensitivity (fear of anxiety).  Ever felt fearless after spending a few good hours in the gym??

 

 

 

 

 

  1. You will catch better sleep

Good news for my sleep-deprived office going friends.  Resistance exercises can reset your internal body clock for sleep cycle by affecting your circadian rhythm.  A study revealed that chronic insomniacs benefited with 45 minutes of extra sleep per night after 4 months of exercise regime.  What’s better than a good night’s sleep for a well worked-out body.

 

 

 

 

  1. You will have a better performing brain

Exercises can increase levels of brain-derived neurotropic factor which helps in building of healthier nerve cells.  Study showed that people who did strenuous exercises actually performed better on a memory test.  Another study noted participants learning vocabulary 20 percent faster than a control group after intense exercises.  So if you need to prepare for a meeting or submit a report at work, a sweat session could actually help your performance at work.

 

 

 

 

  1. You may earn extra

As per a study, employees exercising regularly earned nine percent more than lazy peers.  So, hitting at the gym may not make you rich overnight, but can surely increase your chances at earning some extra cash.  And anyways, I strongly believe that the wealth of good health is far more than any money.

 

 

 

 

Now that we know the benefits of starting working out, I really hope we all will direct our efforts towards starting gym “this Monday”, leaving our “snooze” buttons aside.

SEVERE HEEL PAIN?? Could be Plantar Fasciitis

Do your heels pain when you walk? Do they pain first thing in the morning when you start walking? Well, the answer to this could be “Plantar Fasciitis”.  Studies show Plantar Fasciitis is the most common reason for heel pain.  Symptoms start gradually and are often worse with the first few steps in the morning.

 

About Plantar Fasciitis, and its symptoms

Plantar Fasciitis is the swelling of the plantar fascia (a tissue under the foot forming the arch).  It causes pain under/at the heel, sometimes radiating to the arch of the foot.  Tenderness may also be noted under the sole and inside the heel when palpated.  Intensity may vary between slight discomfort to severe pain, depending on the extent of damage or inflammation to the fascia.  Pain is usually worst in the morning with the first few steps, or with the initiation of walking after prolonged sitting.  This happens due to the plantar fascia being in relaxed position for an extended period of time, shortening it.  After few steps, the fascia usually stretches out and relaxes.

 

Why does it happen?

An overuse injury secondary to over-stretching of the plantar fascia, leading to possible thickening and inflammation of the tendon.  This inflamed condition can lead to pain at its attachment to the calcaneus (heel bone).

 

Who is affected?

It is more common in sports persons who are involved in running, jumping, sprinting etc. that puts over-pressure on the heels.  There are causes other than overuse, however, overuse stays the primary reason.  Other factors include overpronation, tight calves, obesity, previous injury, high arched foot, and poor footwear.

 

What to do?

To understand how to treat Plantar Fascia, we need to first identify the reason.  Until and unless the root cause is treated, the effect of symptomatic treatment is just short-lived.  Some of the common ways to treat a painful heel are:

  • Stretching of the taut fascia
  • Stretching of the lower leg muscles
  • Treating pain symptoms
  • Avoiding stressful activities (of the feet)
  • Corrective measures for other causes as discussed

 

For pain symptoms, rest, ice, compression, and elevation of the feet can be helpful.  Taping techniques can also be used which takes away some of the pressure from the plantar fascia.  Rest and decreased stress on plantar fascia aides in the healing process.

Taping technique (photo credit: uptodate.com)
Plantar Fasciitis Taping Technique

For corrective measures, use of comfortable footwear with extra cushioning, customized/non-customized silicone insoles, and arch supports can be helpful.  Hard or flat-soled shoes can increase the symptoms.  Also, avoiding prolonged time on feet and walking on hard surfaces like concrete provides some relief to the fascia.

Using a night splint can prevent tightening of the fascia, thus providing with a perfect and pain-free start of the day.

Stretching exercises are a must, especially stretching of the calves and the fascia.  Pull the feet upwards/towards the body (dorsiflexing the feet).

