How to reduce finger, thumb, hand, wrist, elbow and arm pain

With the advent of today’s technology, we are using our hands and arms more than ever and in very different ways. Tablets, smartphones, and computers have changed the way that we work, play, and live. The technology is great, but the pain we experience from it, is not so great. It’s not surprising that we feel pain – there are many ergonomic risk factors associated with our devices:

  • Force – from holding our phones and tablets;
  • Repetition – the same movements of keyboarding, mousing, swiping, and pointing are performed over and over;
  • Awkward posture – how we hold our phones and tablets, as well as incorrect set up at the computer;
  • Overuse – the sheer amount of time we use our devices for work and play;
  • Static posture – staying in one place while using our devices, as well as holding our devices with one hand position for too long;
  • Contact stress – our phones and tablets digging into our hands, desk contact while keyboarding and mousing.

But our devices don’t have to cause us pain if we follow a few simple rules:

  1. Prop it up – Force from gripping and awkward wrist postures can be greatly reduced by letting go of your tablet or phone. Prop it up on a stand, or a pillow on your lap, or your backpack/briefcase.
  2. Elbows free – Nerves run through your elbows and can be aggravated with the pressure of leaning. Pain and tingling (“pins and needles”) can start here and travel down to your hands. Keep your elbows free and try not to lean them on anything, no matter how soft.
  3. Hands free or switch hands – Use your earbuds when speaking on your phone or remember to switch hands and ears often. The same elbow pain can result here from bending your elbow and holding it up for too long.
  4. Use all your fingers to type – Try to avoid typing with your thumbs only on a tablet. Many tablets are too big for comfortable typing with your thumbs – pressure is placed into your palm and your thumbs really have to reach to type some keys. Place the tablet down flat to type or set it up with an external keyboard.
  5. Keep it straight – Make sure all your joints are in neutral. Don’t have your thumbs extended down, keep your wrists straight, keep your elbows in-between (not completely straight, and not completely bent).
  6. Switch it up – Avoid using one set of muscles for too long. If you usually text with your thumbs, switch to typing with one finger to take pressure off your thumbs. If you usually hold your phone or tablet in your left hand and swipe/point with your left, switch it up and hold with your right and swipe/point with your left (it’s easier than it sounds!) If you point with your index finger, use another finger instead. If you use certain keys constantly when typing, try other keyboard shortcuts to take pressure off those fingers. If you use your mouse too much, try replacing some movements with keyboard short cuts.
  7. Move constantly – Don’t stay in one position for too long. Move around in your chair or on the couch or stand up. Keep moving your phone and tablet around in your hands. Reach your hands to the sky and stretch up, rotate your shoulders and wrists. Perform any movement you can – just keep moving!
  8. Mini breaks – Incorporate mini breaks into your posture constantly. For example, don’t hover your hand over your mouse when your reading your screen – rest it instead; put your phone or tablet down while it’s loading – look up and give your neck a break from looking down; during breaks in keyboarding – put your hands in your lap.
  9. Shorter, more frequent is better – If you are using your device for a long period of time, it’s better to use it in short stints with breaks in-between. A good rule of thumb is 15 minutes on, 1-2 minutes off.
  10. Less is more – Of course the best thing your can do is use your devices less. Spending the day at work on the computer and then spending the rest of your day on your phone or tablet is just too much device time. Ditch the device as often as you can!

Advice for DIY computer ergonomics


I think most of us have seen this type of ergonomics graphic that depicts the proper heights and distances for computer users.  Although this graphic can be helpful, it can be limiting too.  I’m all for people trying to improve their computer workstation ergonomics on their own using this graphic, but I do have a few words of advice to help you along:

If you change the height of one thing, you need to change everything else too.

  • For example, say you lowered your chair so your feet could be flat on the floor.  You then need to change the height of your keyboard and mouse so that your forearms are parallel and your elbows are at 90 degree angles.  Following that you need to adjust the height of your monitor so that your eyes are level with the top of the screen.  Get a coworker to help you by looking at you from the side and so you achieve the right heights

Even a few millimeters or 1/8th of an inch can make a difference when you’re making height adjustments.

  • Getting your keyboard at the exact position for you is an art.  You want to make sure your shoulders are completely relaxed, and your forearms and wrists are as straight as possible.  Raising or lowering from your perfect position can causes aches and pains right away or over time.  Make a small mark on your desk or wall to make sure you have the right position every time.

