Last reviewed 8 March 2021
Compared to 2019, musculoskeletal injuries are on the rise, with homeworking likely to be the culprit. Laura King considers the issues and solutions.
There is no doubt that homeworking is becoming a feature of many people's lives. Since the initial lockdown nearly a year ago in 2020, many office-based workers will have spent more time working from their homes than their usual workplace. The full impact of such a switch is still crystallising, but one consequence does appear to be painfully clear: our musculoskeletal health is suffering.
A poll by Versus Arthritis found that of every five workers who had switched to homeworking during the pandemic, four had suffered from neck, shoulder or back pain. Almost a quarter of those polled were now experiencing pain all the time.
Worryingly, the poll also found that nearly 90% of people experiencing pain had not told their employers, and over a third had not had any support since making the switch to working from home.
These figures may seem high, but anecdotally they appear to stack up, and research by companies looking into similar issues supports the trend.
So what is the cause of the problem?
Unsuitable desk set-up
In many cases the rise in back, neck and shoulder pain will be caused by sub-optimal desk set-ups, with many staff trying to work in spaces that are a far cry from the typical office environment. In the office, no one would be expected to work all day from the canteen or at a sofa in reception, but data collected from Leesman's Home Working Survey found that nearly a third of people were working from an undesignated home location, such as an armchair or dining table.
Such set-ups are not conducive to maintaining a good posture, and it is well established that working in awkward positions will cause problems, especially if there are any pre-existing conditions. Compliance with the display screen equipment(DSE) legislation is essential to help office workers maintain good musculoskeletal health. In 2019/20, the Health and Safety Executive (HSE) reported that musculoskeletal problems were the second highest reason for absence from work, with awkward positions (including when sitting), and using a keyboard and performing repetitive tasks the second and third most common causes of injury. If musculoskeletal problems are this prominent when working "normally", pandemic working is likely to make the situation much worse. Employers should consider supplying additional equipment to employees, as identified in the DSE assessment.
Another contributing factor is stationary work. Any position can cause fatigue and discomfort if held for a long period of time, and a lack of movement can increase the risk of musculoskeletal problems. This issue has long been recognised in sedentary office work, but homeworking has the potential to result in even fewer opportunities to move. Take, for example, a day of meetings. In the office you often need to walk between meeting rooms; now it is much more likely that the meetings will be held back-to-back using a video conferencing platform. With only 25 steps needed to walk to the kitchen to put the kettle on, options to stretch the legs can be limited.
The more time you spend in a chair, the tighter your quadricep muscles get, which can lead to a painful lower back. Luckily this sort of discomfort can easily be addressed by regular stretching exercises or doing yoga or pilates.
Hacks for a better home office
Ideally, at this stage in the pandemic, anyone working regularly from home should have conducted a DSE risk self-assessment and the company policy on equipment and support should be straightforward. However, the pandemic has been anything but easy, and so it is quite possible that employees are only just starting to consider their aches and pains ? and have already settled into a routine and set-up that might not be ideal. Life is still quite a long way from "normal" and so there is no better time to reconsider the work environment.
Essentially, the same principles apply for an ad hoc desk as an office desk. For example:
elbows should be at the same level as the keyboard for typing
knees and elbows should be at right angles, with the worker able to put their feet flat on the floor
the lower back should be supported
the neck should be in a neutral position with the screen straight ahead.
Most desks in an office will be set up with the basic equipment to achieve this, as well as an ergonomically designed office chair. It only takes some small changes to achieve a similar result at home.
Keep the head up ? the neck needs to be in a neutral position, and it is important to not look down at the screen. If working directly from a laptop on a table put the laptop on a stack of books so that the top of the screen is at eye level. Note that if the laptop is raised, a separate keyboard and mouse will be needed.
Keep the spine neutral and supported ? the neck and torso should be in a relatively straight line and the lower back should be supported. Many chairs in the home do not provide adequate protection for the lower back; a rolled-up towel or cushion can help here. Asking a family member to take a photo can be a useful way of checking that the body and head are in a straight line.
Right angles are key ? the forearms should be parallel to the table, which might mean sitting on a cushion or some folded towels to raise the torso. If this means that the knees are not at right angles and the feet are off the ground, then a box should be used to raise the feet so that they are supported.
Working from the sofa?
Working from the sofa for any length of time is possibly the least ideal set-up. Where the sofa is the only option, it is important to raise the laptop so that the neck is not craning down. This can be done by putting the laptop on a thick cushion and hard surface (such as a book). The lower back should also be supported with cushions.
Mix it up
Creating a standing desk can also be an easy thing to do at home by resting a laptop on books or using a laptop stand. When typing, forearms should be horizontal, so an external keyboard and mouse (also propped up) are needed to maintain a neutral posture.
Standing can be a good way to add variety into the day, perhaps by alternating with periods of sitting down, or by standing during meetings or when on the phone.
If working in a compromised position, regular breaks are essential. For example, when working from a sofa, it is important to get up and move around every 20-30 minutes. It is possible to work for longer at a more traditional desk, but it is still necessary to move around every hour or so.
Longer periods of movement, such as a walk at lunchtime, are also hugely beneficial to keeping good musculoskeletal health, and should be widely encouraged.
Musculoskeletal injuries are a very real threat. Check in with employees to see if they have been experiencing any new aches and pains that appear to be related to homeworking. Ask employees to conduct a DSE risk assessment.
Stress the importance of musculoskeletal health and encourage staff to take the time to make changes and get their home set-up right.
Ensure staff take regular breaks.
Work with staff to find solutions to any pain they are experiencing and identify any equipment that might be needed.
Where problems are identified, it is best to act as soon as possible.
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