Over the years I have read many articles about the latest ‘ergonomic’ chairs or a mouse or keyboard or desk that have become available that will revolutionise your life as they will help to relieve or even stop your back or neck pain from developing. What does it actually mean? Ergonomics is the science of designing the workplace to reduce risk factors that lead to musculoskeletal injuries.
Over the years I have often passed on information about these latest developments to my patients because I believed that some of these things may well help. If a chair helps you to sit more upright and reduce slouching it has got to be good, right? If a keyboard can reduce repetitive strain on your forearms then why not give it a go. But DO they do what they profess to do?
A professor at Sydney University, Chris Maher, who is a leading expert on back pain says that actually “Ergonomics does not have a firm basis in science”.
Now you all know by now that this clinic likes to base advice and treatment on the best scientific evidence we can find, so this got my attention. We don’t want you to waste money on things that are not likely to help you. There are so many things you can do for yourself to reduce back and neck pain at work that will cost you nothing and we believe that you should spend money wisely, not on things that tell you they are going to help us when they do no such thing.
Placebo is a wonderful thing, however! You spend £50 on a lovely looking funky keyboard or £500 on a chair that promises you all sorts of pain relief. Some of you are therefore going to get a certain amount of placebo effect from the purchase. That’s how it works. You think it is going to help and you have read lots of information about why it will help and someone who sounds like an ‘expert’ has written that it will help with x and y and you have spent a lot more on it than on an ‘ordinary’ keyboard or chair. You feel better before you have even used it! But…….
Professor Maher says that many standard ‘ergonomic interventions’ for example desk adjustments lack evidence to show that they work. Too many people apparently just call themselves ergonomists when they are not. They offer their services to your workplace and offer ergonomic advice without having had any training at all.
You may have had an ergonomist look at your workplace – they may have moved your monitor, your keyboard, changed your desk height, advise a better shaped mouse, all in the name of preventing office work related injuries.
The evidence that these interventions really are not worth doing has been produced by Cochrane which is a non-profit, Non-Governmental Organisation formed to look at medical research findings. Reviewers at Cochrane have examine studies to find the best scientific evidence for claims made and five times they have looked at ergonomics for carpal tunnel syndrome and for preventing and treating work-related arm, neck and shoulder pain.
The only thing they found that reduced the risk of neck and shoulder disorders was when an ‘alternative’ mouse was used in conjunction with a shoulder support but not when the mouse was used on its own.
The things that probably do not affect neck pain in their opinion are workstation adjustments and training and also ergonomic mice do not cut shoulder and arm injuries when compared with ordinary mice.
Cochrane look at the level of the evidence of a research paper and rank it as high, low or very low and said that the evidence regarding whether using special keyboards and desk adjustments are better than placebo cannot be commented on due to the fact that the evidence is of such low quality.
Trouble is when you, the consumer, reads that an ‘expert’ says these things WILL help you, you want to believe it. Why wouldn’t you? But if you knew that the evidence that this ‘expert’ is using was of such low quality, then maybe you wouldn’t want to waste your money. We are all at the mercy of the ‘blurb’ if we are not privy to the quality of the evidence that supports the claims, which usually we are not!
The interventions that prompted Cochrane to say ‘we don’t know if they work or not’ include:
Changing monitors and chairs and undergoing ergonomic training and training plus workstation redesign.
In 2015 the British Medical Journal discovered some moderate strength evidence that having someone adjust your desk or monitor did not work at all.
Another professor calls ergonomics “the science of belief. Just because you are in pain when you are sitting does not mean that the way you sit caused it. There is NO correct way to sit!
I discussed standing desks in another post – there is no evidence to say they are effective in controlling work-related musculoskeletal disorders. Standing for too long is just as irritating as sitting for too long.
The bottom line for you all – and you are going to love this – or hate me for repeating myself – but I MUST – the ONLY thing that has good quality evidence that it helps is to do EXERCISES!!!!
A Distinguished Professor at Curtin University and the British National Health Service’s first ergonomist said this:
“People often ask me ‘what’s the best ergonomic chair?’ and I say ‘a wooden church bench’. Because you’ll feel so uncomfortable that you’ll have to get up after half an hour’.
SO – it’s not just ME who goes on and on about exercise being the best thing for you to do to help with recurrent back and neck pain!
A bit of treatment from one of us to keep things moving optimally when you feel you need it – see last week’s post on the benefits of maintenance care – and then exercise daily and move regularly when you are sitting or doing something repetitively.
It will help you more than spending lots of money on useless gadgets!