Office Injuries! Why They Occur and How to Stop Them [NYC Guide]
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As a medical massage and injury repair specialist in New York City, I get a steady and growing number of clients with regular office jobs coming to me with work-related injuries. Office jobs that require long hours of sitting at a desk are all too common in New York and all over the country, and as you may already know, they can take their toll on the human body in many ways. Moreover, in recent years we are starting to see an epidemic of poor posture and cervical spine disc degeneration in children and young adults. This is from not only sitting but also looking down at screens, whether it is laptops, phones or tablets.
It’s no secret that sedentary office-based jobs have increased over the past several decades in the most developed countries, including in cities and states across the United States. This is especially the case with the decline of manufacturing jobs and the growth of the office job market in cities like NYC and elsewhere. With the increasing dependence on desktop computers, laptops and smart phones and concurrent disappearance of manufacturing jobs, more Americans have found themselves sitting at desks in various office settings far more than ever.
This trend doesn’t show any signs of reversing any time soon, especially in high density urban areas. In addition, obesity and healthcare costs in the United States keep increasing.
If anything, the Covid-19 pandemic has intensified this sedentary trend. In particular, in large cities like New York, people don't have to walk to work or commute on the subway like in the past. Remote work has also all but eliminated the need to take a short walk for meetings and a longer outing for lunch or off-site conferences or events.
Some people don't even need to leave their apartment, thus increasing the sedentary behavior that can lead to orthopedic injuries, back pain, poor posture, de-conditioning and other medical conditions, not to mention the mental health challenges that can come from increased isolation.
Is there a connection here between office jobs and orthopedic injuries?
While office jobs that usually require long hours of sitting don’t pose the same sort of acute risks that other more labor-intensive jobs do, office environments do indeed contribute to health problems. And while few comprehensive studies have been completed to date to add detailed facts to this phenomena, the problem is real and it is important that individuals, companies, healthcare providers and government try to mitigate these health risks.
Sitting at desks, often staring at computer screens, all day is not good for the human musculoskeletal system. Simply stated, humans did not evolve by sitting down all day. The three areas of the body that are most vulnerable to office-induced injuries are the low back, the neck and the forearm/hands.
This is due to specific biomechanical stressors that sitting and staring at a computer puts on these areas of the body. We will discuss these in detail and offer simple solutions and treatments to help you prevent and overcome these injuries. In short, excessive sitting contributes to many orthopedic conditions and a decrease in overall fitness.
In addition to the biomechanics component that will be discussed at length below, it is important to mention the overarching sedentary lifestyle to which office jobs undoubtedly contribute to. A sedentary lifestyle is directly tied to obesity, diabetes and heart disease which all pose not only their own very serious health risks but also can further exacerbate muscle and joint injuries sustained from sitting long hours.
For example, being overweight puts extra load on the knees and low back. So if there is already a low back or knee injury, being overweight can just make it worse. In addition, metabolic diseases can impede one’s ability to perform the types and amount of exercise needed to prevent and recover from these injuries.
Cervical Spine, Head and Shoulders
The cervical spine or neck is one of the most often injured areas of the body due to office jobs that require extensive sitting. Arthritis, disc herniations, muscle tightness, headaches, TMJ dysfunction, nerve entrapments in the neck and arms, and acute neck pain are not uncommon amongst office workers. To understand why, let’s briefly discuss anatomy of the area.
The cervical spine is highly mobile, much more so than the lumbar spine (low back) in order to allow for a lot of movement and mobility. The cervical (neck) vertebrae are also very small in size compared to the vertebrae in the thoracic and lumbar regions of the spine. In addition, the neck is where much of the force and tension from the weight of the head ends up.
So, combine mobile joints made up of small bones that withstand a lot of force, motion and weight and you have a perfect storm of risk factors for injury. Add poor posture and repetitive use, not to mention common traumas, for example whiplash from car accidents, to the picture and you can start to get the point. It can get very complicated but it's pretty straightforward in some ways.
Perhaps the single biggest neck-related issue with desk-office jobs is that they cause postural and eventually structural changes in the cervical spine and thoracic spine which can predispose someone to many different injuries, including early-onset degenerative disease. The most obvious and common of these postural changes is what is known as Forward Head Position.
When staring at a computer most people place their head further in front of their body than what it should be. And in fact, chronic forward head posture triples the weight of one’s head on the neck. Over time, this can put extra stress on many structures in the cervical spine including disc arthritis and herniations, irritation of the facet joints, impinging the spinal nerve roots, weakening neck-head ligaments and compressing the spinal cord (Stenosis).
Disc Arthritis and Disc Herniations: The Intervertebral Discs are positioned in between each vertebrae in the spine. They function as cushions for the spine, shock absorbers in essence that allow safe and smooth movement. When these Discs are placed under chronic and excessive tension, as is what happens with forward head posture, they reposition backwards and laterally which can weaken the delicate fluid and cellular material contained in them.
Disc bulges or herniations are very common and can cause mild to severe pain as well as numbing, tingling, weakness and burning locally and into the arms, hand and fingers. Disc herniations and arthritis are very common in adults but desk jobs in offices only serve to accelerate the degenerative process.
Nerve Impingements: Disc arthritis, bulges and herniations can pinch the nerve roots that branch off of the spinal column. This can cause acute pain as well as tingling, burning and numbness from the neck all the way into fingers.
Muscle Pain and Tightness: You don’t have to have a clinically diagnosed disc herniation to experience pain and tightness in your neck. Overworked and tight muscles in the neck and shoulder can cause chronic and debilitating discomfort for office workers. Muscle tightness can actually contribute to headaches and TMJ discomfort as well.