Stretching (photo credit: cureplantar.org)
Stretching of the Gastrocnemius muscle
Plantar Fascia stretching (photo credit: pinterest.com)
Plantar Fasciitis Plantar Fascia stretching
Plantar Fascia Stretching (photo credit: podiantics.com.au)
Plantar Fascia Stretching

 

For severe pain, use OTC anti-inflammatories such as Ibuprofen, however, for severely affected plantar fascia, Corticosteroid injections can be prescribed.  Surgery, though performed rarely, should be the last resort for Plantar Fasciitis, and the preferable treatment protocol should be through activity modifications, appropriate choice of footwear/insoles, and exercise therapy.

BACK PAIN – Understanding the Common Causes

Back pain is a very common concern with most of us.  But have we ever given it a thought that our back pain can be due to myriad causes and the approach of treatment may vary with each different contributing factor?  Through this post, we will have an insight into these factors.

Pain is an unpleasant stimulus perceived by a person.  This sensation may vary from person to person in intensity and characteristics as it is completely subjective.

Same is the case with back pain.  The perception of pain may vary.  For example, a mild strain in a patient’s back may cause severe pain, whereas, another person with a disc extrusion may not have any pain.  Also, there can be underlying conditions that may flare-up at times, then subside again, only to flare-up and intensify.  As only you know and understand your pain and its characteristics better, active participation in your treatment protocol will make treatment more successful.

 

CAUSES

The back is a complex mesh of structures, any of which can be a cause of pain.  The spine is prone to injuries due to movements causing strong forces act upon it, for example- bending, sudden jerks, or twisting forces.  The spinal injuries of the low back can be due to:

  • Orthopedic factors
  • Neurologic factors

 

The manifestations, however, are interconnected and predisposition to one may lead to another.

Orthopedic Factors

  • Injury to bones, joints, ligaments or muscles of the back
  • Strain of the large muscles at the back

Neurologic Factors

  • Injury to the spinal cord
  • Disc protrusion/herniation
  • Nerve impingement/irritation

Degenerative changes can be characterized under both orthopedic and neurologic factors depending upon the structures involved and their manifestations.

 

CHALLENGES FACED IN IDENTIFICATION OF BACK PAIN

The nerve supply to most of the structures at the back overlap, often making it difficult to identify the actual underlying cause of the back symptoms.  For example, muscle strain, ligament injury or disc herniation may present with similar signs and symptoms.

 

STEPS TO IDENTIFY THE CAUSES BACK PAIN

Thorough medical history, physical examination, and special tests.

Observation and evaluation of the signs and symptoms.

According to the indications and presented symptoms, careful selection of diagnostic testing, for example, an orthopedic injury may often be identified by an x-ray, however, to evaluate the soft tissues, discs and nerves, MRI scans may help as confirmatory tests.

All the factors including pain type, characteristics, duration, reason for onset, and areas affected help in diagnosing the cause of the back pain.  The most noted types of back pain are:

  • Mechanical pain: Also termed as axial pain.  The pain can be sharp or dull, or intermittent/constant.  This is usually precipitated by muscle strains.
  • Referred pain: Pain dull and achy.  As the name suggests, this pain is usually felt at a location away from the actual region of impaction.  For example, DDD or a degenerative disc disease may produce a referred pain in the course of a nerve irritated or impinged at the back, without necessarily causing back pain.
  • Radicular pain: Deep pain.  This pain follows the path of any nerve in the lower limbs, with possible weakness, loss of sensation or numbness.  This is caused by any injury to a spinal nerve root, irritated or compressed by surrounding structures.  Some common underlying disease conditions include sciatica, spondylolisthesis, disc degeneration, spinal stenosis etc.

 

At times, even after thorough medical examination and diagnostic testing, a proper etiology of your back pain may not be found.  In such a case, symptomatic treatment is done, through conservative care (non-surgical care), to help manage back pain.

