Forearm support reduces pain linked to computer use

Providing forearm support is an effective way to prevent musculoskeletal disorders of the upper body and helps reduce upper body pain associated with computer work, according to a study reported in the April 18 issue of the British Journal of Occupational and Environmental Medicine.

The study shows that use of large arm boards significantly reduces neck and shoulder pain as well as hand, wrist and forearm pain. "Based on these outcomes, employers should consider providing employees who use computers with appropriate forearm support," said lead author Dr. David Rempel, director of the ergonomics program at San Francisco General Hospital and professor of medicine at the University of California, San Francisco.

Study findings also show that arm boards and ergonomics training provide the most protective effect with a statistically significant reduction in both neck and shoulder pain and right hand, wrist and forearm pain compared to the control group that did not receive forearm support. The boards reduced the risk of incidence of neck and shoulder disorders by nearly half.

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 tendonitis, elbow tendonitis and muscle strain of the neck and upper back. These health problems account for a majority of lost work time in call centers and other computer-based jobs. "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," Rempel added.

The one year, randomized study evaluated the effects of two workstation interventions on the musculoskeletal health of call center employees - a padded forearm support and a trackball. The forearm support is commonly called an arm board and attaches to the top front edge of the work surface. The trackball replaces a computer mouse and uses a large ball for cursor motion.

The researchers tested employees from two customer service center sites of a large health maintenance organization. Employees had to perform computer-based customer service work for a minimum of 20 hours per week in order to qualify for the study. For one year, 182 participants filled out a weekly questionnaire to assess pain level in their hands, wrists, arms, upper backs and shoulders. Participants were randomized into four groups, each receiving a different intervention - ergonomics training, training plus a trackball, training plus forearm support, or training with both a trackball and forearm support.

Outcome measures included weekly pain severity scores and diagnosis of a new musculoskeletal disorder in the upper extremities or the neck-shoulder region based on physical examination performed by a physician. The trackball intervention had no effect on right upper extremity disorders. "The trackball was difficult for some participants to use," said Rempel. "Employees with hand pain may want to try them, but they should stop if it is difficult to use."