Ergonomics is the study of optimizing the interaction of human beings with their tools and environments to maximize safety, health and comfort. The principles of ergonomics are often applied to the workplace because many injuries and illnesses happen on the job.

Some workers develop poor posture or pain due to common activities in the workplace, such as sitting in office chairs, working at computers or standing for long periods of time. A variety of painful conditions occur as a result of work environments, such as back pain, shoulder pain, neck pain, tendinitis and possibly carpal tunnel syndrome.

Ergonomics is often considered during the design of tools and working environments. Among tools that are subject to ergonomic design are chairs, computer monitors, keyboards and household tools. Among environments subject to ergonomic design are offices, laboratories and industrial work spaces, such as factories.

Workers can improve their posture by standing up and moving, using ergonomic chairs and remembering proper posture while in motion. Ways to minimize eyestrain include blinking and yawning, resting the eyes and performing eye movement exercises. Other exercises aimed at preventing musculoskeletal problems include deep breathing, executive stretching and hand massages.

Posture and ergonomics also have many applications outside the workplace. These techniques are valuable treatments for people who would benefit from joint protection, such as those with rheumatoid arthritis or osteoarthritis, or energy conservation, such as those with chronic fatigue syndrome, lupus or fibromyalgia. Occupational therapy and physical therapy can cover this type of instruction.

Ergonomics is the engineering science that focuses on the design, manufacture and arrangement of products and environments to maximize comfort, health and safety of humans. It is derived from the Greek words ergos (meaning work) and nomos (meaning laws). Ergonomics is sometimes referred to as human factors or human factors engineering.

A Polish scientist named Wojciech Jastrzebowski coined the term in 1857. Ergonomics grew as a discipline during World War II when it was discovered that the use of sophisticated military equipment could be compromised by poor operator decision. After the war, the field continued to grow with the formation of ergonomics societies and initiation of research into areas such as cardiovascular response to work and the impact of stress on the intervertebral discs of the spine.

Today, principles of ergonomics are guided by the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA). OSHA issues ergonomics standards, which are rules employers must follow. The agency also issues ergonomics guidelines, which are voluntary tools to assist employers with maximizing the comfort, health and safety of workers.

Ergonomists can earn degrees in ergonomics, human factors or related fields such as industrial engineering. They can obtain voluntary certification through organizations such as the Board of Certification in Professional Ergonomics or the Association of Canadian Ergonomists. Other professionals who have some training in ergonomics and biomechanics include occupational and physical therapists.

The use of ergonomics in the workplace is common because many injuries and illnesses occur on the job. Most workplace injuries are the result of physical stress, such as awkward positions and overuse. Some workers develop poor posture or pain due to common activities in the workplace, such as sitting in office chairs or vehicles, working at computers or on assembly lines, or standing for long periods of time. This is because maintaining a sustained posture over time is more taxing to muscles than alternating between rest and work. Principals of ergonomics also have many applications outside the workplace, notably for people suffering chronic pain from conditions such as arthritis.

When muscles are resting, they require fewer nutrients than when they are contracting to perform work. When muscles are alternating between rest and work, the blood flow through muscles is enhanced by muscles’ pumping action. This pumping helps keep the muscle cells supplied with adequate nutrients. A muscle contracting to maintain a position requires even more nutrients than alternating between rest and work.

Common conditions that occur as a result of activities in the workplace include:

• Poor posture. Although poor postural habits usually develop during the teenage years, they can be worsened by work activities as an adult, such as sitting or standing for long periods of time. Poor posture can result in chronic low back pain.
  
  
• Repetitive motion injuries. Also called repetitive stress injuries or cumulative trauma disorders, they are caused by excessive and repeated physical stress on the musculoskeletal system from certain activities. Repetitive motion injuries can occur in many joints, including the hands, wrists, elbows, shoulders, neck and back. Cumulative trauma from activities such as excessive typing or use of vibrating tools may play a role in carpal tunnel syndrome, an impingement of the wrist’s median nerve that likely involves a congenital predisposition.
  
  
• Back pain. Improper lifting of heavy objects can cause acute pain and poor posture can result in chronic low back pain.
  

• Elbow, wrist and arm pain. Injuries such as tendinitis (inflammation of a tendon) and bursitis (inflammation of a bursa) can be found in the elbow, wrist and arm. This can occur from repetitive motions conducted in industrial workplaces (such as factories) and other types of work environments.
  