Some of the ways to self-treat back pain as the first line of treatment include:

  • Heating
  • Maintaining proper posture and relaxation techniques
  • Use of OTC pain pills as needed
  • Anti-inflammatory pain killing ointments
  • Isometric and strengthening exercises
  • Stretching exercises
  • Activity modification and posture correction

If pain still persists, consult spine specialist for further line of treatment and for ruling out more severe/fatal underlying causes.

CARPAL TUNNEL SYNDROME –Major Cause of Hand Pain

 

About Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the squeezing or pressing of the median nerve at the wrist (running from the forearm into the palm).  Carpal tunnel is a rigid narrow passageway at the wrist housing the median nerve and the finger flexor tendons.  The median nerve supplies the lateral 2/3rd of the palm (the thumb, index, middle and part of the ring fingers).  Narrowing of this tunnel secondary to swelling or thickened lining of the irritated tendons compresses the median nerve, resulting in weakness, numbness and/or swelling in the hand/wrist, or sometimes even up to forearm and arm.

 

Signs and Symptoms of CTS

It usually has a gradual onset of symptoms with tingling, numbness or burning in the palm and fingers (lateral 2/3rd of palm as noted above).  Symptoms usually initially appear in the night (due to bent wrist during sleep).  It may cause an awakening in the night.  The symptoms gradually develop in the daytime as well.  Symptoms are often noted as severe by people engaged in manufacturing/assembly line, or who do a lot of typing.  Grip strength decreases the ability to grasp small objects, precision handling of things, making a fist or other tasks.  This leads to difficulty in the activities of daily living and job responsibilities.  If not treated, chronic cases may observe wasting of the muscles at the base of the thumb (the thenar eminence).  Sensation may also be affected in some cases.

 

What causes CTS and who are at risk?

CTS may be caused secondary to an injury to the wrist causing swelling, thus narrowing the carpal tunnel.  Injury can be a sprain/fracture.  It can also be caused due to degenerative changes as in rheumatoid arthritis.  Other mechanical causes can be repetitive use of vibrating hand tools, jobs requiring repetitive movement of wrists, occupational stress, and overpressure on the wrists, hands and fingers.  In these cases, onset is gradual, and the condition often becomes chronic.  Some other rare causes are presence of cyst/tumor in the canal or fluid retention during pregnancy or menopause.  Due to varied reasons and a common manifestation, it is difficult to identify the cause.

CTS is usually noted in adults.  Women are more than twice more likely to develop CTS than men (the carpal tunnel may be smaller in women).  Dominant hand usually gets affected first, and the symptoms are more severe.  Disease conditions like diabetes affect the peripheral nerves, making the patient more susceptible to compression.

The risk of developing CTS is not limited to people with any single industry/job, however, it is more common in those employed in assembly line work involving finishing, packing, manufacturing, sewing and any kind of precision handling.  As observed in few studies, CTS is three times more common in people employed in assembly line than people in data entry/typing.

 

Diagnosing CTS

Medical history and physical examination including special orthopedic tests, imaging studies including x-rays and ultrasounds, electrodiagnostic studies including electromyogram and nerve conduction study, and laboratory tests are the ways CTS can be diagnosed.

 

Treating CTS – The Appropriate approach

Let us now begin with the treatment of carpal tunnel syndrome.  Early diagnosis is always helpful in appropriate treatment.  The first line of treatment should always focus on conservative management including:

  • Splinting at night avoiding further narrowing of the tunnel, and/or preventing irritation to the median nerve.
  • Avoiding/minimizing activities aggravating symptoms. Taking rest/stretch breaks at work may help.  Applying cold packs can help in reducing swelling if present.
  • OTC drugs/NSAIDs may be helpful in providing short-term relief from pain and swelling.
  • Therapeutic treatment including physical therapy, occupational therapy, acupuncture, or yoga can be helpful
  • Home exercise program suggested by a PT/OT can prove helpful
  • Prescription medications (such as prednisone) by your doctor or a specialist
  • Any possible secondary/underlying cause (such as diabetes or arthritis) should be identified and treated accordingly

Surgical management should be the last resort if nothing else is proving to be helpful in relieving the symptoms.  Surgery may include open release or endoscopic surgery.  Surgical management has its own pros and cons so it is necessary to decide the line of treatment after factoring in all the possibilities.

