Working with computers

What is RSI?

RSI (repetitive strain injury) is an umbrella term for a range of symptoms of the hand, wrist, elbow, shoulder or neck due to an inappropriate posture, repetitive movements or indeed the lack of movement (static posture). Employees using computers run a significant risk of developing RSI. And that is why it is so important to devote considerable attention to this issue.

How do I recognise complaints or symptoms in myself?

Broadly speaking, three phases can be distinguished. However, depending on the stress (cause) and symptoms, the transition from one phase to the next does not necessarily have to be gradual. Unfortunately, the symptoms can sometimes develop surprisingly quickly!

Phase 1: Initial phase

In the initial phase you experience symptoms that appear sometimes when you work with the computer and then disappear again when you stop. You can usually carry on working. The symptoms can be:

• pain or heavy feeling in the arm;
• pain in the neck and shoulders;
• weakness in the hands or a lack of control;
• stiffness upon clenching and unclenching the hands;
• tingling sensations in the lower arms. 

If the aforesaid  symptoms keep recurring then seek advice from the occupational physician or your general practitioner. You can make an appointment with the occupational physician without prior permission. Ask your health & safety coordinator for the contact details.

Phase 2: Advanced phase

The symptoms no longer disappear when you relax and you can also experience these during the night. At this point you should be seriously concerned. You can only carry on working to a limited extent and you may experience symptoms during everyday activities such as cleaning your teeth, combing your hair, opening bottles or riding your bike. Consult the occupational physician!
Symptoms in the advanced phase:

• nagging and stabbing unbearable pain in the arm;
• tingling sensation in the fingers and arms;
• loss of strength in the hands.

Phase 3: Persistent phase

The persistent phase is chronic. You have severe complaints and serious limitations in both your work and daily life. As nerve damage occurs then even light tasks such as lifting up a glass of water can become impossible. A small number of employees eventually end up in this persistent phase. The symptoms are chronic.
Then you can no longer work properly with your laptop or computer. This can have annoying consequences for your work.
In this phase you need help from a rehabilitation physician who teaches you how to deal with pain and other symptoms.
This can lead to a reduction in your symptoms but that might take a considerably long time.
Symptoms in the persistent phase:

• pain radiating to other limbs;
• constant nagging or stabbing pain;
• tingling sensations with a paralysing feeling.

What are the causes of my complaints?

Often an inappropriately set up work station is seen as the sole course of RSI. However: a correctly set up work station does not guarantee the prevention of RSI. Many RSI symptoms develop as a result of frequent computer work in combination with other factors.

The following factors can increase the risk of RSI:

• wrong work posture or technique;
• prolonged static work posture or repetitive movements (staring, lack of movement, mouse clicking);
• prolonged work under high work pressure;
• prolonged slight tensioning of the muscles.

This reduces the circulation to the muscles and the arms and hinders the removal of waste substances, with the result of pain symptoms.

How can I prevent symptoms?

If you are aware of the health risks then you can recognise the symptoms early and prevent the problems. Determine if you and your working enviroment comply with the rules.

My posture or technique

A good posture reduces the stress on your body. Use the following checklist to see if you have the correct work posture:

• your back has an active posture and the vertebrae are straight;
• your head is aligned with your back and bending forwards;
• the angle between your lower and upper legs is greater than or equal to 90 degrees; the same applies to your lower and upper arms;
• when typing your fingers are relaxed (the keyboard has a light, but not too light, a touch);
• your wrists are relaxed and your hands are not at an angle to your arms;
• you vary your work posture.

Content and organisation of my work

Sufficient variation in your work and limiting work peaks are vitally important for preventing physical symptoms. Here are several useful tips for preventing RSI symptoms:

• make sure you have a relaxed work attitude and working posture;
• try to prevent long periods of intensive work behind the computer (also at home). Working for more than 5 to 6 hours per day behind the computer is strongly advised against;
• do not work continuously but take 'mini-breaks' to move; a ‘mini-break’ of several minutes after 20 minutes of intensive computer work is not an excessive luxury;
• try to relax regularly, for example, by walking to the printer, the photocopier, the storage or the coffee machine;
• take a 'real' break after a maximum of 2 hours of computer work (10 to 15 minutes each time, ideally 10 minutes after every hour). A software programme such as 'CtrlWORK' can be helpful in this respect.

User-friendly software

User-friendly software obviously contributes to a relaxed work attitude and working posture. Do not allow annoyances about software problems to persist. Solve them! Use the settings options in the software to optimise your work.

My working environment and work station set-up

Not just the set-up of the furniture and equipment but also the working environment contribute to a relaxed work attitude. Examples are work space, lighting, no noise nuisance and indoor climate.

Working environment
Use the following questions to check your working environment:

• is there enough light?
• is there little light contrast between the computer monitor and the surroundings?
• is it quiet enough and is the indoor climate pleasant?

Work station set-up
A poor positioning of the computer monitor, keyboard and mouse, chairs that are not adjustable in height, that do not provide support or miss arm rests, wrong desk height, and a cold work environment are all factors that increase the chances of RSI symptoms developing.

A correct work station set-up that meets your needs might require specific aids such as a monitor stand, document holder, wrist support, extra support for the arms, foot support, et cetera.

Several points are tackled below with due consideration to current ergonomic insights. Run through this step by step for your own situation:

The monitor

• has easy to read characters, in other words sufficiently large and focussed, with sufficient distance between the characters and the lines;
• is free of annoying shine and reflections;
• has a stable image and an adjustable contrast and brightness;
• is preferably adjustable in terms of height over a range of 16 cm (with or without a monitor stand);
• can be tilted on its own foot.

The keyboard

• is independent of the monitor; if a laptop is used for more than 2 hours per day then a separate keyboard is recommended;
• does not move on the work surface;
• is set up such that the wrists are straight. 

The mouse

• has a height such that the wrists are straight;
• can be used by both the right and left hand;
• has buttons the fingers can rest on without these being pressed.

The document holder

• is offered to staff who frequently or for a longer period have to type data from paper onto the computer;
• can be adjusted in height;
• can be set at any position on the work surface;
• is stable;
• its minimum size is that of the most frequently used documents.

The laptop stand

• its purpose is to position the laptop screen at the correct height;
• can be adjusted in height;
• can be collapsed, is lightweight and is highly portable.

Work table or work surface

• is sufficiently spacious to comfortably work at and put your stuff on;
• if necessary has a document holder that is adjustable and stable. 

The office chair

• rests on the floor at a minimum of five points;
• provides sufficient support for your body;
• can, if necessary, be adjusted to your body size and work posture.

I would like to know more about working with a computer

This website only provides general guidelines. Do you want to find out more about working with computers in a safe, healthy and ergonomically responsible manner? Your local health and safety coordinator or the health and safety officer of NWO-I will be happy to give you advice.

The link below provides more information about working safely with computers.
The Dutch RSI association: www.rsi-vereniging.nl (in Dutch)