Reducing Pain and Preventing Musculoskeletal Disorders in Computer-Based Customer Service Workers

A University of California, San Francisco study led by professor of medicine David Rempel has shown that using large arm boards for forearm support significantly reduces neck and arm pain associated with computer work, and is an effective intervention for preventing related musculoskeletal disorders of the upper body.

Using workers' compensation cases involving neck and shoulder disorders, the researchers performed a return-on-investment calculation and estimated that a full return on the cost of arm boards would accrue within 10.6 months of purchase to employers who invested in them.

"Based on these outcomes, employers should consider providing employees who use computers with appropriate forearm support and training," said Dr. Rempel. "Extended hours of mouse or keyboard use and sustained awkward postures, such as wrist extension, are the most consistently observed risk factors for musculoskeletal disorders."

The one-year study randomized callcenter employees at two Kaiser Permanente customer service centers to evaluate the effects of two workstation interventions on musculoskeletal health: a padded forearm support board and a trackball. The forearm support, often called an arm board, attaches to the top front edge of the work surface. The trackball directs cursor motion and replaces the mouse.

Participants were randomized into one of four groups, receiving either ergonomics training, training plus a trackball, training plus forearm support, or training with both a trackball and forearm support. The 182 participants, who worked a minimum of 20 hours per week, filled out weekly questionnaires to assess pain levels in their hands, wrists, arms, upper back and shoulders. A physical examination was performed when the reported pain reached a moderate level.

Results of the study, published in the British journal Occupational and Environmental Medicine, showed forearm support boards and training provided the most protective effect, with a statistically significant reduction in both neck and shoulder pain and right hand, wrist, and forearm pain in comparison to a control group. The boards reduced the incidence of neck and shoulder disorders by nearly half. The trackball intervention reduced left upper extremity disorders, but it had no effect on right upper extremity disorders.

Co-investigators on the project were Niklas Krause, Robert Goldberg, Mark Hudes, and Doug Benner. According to the authors, musculoskeletal disorders of the neck, shoulders and arms are a common occupational health problem for individuals involved in computer-based customer service work. Specific disorders include wrist and elbow tendonitis and muscle strain of the neck and upper back. They account for a majority of work-related lost work time in call centers and other computer-based jobs.

The authors outlined other actions that employees who use computers can take on their own to relieve pain. They suggested employees take scheduled breaks, maintain an erect posture, adjust chair height so that thighs are parallel to the floor, and adjust arm support and work surface height so that forearms are parallel to the floor. They should also adjust the mouse and keyboard location to minimize reach and adjust monitor height so that the center of the monitor is approximately 15 degrees below the visual horizon.