Features August 2012 Issue

Computer Angst? Position, Posture, Peripherals to the Rescue

Shoulder, back, and neck pain are common problems if you use a desktop, laptop, or tablet. Here’s how to ease the discomfort.

The biggest problems for people with arthritis using computers face are thought to be the hands and wrists. But Michael Milicia, OT/L, a clinical specialist in industrial rehabilitation at Cleveland Clinic, is just as concerned about other areas of the body.

“The computer-related complaints I hear most often from arthritis patients are about the shoulder, back, and neck,” he says. “Before addressing stiff fingers and sore wrists, I look at how they are sitting, where their monitor is positioned, and where their keyboard and mouse are relative to their bodies. Then we can suggest devices and peripherals that can make using desktop, laptop, and tablet computers a lot less painful and a lot more productive.”

Sitting Posture
“People need to have balanced alignment in the whole lumbar (lower) and cervical (upper) spine,” says Milicia. “I encourage them to sit so that the hips and knees are at 90-degree angles, with feet flat on the floor or on a supported foot rest.

“Elbows and forearms should be at the sides, not extended out and away from the body and not so high that the shoulders are in a constant position of elevation.”

Monitor Position
“Next,” says Milicia, “you should adjust your monitor so that you’re looking directly ahead at the screen—not off to one side—with eyes approximately level with the toolbar at the top of the screen. Don’t force yourself to look up or down.”
Laptops and tablets

“The problem with laptops and tablets is that the monitor is usually connected to the keyboard,” says Milicia. “That forces the user either to look up or down for extended periods of time. My recommendation for a laptop or tablet user is to have a separate keyboard so that the monitor can be placed to allow the user to look straight ahead.”

Keyboard and Mouse
The keyboard and mouse should be on the same surface, next to each other. Milicia often finds that the mouse is often placed off to one side so that the person is always reaching out to move it.

“The keyboard should be at elbow height and the wrists in a neutral position, not extended upward or flexed downward,” he continues. “With constant extension and flexion, the bones bump against each other and nerves are compressed.”

Arthritis-Friendly Peripherals
The dilemma is not availability, but choosing which of the dozens of devices you may need to meet your needs. There are split and curved keyboards, arm and wrist supports, oversize touch pads, forearm rests, large-key keyboards, voice-recognition software, ergonomic mouses, and even cursors that can be directed by the nose or eyes and respond to one or more blinks.

Milicia has seen especially good results with adjustable forearm support devices that clamp onto a desk surface and support the forearms in an ergonomically correct position.

“Don’t simply ‘plop down’ at a computer workstation and accept the way your chair, desk, monitor, and keyboard are set,” concludes Milicia. “Adapt to your environment. Acknowledge what your body is telling you. If something hurts after every computer session, take steps to do something about it.”