Shoulder Pain and Injuries: Forward head posture often occurs along with other postural changes in the thoracic spine and shoulders. The rounding / hunching of the upper back and internal rotation of the shoulder joint can lead to chronic chest muscle tightness, shoulder impingement and biceps tendonitis.
Low Back, Hips and Pelvis
The ways in which office jobs affect the low back are similar to those in the neck. This is especially true when it comes to Disc Arthritis, muscle tightness and Disc Herniations / Bulges. What is uniquely different about the low back region is the connection to the pelvis and hips.
Disc Arthritis and Disc Herniations: As with the cervical spine, the Intervertebral Discs in the lumbar spine are positioned in between each vertebrae. They similarly cushions the spine and when constantly placed under chronic tension from slouching, they get displaced posteriorly and laterally, weakening them. Disc bulges or herniations in the lumbar spine can cause pain as well as numbing, tingling, weakness and burning locally and down the back of the legs known as Sciatica.
Sciatica: You’ve probably heard of this condition before, as it is very common in adults for many reasons. Heavy lifting with improper technique is a big one. The other is sitting at desks for hours upon hours, as so many people do. Sciatica can be a very debilitating condition in which a person loses sensation or has chronic nerve symptoms along in the low back, pelvis and the Sciatic Nerve pathway down the back of the legs.
Piriformis Syndrome is very similar to Sciatica in its symptom pattern. The difference is that the Sciatic nerve has become entrapped by the Piriformis muscle rather than by a herniated or arthritic intervertebral disc. Piriformis Syndrome essentially mimics Sciatica in some ways but the treatment and prevention measures can be slightly to significantly different, depending the the person and how severe one's symptoms are. Often times Piriformis Syndrome is the result of constant compression on that muscle and the sciatic nerve that runs through it due to hours and hours of sitting at a desk. This is due to direct pressure from sitting and from not having enough mobility and flexibility in the lumbar and pelvic regions to due a sedentary lifestyle.
Hip Pain and Injuries: Labrum tears, hip arthritis, muscle pain and impingement are very common in the US due to an increasingly sedentary lifestyle and poor nutrition. And while there are many reasons for this, including the natural degenerative process that affects millions or injuries from sports or trauma, there is no doubt that sitting for long hours plays a part for many people as well. For more info on hip injuries and anatomy, you can also check out the web site of world-renowned Orthopedist Bryan Kelly of HSS.
Muscle Pain and Tightness: Often times low back pain is muscular in nature, meaning there isn’t a structural injury to the spine but rather a chronic strain to some of the back musculature. This can occur along with or result from a spine injury as well.
Carpal Tunnel and Pronator Teres Syndrome
Carpal Tunnel Syndrome is one of the most common injuries in the body. It is characterized by any combination of weakness, pain, numbness, burning and tingling in the hand and first three fingers. It can be undeniably painful and stubborn. Pronator Teres Syndrome ‘mimics’ Carpal Tunnel in the same way Piriformis Syndrome mimics Sciatica. In both Carpal Tunnel and Pronator Teres Syndromes, the radial nerve gets entrapped/impinged, just in different areas.
Injury Prevention for Office Injuries
There are are many ways to help prevent office / desk-related injuries. Applying a combination of them can help prevent many of the injuries listed above.
Standing Desk: There are now a plethora of adjustable and standing desk options on the market across a wide price range. Standing for just two hours per day will add up to about 450-500 hours over the course of a year in which you are not sitting. That is significant. Standing desks can be equally helpful for preventing injuries to the neck, low back and hip.
Ergonomic Assessment: Occupational Therapists and Ergonomic specialists can be valuable assets in helping individuals and entire companies improve their posture, feel better, decrease missed work time and improve morale. These professionals are highly trained in anatomy and biomechanics. They can help each person create a customized workstation based on his or her specific needs. This injury prevention strategy can help with all of the injuries discussed above but for unique reasons relevant to each body part, body region and specific injury.
Stretch the Hip Flexors: The group of muscles known as the hip flexors include the Psoas, Illiacus, TFL, Rectus Femoris and Sartorius muscles. They shorten the more we site and can cause direct stress on the lumbar spine and overall changes in muscle balance, strength and alignment. Stretching them regularly can help.
Stretch the chest and hips regularly: There are some great yet simple chest and hip stretches that you can do close to your desk and against a wall. Doing these a few times daily can help counteract the negative effects of sitting all day.
Postural exercises to strengthen upper back muscles: Find yourself a Physical Therapist or advanced Personal Trainer who can show you some strength exercises to help you maintain good posture. It’s not so simple to just tell yourself to sit up straight. As with any sport, hobby, habit or skill, having good posture requires some training and conditioning.
Get a Massage: Massage and Active Release Techniques (ART) are proven to reduce muscle tension, relieve muscle pain and tightness, reduce stress and increase blood circulation to tight muscles as well as enhance body awareness. Getting a massage with some regularity can go a long way in helping you prevent and manage pain and injury.
Massage Yourself: Self-massage and trigger point release can reduce pain, increase flexibility and relieve stress. You can do it at home pretty easily and it goes great in combination with stretching and postural exercises.
Stand up at least once an hour: It is so easy to sit for endless hours without moving from your chair. Time can pass quickly when you’re in the zone, have a deadline or are exhausted. If this is you, then perhaps try setting an hourly alarm that signals to you that it’s time for a 5-10 minute walk and stretch. It will also be good for your eyes and mental stress as well as help you refocus and reset. Getting up regularly can be especially beneficial for preventing and managing low back pain and injuries to that region of the body.