 

Preventing CTS in an easy way

Ergonomic adjustments are the key to preventing and treating CTS at work.  On-the-job conditioning, stretching and other exercises, rest breaks, positioning of wrist and posture maintenance are the ways to prevent CTS.  Regular stretching and exercising the structures around wrist can be helpful in daily routine.

 

The better understanding we have of Carpal Tunnel Syndrome, the better we can manage/prevent the condition ourselves.

 

HURTING KNEES – A Common Sports Injury

Are you a fitness enthusiast? Do you run? Do your knees hurt?

It’s great to run or jog to stay fit for a good and healthy lifestyle.  But at times, jogging/running can get troublesome and we may end up with a knee pain.  This condition is usually termed as “Runner’s knee”, as it is usually observed in runners or athletes due to lot of strain on the knees.  Medically, it is Patellofemoral Pain Syndrome (PFPS).  It affects anyone doing frequent/repetitive bending of knees, like cycling, jumping, squatting or excessive walking.  It can also precipitate with a direct blow/hit to the knee from an assault or a fall.

It often starts as a sharp and sudden pain.  This pain may go away while running but returns, and gradually may transform into a dull and chronic pain in the knees.  It may arise from improper biomechanical factors, poor conditioning of quadriceps and tight hamstrings.

 

Who are worst affected

Runner’s knee may affect only one, or both knees simultaneously.  Most affected are young athletes (especially runners).  Also, per British Journal of Sports Medicine, women are affected almost twice as much as men are, due to broader pelvis that tends to put more pressure on the knee.

 

Identifying symptoms

If we start developing pain/tenderness towards the center of the knee, behind the patella or around the knee, it can be initiation of “Runner’s knee”.  Pain can at times be felt at the back of the knee with a cracking, popping or grinding sound inside the joint with movement.  Swelling may also be present.  The knees may also give out.  Uneven surfaces, stairs, and elevated paths seem to aggravate the condition.  Even simple daily tasks like getting up from the chair or climbing a flight of stairs can cause a shooting pain in the joint.

 

Understanding the causes

Most common is a muscular cause due to poor conditioning of quadriceps (front thigh muscles), and tight hamstrings (muscles behind thigh) and calves, causing increased pressure on the knee with the patella (knee cap) going out of alignment.  A mere repetitive force while running can give rise to runner’s knee.

Some other causes can be biomechanical issues like malalignment, improper gait/running/jogging pattern.  Anatomical problems like the patella riding too high in femoral groove or easily dislocated patella, high-arched feet or flat feet may also induce knee pain.  Reduced shock absorption in the knee due to worn cartilage can be another cause.

 

Prevention and Treatment of Runner’s Knee

“How to prevent or treat it?” with still being able to jog/run.

At the first sign of pain, reduce the distance, speed, and duration of your daily circuit.  It helps in speedy recovery.  Next, strengthen quadriceps, and stretch hamstrings and calves.  Also, wear proper running shoes according to your feet and gait.  Ice your knee for 20-30 minutes 3-4 times daily for the initial 3 days or until the pain subsides.  Also, kneecap (elastic bandage) or sleeves can be worn to provide extra support.

Run on softer and even surfaces, avoid concrete.  Increase about 7-8 percent of mileage every week as per the recovery and comfort.  Gradually return to inclined surface running.  Until pain subsides, avoid knee-bending activities, stairs, and uneven and/or inclined surfaces.  Swimming laps in the pool is a good alternative in the healing phase.

Healing phase is the right time to start with static strengthening (isometrics) and then gradually move to dynamic strengthening of the quadriceps.

If pain persists after taking care of all these factors, see a doctor to rule out other possible causes.  First line of treatment should be OTC painkillers/anti-inflammatories, and PHYSICAL THERAPY.

 

ERGONOMICS – solution for occupational disorders

 

What is Ergonomics

Ergonomics is a word derived from two Greek Words:

  • Ergon – work
  • Nomoi – natural laws

Ergonomics is the study of human capabilities in line with the occupational demands/requirements.