  
• Neck pain. Sitting or standing for long periods of time can cause the neck to become sore.
  
  
• Eye pain. Computer work can cause dryness and other irritation of the eyes.

Posture and ergonomics are also important outside the workplace. For example, they are important home treatments for people who would benefit from:

• Joint protection. People with conditions such as rheumatoid arthritis and osteoarthritis can reduce damage by favoring larger joints over compromised smaller joints (for example, lifting a pot with both hands instead of a few fingers) and using adaptive equipment (for example, a jar opener or bathtub bench).
  
  
• Energy conservation and task simplification. People prone to fatigue, such as those with fibromyalgia, chronic fatigue syndrome, lupus, late-stage Lyme disease or sickle cell anemia, can learn techniques that conserve energy after a task analysis is performed to break down an activity and eliminate or modify steps.

Occupational therapy, which focuses on maximizing independence in daily activities, covers this type of instruction. Patients may also benefit from physical therapy.

The principles of ergonomics are sometimes applied during the design of tools used in the workplace or during the design of workspaces. The goal of ergonomics is to improve safety and comfort of workers and to prevent injuries and reduce healthcare costs. In some workplaces, the goal is to increase productivity.

There are catalogs of ergonomic tools for many jobs and functions. Common workplace tools subject to ergonomic design include:

• Office chair. Sitting for long periods of time can cause increased pressure on the intervertebral discs in the spine and may contribute to a pinched nerve. Chair components that may be specially designed include casters and base, seat pans, backrests and armrests.
  
  
• Desks. Can be raised or lowered depending on a person’s height. Desks should also have ample space underneath to allow for stretching.
  
  
• Computer monitors. Can be raised or lowered so they are positioned at the appropriate eye level. Screens can be purchased to minimize glare.
  
  
• Keyboards. Specially designed keyboards aimed at preventing carpal tunnel syndrome are available.

• Mouse. A computer mouse is often designed to minimize shoulder, elbow, wrist and arm pain.
  
  
• Forearm boards. These devices, attached beneath the front of the desk, keep the arms in a neutral 90-degree position and can help prevent arm and shoulder pain.
  
  
• Telephones. Use of headsets may avert neck pain in those who often are on the phone.
  
  
• Lighting. Lighting that is unsuitable for performing computer applications is a major contributing factor to eyestrain, burning or itching eyes, and blurred or double vision.

Workplaces that are subject to ergonomic design include:

• Offices. A variety of features are considered when designing office environments, such as making sure workstations have adequate space for workers to perform duties and ensuring that lighting is appropriate for the type of work being performed.
  
  
• Laboratories. Laboratory researchers are at risk for repetitive motion injuries due to routine procedures, such as working with microscopes.
  
  
• Industrial workplaces. Many industrial workers are required to lift heavy items on the job. This can be strenuous and requires proper training to be performed safely. Back pain and injuries may be avoided by lifting with the leg muscles instead of the back because leg muscles are larger and stronger. Some workers wear back braces to provide support while lifting. Factory workers on assembly lines may be taught techniques to avoid repetitive motion injuries.
  
  
• Trucking. Long-haul drivers are at risk of sciatica and other types of back pain and leg pain. Stretching and other exercises, manipulation therapy and physical modalities such as thermotherapy and cryotherapy can help in addition to ergonomic modifications.

An ergonomist, occupational therapist or physical therapist can perform a job site analysis to make recommendations that may reduce risk of workplace injuries. Therapists can also conduct a functional capacity evaluation to assess an employee’s ability to work physically.

There are also many ergonomically designed tools for home. These include items widely available in discount and department stores, such as kitchen and garden gadgets with improved, easy-to-grip handles. Other items are available from occupational therapists, physical therapists, medical supply stores or other specialty stores, catalogs and some discount stores. Examples of these goods include bathtub benches, commode chairs, reachers, jar openers, long-handled shoehorns and button hooks.

By applying the principles of ergonomics in the workplace, people can often improve posture and avoid injuries and painful conditions.

Poor posture can become second nature over time. When undergoing a physical examination, it may be helpful for patients to ask their physician if there are any signs of poor posture or a condition that may result from it, and to ask for any specific recommendations. The following are tips to improve posture, especially for people who sit most of the day:

• Identify the warning signs of back pain caused by poor posture. Back pain may be the result of poor posture if it occurs during specific times during the day or starts in the neck and moves to the back.
  