Even a few millimeters or 1/8th of an inch can make a difference when you’re making depth adjustments.

  • Achieving the proper lumbar support is important.  If you don’t get it right, you can end up with increased back pain.  Many chairs have pre-molded lumbar support that unfortunately cannot be adjusted.  If you have the means, adjustability in the form of an air pump feature in your chair is the best because you can inflate and deflate the lumbar support to the right depth for you.  A height adjustable backrest will help you get the proper positioning so that the curve of your low back is supported.

Monitor positioning is different for bifocal, trifocal and progressive lens use

  • If you wear bifocals, trifocals or progressive lenses, the monitor is best 2-3 inches lower than recommended.  That’s because you read out of the bottom of your lens and having the monitor at the “correct height” will result in neck discomfort from your chin tilting up.  Once again, height is crucial so keep playing with the height until you get it right.

Buying random “ergonomic” computer equipment is a game of roulette.

  • If you have wrist pain and buy a split keyboard or a new mouse hoping it will help, there’s a chance it will, there’s a chance it won’t, and there’s a chance you can make your pain worse.  Also what’s termed ergonomic is always the case.  Sometimes the word ergonomics is thrown in for marketing purposes.  You can keep buying and trying stuff, but it’s better to get advice from a certified ergonomics consultant.  It will save you money in the long run.

Looking at the graphic can’t help you with unique postures.

  • Leaning on an armrest, tilting your head to the side, or peering into the screen with your chin jutted out – these are all postures that aren’t helping you, but you may not even be aware you are doing them.  If you do them too much, you can end up in pain.  Your coworker can help you here again by observing you during the day and pointing out these potential problems as they see them.

Looking at the graphic can’t help you with changing position.

  • Changing your position is the best thing you can do to help yourself ergonomically.  Make sure you move around in your chair as much as possible (even slouching and sitting forward on occasion) along with getting up and to stand, walk, or exercise.  Staying in the “proper ergonomic position” all day every day is not very good at all.  This graphic needs a picture of break time too!

Computer ergonomics when working from home – Part 1

In this day and age, people are working from home more and more often.  Some people work overtime on weeknights and weekends and some people work from home full-time and don’t go into an office at all.  There are definite pros for working at home such as taking breaks more often and eliminating a long commute, but there are cons too.  The most noticeable con is a working environment that is not ergonomically correct. Very rarely does ergonomics come to mind when putting a home workstation together – there is likely more concern about where space can be found!  For many people, there is no home workstation at all, but rather the kitchen table or the couch with their laptop.

So how can you put your home office together without breaking the bank?  Here are a few tips:

1.  Office chair – For full-time at-home workers, I don’t think there’s any way around not getting a good office chair.  There are too many hours in the day to be sitting on a hard, non-adjustable kitchen chair.  These are the minimum chair features you will need:

  • Height adjustability – For the most comfort, your feet should rest on the floor with your knees and hips at 90 degree angles.
  • Proper seat pan depth – For those with shorter legs, you will need a small seat pan.  You don’t want the backs of your knees coming in contact with the front of the seat or you will be uncomfortable and will end up sitting at the front of your chair.  For those with longer legs, you will need a larger seat so that your legs are supported fully.  For everyone, make sure there is 1-2 inches between the front of the chair and the back of your knees.
  • Height adjustable armrests that lower below the worksurface – Most chairs don’t have armrests that lower enough to fit under your desk or keyboard tray.  Sometimes it’s better not to have armrests at all.
  • Comfort – This is not a feature as much as how the chair feels to you.  Ideally you would be able to try the chair out at home for a few days before buying.
  • Extras – For greater comfort, try to get a chair with lumbar support and a height and angle adjustable backrest.

2.  Height adjustable worksurface – To reduce strain on your neck, shoulders, and back while using your keyboard; your elbows should be at your sides at a 90 degree angle with your forearms parallel to the floor.  Standard desks will be too high for most of the population, except maybe for those who are 6’6” or taller.  A great inexpensive solution is the Galant desk from Ikea – you can raise or lower the legs to the proper height for you.  However if you are shorter or taller than most people and if more than one person is using the workstation, a better choice would be a standard desk with a height and tilt adjustable keyboard tray

3.  Computer – Use a separate monitor and keyboard rather than a laptop.  When using a laptop, you can’t separate the monitor and keyboard which leaves you with your head and neck bent down and your arms and shoulders raised up.  If you must use a laptop:  recline on your bed or on the couch with your back, neck and head supported with pillows; your legs straight and supported; and your laptop on your thighs.