 

History

The history of Ergonomics dates back to as early as the 18th century when doctors noted musculoskeletal problems in workers required to maintain body positions for prolonged periods of time.  Over the years, it has been noted that repetitive strain injuries/musculoskeletal disorders are directly caused from job duties/requirements.

 

Understanding Biomechanics

To hold a certain body position, musculoskeletal effort is required.  This is irrespective of whether the position is comfortable or not.  Thus, our muscles are in a state of continuous tension.  Repetitive prolonged tension subject the muscles to high risk of injury, as this tension in the muscles is directly proportional to the force the muscle has to produce to maintain any position.

This force may increase many folds if our body position is not right while performing a task, or with movement.  This alteration and/or increased force may lead to injuries, and any injury caused from performing a job at work, acute or chronic, is known as an occupational injury.

For example, a laborer, whose primary duty is lifting weights, may injure his back due to improper body position or lifting techniques.

Or, a person whose job duties include working at the computer for long hours may develop neck and low back pain, and pain in the forearms, wrists, and hands.  It can also lead to problems with vision.

 

How injuries happen

Injuries can happen due to

  • Repetitive motion
  • Acute strain/exertion
  • Taut/weak muscles
  • Sustained-awkward positioning/posture
  • Chronic or acute exposure to heat, cold, vibration, radiation, chemicals, smoke inhalation, fumes or hazardous working conditions
  • Contact pressure

 

With time, these risk factors, alone or in combination, can lead to disabling pain or injury.  The injuries can happen with time (chronic) or can be of sudden onset (acute).

Best examples of chronic injuries can be chronic obstructive pulmonary diseases (COPD-diseases of the respiratory system), spondylosis of neck or back (neck or back pain due to degenerative changes), carpal tunnel syndrome (pain in wrists and hands with numbness/tingling), cancer due to exposure to radiations, or hearing disorders from exposure to high volumes.

Some of the examples of acute occupational injuries can be disc herniation of the back or spinal cord injury due to sudden lifting of heavy weight (in an improper technique), smoke inhalation causing breathing distress, or injuries caused from fall due to poor maintenance of work environment.

 

Identifying these injuries

  • Joint stiffness/swelling
  • Muscles spasm and pain
  • Muscle tightness or cramping
  • Dull aching/sharp stabbing pain in any part of body, majorly observed in wrists, hands, and fingers
  • Tingling/numbness in the extremities
  • Functional loss or difficulty
  • Fatigue
  • Pain/discomfort in shoulders, knee, neck or back
  • Loss of motion/mobility
  • Vision problems/headaches

 

Ergonomics as a solution

  • Identify the problems as early as possible-be watchful for the signs/symptoms
  • Identify the cause of the problems at your workplace
  • Bring in ergonomic modifications to your work environment
  • Do appropriate exercises and participate in therapy
  • Maintain body conditioning through regular exercises and stretches
  • Take frequent stretch breaks at work, relax
  • Correct the deviations in posture

 

Remember, with guidance, knowledge, attentiveness and innovative ideas, we can avoid nearly all the occupational injuries, and Ergonomics is one powerful key to it.

 

-Keep watching this space for specific ergonomic solutions related to various work types and body parts.

Tele-Health – An Answer to All Your HealthCare Hassles

We all are aware of the benefits of a healthy life.  The Healthcare industry has worked wonders in serving people in need and saving lives.  But as the saying goes “every coin has two faces”, there is a dark side to it as well.  It is a complex mesh of appointments, insurance approvals, waiting time, financial burden, and a very precious component, TIME.  The time that is lost in going for appointments, waiting, parking hassles, commute and coordinating with the insurance companies.  This again further leads to more financial burden.

 

The solution to all these problems in the current Healthcare scenario is TELE-HEALTH.  Tele-health has started proving as a boon to the people affected by the Healthcare sector.  It is the provision by means of which, a person/patient can avail healthcare services at the comfort of his/her home through telecommunication technology, without having to wait for appointments, miss work to be physically present for the appointments driving all the way, or wait for insurance approvals or referrals, even after paying a huge amount as co-pay. Also at times, the patient may not have insurance cover.  In such a scenario, this proves to be all the more helpful.