  
• Stand up and move. Slouching is more likely when muscles become tired. Workers should get up and move at least once every half hour. Unless prescribed bed rest by their physician, patients are generally advised to engage in some exercise because moderate physical activity can reduce fatigue, pain and disability.
  
  
• Maintain proper alignment while sitting or standing. Distribute body weight evenly while standing and sit up straight to improve posture.
  
  
• Use ergonomic equipment. Using ergonomically designed equipment, such as chairs, can improve posture.

Individuals can also improve posture at home and other everyday settings. Tips include:

• Exercise. Walking, swimming and bicycling can keep the body aerobically conditioned and strengthen muscles, improving posture.
  
  
• Wear appropriate footwear while standing. Avoid wearing high-heeled shoes, which can harm posture.
  
  
• Remember good posture during everyday activities. Walking, lifting heavy objects, using a telephone and typing are activities that require good posture. People can reduce their risk of back injury by practicing good body mechanics when lifting objects: getting close to the object, keeping the back straight and using the leg muscles to rise.
  
  
• Avoid overprotecting posture. It is important to maintain an overall relaxed posture to avoid restricting movements and adopting an unnatural posture.

Eyestrain can be prevented or lessened by performing the following:

• Blink and yawn. This produces tears to moisten and lubricate the eyes.
  
  
• Expose eyes to natural light.
  
  
• Periodically focus on objects at least 20 feet away.
  
  
• Rest the eyes. While seated, place elbows on the desk and place hands over the eyes. Close eyes and breathe deeply for 15 to 30 seconds.
  
  
• Perform eye movement exercises. Close the eyes and slowly move them up to the ceiling, then down to the floor. Then move eyes slowly to the left and right.
  
  
• Perform focus change exercises. Hold a finger a few inches away from the eyes, focus on the finger, then slowly move the finger away. Focus far into the distance and then back to the finger. Slowly bring the finger back to within a few inches of the eye. Then, focus on something more than eight feet away.

There are several other exercises that can be performed to prevent or reduce musculoskeletal injuries and pain. They include:

• Deep breathing. While standing or in a relaxed position, place one hand on the abdomen and the other on the chest. Inhale slowly through the nose and then exhale slowly through the mouth. Repeat.
  
  
• Cable stretch. While sitting with the chin and stomach in, shoulders and hands relaxed and feet on the floor, move head upward as if a cable were pulling it. Hold for three seconds and then relax. Repeat three times.
  
  
• Side bend neck stretch. Tilt head to one side, hold for 15 seconds and then relax. Repeat three times on each side.
  
  
• Diagonal neck stretch. Turn head slightly and then look down as if looking in a pocket. Hold for 15 seconds and then relax. Repeat three times on each side.
  
  
• Shoulder shrug. Slowly bring shoulders up to the ears and hold for three seconds. Rotate shoulders back and down. Repeat 10 times.
  
  
• Executive stretch. While sitting, lock hands behind the head. Bring elbows as far back as possible. Inhale deeply while leaning back and stretching and hold for 20 seconds. Exhale and relax and then repeat.
  
  
• Foot rotation. While sitting, slowly rotate each foot from the ankle. Rotate three times in one direction, then three times in the opposite direction. Relax and repeat.
  
  
• Hand shake. While sitting, drop arms to the side. Shake hands downward gently and repeat frequently.
  
  
• Hand massage. Massage the inside and outside of one hand using the thumb and fingers of the other. Repeat frequently.
  
  
• Finger massage. Massage fingers of each hand individually, slowly and gently. Move toward the nail gently and massage space between fingers. Perform daily.
  
  
• Wrist stretch. Hold arm straight out in front of torso. Pull the hand backwards with the other hand. Hold for 20 seconds, relax and repeat three times for each wrist.

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about posture and ergonomics:

1. What is ergonomics, and how can it help me?
   
   
2. Why is understanding ergonomics important to me?
   
   
3. Why is having good posture important to me?
   
   
4. Does my physical examination reveal any problems with my posture? If so, can they be fixed?
   
   
5. How can principles of ergonomics be applied at my workplace?
   
   
6. Can principles of ergonomics be applied in my home as well?
   
   
7. What tools or devices that incorporate ergonomics can benefit me?
   
   
8. What types of exercises or activities can I do to improve my posture?
   
   
9. Can occupational therapy teach me techniques in joint protection or energy conservation to reduce my pain and disability?
   
   
10. How can I avoid injuries or pain in my work environment and elsewhere?