More people are complaining of aches and pains after companies in Singapore opted for work-from-home (WFH) arrangements for employees since early February to stop the spread of the coronavirus.
Ms Adda Chua, 32, who is self-employed in the digital marketing industry, says she has been losing track of time and working longer hours at home since her appointments to see clients at their offices were cancelled.
As a result, she says she often finds herself in the same seated position for prolonged periods.
“Although my schedule is flexible, I have been working a lot more when I’m at home,” says Ms Chua, who is married with two daughters. “That eventually led to persistent neck and back pains.”
Although she acknowledges that it is her responsibility to ensure she has breaks in between, she says that is easier said than done.
“The different work environment at home, without interruptions or social interactions unlike in the office, can make you get absorbed in your work,” she adds.
“But as WFH looks to be the new normal, I must manage my work hours and breaks better.”
Architect Charmaine Wong echoes that sentiment.
“With architectural design work, we often find ourselves desk-bound for long hours and more so with the WFH arrangement, where the balance between work and rest is delicate,” says Ms Wong, 38, who is the founder of Chalk Architects, a multidisciplinary design consultancy.
“The prolonged hours at the desk and decreased mobility often lead to stiff shoulders and sometimes sore backs,” she adds.
For undergraduate C.H. Teo, a current patient of Dr Philip Cheong, principal physiotherapist at Singapore General Hospital (SGH), the pain in his right neck and shoulder became so severe that he had to seek medical advice.
Working from home has the propensity to encourage sedentary behaviour, which places an individual at a higher risk for ischaemic heart disease, diabetes mellitus and stroke.
DR GAN WEE HOE, head and senior consultant of the department of occupational and environmental medicine at Singapore General Hospital
“I was doing a lot of work on my laptop for a few weeks before the pain started,” he says. “I was referred for physiotherapy after seeing an orthopaedic specialist.”
Dr Cheong conducted a thorough assessment of Mr Teo’s neck and shoulder and performed spinal manipulation on his upper back, which helped reduce the pain.
Mr Teo says: “He said it was to give me temporary relief so that I could start prescribed exercises at home to alleviate the pain.”
These included exercises to promote movement and blood circulation as well as stretches to help loosen taut muscles.
“Dr Cheong taught me how to set up my laptop properly at home and said there is no such thing as ‘perfect posture’, and to take frequent breaks while working,” he adds.
Inactivity, especially in confined spaces like the home, is a cause for concern, says Dr Gan Wee Hoe, head and senior consultant of the department of occupational and environmental medicine at SGH.
“Working from home reduces an individual’s overall physical activity level if there is little motivation to incorporate a regular exercise routine,” says Dr Gan.
“With no requirement for commuting and workplace activities, working from home has the propensity to encourage sedentary behaviour, which places an individual at a higher risk for ischaemic heart disease, diabetes mellitus and stroke.”
Although there are no statistics from SGH to show that more people are seeking help for body aches and pains, Dr Gan says anecdotally, those seeking treatment for neck and back aches and pains tend to be from the middle to older age groups.
“Younger individuals, due to their functional reserves, have a higher threshold before symptoms arise,” he adds. “But some studies show that extended use of mobile devices may lead to ‘text neck’ in young adults.”
“Text neck” is one of a range of repetitive stress injuries (RSI) that cause pain resulting from repeating a certain activity for long periods.
“Excessive ‘keyboarding’ (long periods at the keyboard) is well known to cause RSI of the wrists,” says Dr Gan. “The slope of a computer keyboard may have a compounding effect on the risk of RSI over prolonged use.
“A larger slope angle of the keyboard forces an individual to extend his wrists more when typing. If this non-neutral posture is sustained over long periods of time, it not only causes aches over the forearm muscles, but may also increase the pressure on the median nerve in the carpal tunnel, predisposing the individual to the development of carpal tunnel syndrome.”
Carpal tunnel syndrome (CTS) is the result of the compression of the median nerve as it travels through the carpal tunnel at the wrist, which can cause numbness, tingling or weakness in the hand.
“Long and uninterrupted hours spent working with digital devices can result in pressure loading on to the spine, as well as the back and shoulder muscles,” says Dr Gan, referring to muscles that stay contracted for long periods of time to support the posture of a person.
“The chronic strain on these muscles and ligaments will be greater if the posture is poor, giving rise to symptoms such as neck, shoulder and back aches.”
Another side effect of the prolonged use of digital devices is computer vision syndrome, also known as digital eye strain, says Dr Gan
“Similar to carpal tunnel syndrome, the eyes have to move repetitively to capture text and images on a digital screen. The flicker and glare of the digital screen may also add to the strain of the eyes, leading to symptoms such as headache, dry eyes and blurred vision.”
To avoid the harmful effects of a sedentary lifestyle, prevention is the best medicine, says Dr Gan.
“Research shows that when a person does a 30-degree forward head tilt, he is applying more than 18kg of stress on his spine. Such stress may lead to spinal problems in the long run,” he says.
“Exercise and stretching help to strengthen the muscles responsible for supporting the neck and back,” he adds. “Regular rest breaks also prevent stress on the spine from building up and breaching the threshold for injury.”
MORE WORK, LESS STRAIN
Dr Philip Cheong, principal physiotherapist at Singapore General Hospital, shares tips on avoiding repetitive strain injury (RSI) by being mindful of the shoulders, distance from the screen, neck positions and eye level.
SGH senior physiotherapist Belinda Liew and physiotherapist Kenneth Goh also offer guidelines for better posture when working from home.
Dr Cheong says: “It is important to keep in mind that any posture held for prolonged periods is not good for the body. The key is to take frequent breaks and change your position often.”
Proper posture for working on the keyboard and using the mouse: The arms are resting comfortably on the table and the wrists are relaxed and supported. The mouse and keyboard are also within comfortable reach.
The arms are not resting comfortably on the table and the wrists are not in a comfortable position. The cluttered work area leads to the awkward placement of the mouse where one has to strain and reach forward.
Proper posture on a plush chair or sofa: The thighs are resting comfortably on the seat of the sofa and the back is supported with a cushion. The feet are resting on the ground with the laptop propped up on a cushion.
The laptop is not propped up and both feet are not on the floor. The weight is not distributed evenly through the buttocks and posterior aspect of the thighs.
Proper posture on the bed: The back is supported with a pillow with the laptop propped up on a pillow or cushion and there is also support under the back of the knees. The neck and shoulders are relaxed and in a comfortable position.
The hunched position with back unsupported, head protruding forward and laptop not propped up properly will lead to strain and pain over the long term.
The body weight is propped by the elbows with the back extended. Also, the shoulders are elevated with the head protruding and wrists flexed and tensed up.
Proper posture with table and chair: The thighs are resting comfortably on the seat of the chair. In this position, the body weight is distributed evenly through the buttocks and posterior aspect of the thighs.
Also, the back is well supported, with feet resting on the ground, and knees and elbows bent at 90 deg angles.
The monitor is placed at arm’s length away from the eyes, with the top of the monitor at approximately eye level.
Sitting at the edge of a chair with your feet not resting fully on the floor can increase the strain on the buttocks, lower back and legs.
Also, the back is not supported, the shoulders are hunched forward and elevated, with the head protruding to look at the monitor. The monitor is also placed too close and too low.