 

Today, telehealth has attained such a place in the healthcare sector that it needs no introduction.  It has attained this special place because of the feasibility, ease of availability, and patient comfort it offers.  Patient consultations and follow-ups are now just a click away with the help of their laptops or phones, without having to waste any time or shelling extra cash.

 

Another promising and upcoming segment in telehealth is TELE-REHAB.  Rehabilitation visits are typically more frequent and necessary.  But can this be done from the comfort of a patient’s home? The answer is YES, it is possible.  These services can be related to any kind of rehabilitation including Physical Therapy, Occupational Therapy, Speech Therapy, Psychotherapeutic counseling, or women’s health associated with pre-natal and post-natal care or any other condition requiring rehabilitation.  The best part of tele-rehab is that the patients are not required to drive for the appointments or spend time in the waiting room of the clinic almost every day, take pre-authorizations or referrals by the primary treating physicians (because of direct access, referral is not required, but without a referral, insurance will not pay most of the times).  Also, it is easy on the pocket.  This methodology of patient care is very useful for the geriatric (old-age) patients who are practically unable to attend rehab on a frequent/daily basis.  Tele-rehab is also covered by insurance so it is not only a direct-pay option.

 

The way technology is evolving, soon tele-rehab would be the most preferred form of treatment.  However, of note, this is not a replacement to conventional treatment methods but just another mode of treatment with its own benefits unique benefits.  As patients keep getting more proactive with technology for managing health, alternative ways of getting care involving telemedicine will keep evolving and improvising. This model of healthcare delivery empowers patients to be in charge of their own health, further leading to educating patients in better prevention approach.

 

“The World is changing, so are we… Let’s promote health the smarter way” 

IS ARTHROSCOPIC SURGERY KILLING YOUR KNEES??

The most common line of treatment doctors recommend for knee degenerative disease like osteoarthritis (OA) or meniscal tears is knee arthroscopy.  However, a very recent study’s conclusion will surely blow your mind.  As per the article published in “The BMJ”, guideline strongly recommends AGAINST arthroscopy for ‘nearly all’ patients with knee OA or meniscal tears.

 

Historical data review showed that knee arthroscopy is the most common orthopedic procedure performed.  This data was reviewed by an international multidisciplinary panel including orthopedic surgeons, a rheumatologist, physiotherapists, a general practitioner, general internists, epidemiologists, methodologists, and people with live experience of degenerative knee disease (including those who had undergone and those who had not undergone arthroscopy) met to discuss the evidence.

The Guideline strongly recommends against arthroscopic surgery in almost all patients with degenerative joint disease of the knee, based on linked systematic reviews.  The authors also advise that “further research is unlikely to alter this recommendation”.

They further state that “health care administrators and funders may use the number of arthroscopies performed in patients with degenerative knee disease as an indicator of quality care”.  However, the small and short-lived pain reduction and increased function after arthroscopic surgery are greatly outweighed by the financial burden, post-op limitations, and complications (rare).

 

On the Other hand, conservative treatment is suggested as the best-recommended line of treatment for almost all the patients with knee DJD.

 

Based on a systemic review in 2016, BMJ published the guidelines on May 10, 2017, indicating that exercise therapy is as effective in patients with degenerative medial meniscus tear, as the outcomes from knee arthroscopic surgery.

Degenerative joint disease of the knee, as considered by the authors, is atraumatic knee pain in patients over age 35, irrespective of radiologic evidence of osteoarthritis, mechanical symptoms, meniscus tear, or acute/subacute symptom onset.

The Conclusion

In conclusion, the authors advised, “Given that there is evidence of harm and no evidence of important lasting benefit in any subgroup, the panel believes that the burden of proof rests with those who suggest benefit for any other particular subgroup before arthroscopic surgery is routinely performed in any subgroup of patients.”