4.  Monitor – Place it directly in front of you an arm’s length away and make sure the top of the monitor is level with your eyes.  If it’s not, use books to prop it up.

5.  Telephone – Use speakerphone if you can, or invest in a headset.  You should always avoid cradling your phone between your ear and your shoulder.

The above tips will help you take care of the environment around you, but there are other things you can do to make your home working experience more ergonomic.  Stay tuned for Part 2…

Headaches, Computers, and Ergonomics

Headaches are never fun to have, so it’s important to try and find the root cause as soon as possible.  One thing that has been linked to headaches is poor ergonomics during screen time.  In a 2010 study done by Torbjorn Torsheim from the University of Bergen in Norway and a team of international researchers, it was found that screen based activities were consistently associated with recurrent headaches in adolescents.  They also suggest that the type of screen time (e.g. computer, TV, smartphone, tablet) is not as much a factor as is the duration and ergonomic aspects of the activity.

So if ergonomic aspects are a factor, workers who are having headaches need to make sure they are set up ergonomically when engaging in a screen-based activity.  Here is a list of things to check for:

1.      Head and neck rotation

Is your screen to the left or right of you?  If so, you need change the position of yourself or the screen so that you are directly in front of it.  That way you don’t have to use your neck muscles on a continuous basis keep your head turned to the screen.  Neck pain and fatigue has been linked to headaches.

2.      Head and neck flexion/extension

Is your screen too high or too low?  If so, you are placing extra strain on your neck muscles as they try to hold your head up or down for extended periods.  Change the height of your screen so that the top of your screen is level with your eyes.  You can accomplish this by raising or lowering your height-adjustable monitor, using a height adjustable monitor stand or a few books to raise your monitor, using an external keyboard with your laptop so that you can raise the screen of your laptop, or using a stand for your phone or tablet.  One thing that should be noted for bifocal, trifocal, or progressive lenses wearers is that the top of the screen should be 2-3 inches lower than your eyes so that you don’t have to tilt your head up to read the screen.

3.      Screen distance

It depends on the person, but a general rule of thumb for computer use is having the screen an arms’ length away from you.  Of course this is going to depend on your eyes and if you wear glasses or not.  What you want to do is not have the screen so close that you strain your eyes, but not have it too far away so that you’re leaning in to see the screen.  Leaning in towards your screen puts extra pressure on your neck and in turn can cause headaches.  If you wear bifocals, trifocals, or progressives, you need to find that sweet spot where vision is clear – this will require some experimenting with distance.

4.      Body positioning

Proper posture is always important so make sure you are sitting up straight or slightly reclined, back resting on the backrest of your chair, and elbows at 90 degrees of flexion when you are using your keyboard.  If your keyboard is too high, you will activate one of the neck muscles, the trapezius.  Continuous trapezius activation is associated with neck and upper shoulder pain and in turn headaches.  When using your laptop, recline on the couch or bed with pillows supporting your head all the way down your spine to your low back.  Positioning while using a tablet can be improved by using a stand while reclining on the couch or bed.  Smartphone use is cannot be readily adjusted, so smartphone users need to adhere to frequent rest breaks from their phones – aim for no longer than 15 minutes at a time.

5.      Rest breaks

It’s important to take standing breaks and breaks away from the screen.  Stand or walk for 1-2 minutes every hour to alleviate body cramping.  Look to a far distance every 30 minutes to give your eyes a break from focusing on the same spot for long periods of time.

6.      Lighting

There should not be too much light when using a screen.  Overhead lights and sun from the windows can cause glare which can cause eye discomfort which can cause headaches.  It’s also important not to work in a dark room with a screen.  The contrast between the dark room and light screen is tough on your eyes.  Also having too much or too little light emitting from your computer can be a problem.  Play with the brightness settings on your monitor to increase or decrease light from your screen.

These ergonomics tips will help you position your body and adjust your workstation for increased comfort and hopefully the reduction of headaches.  If your headaches are not alleviated by following the tips above, be sure to see your doctor to check into other causes.

Computer use in vehicles

Before starting, it must be made clear that the computer use in vehicles I will be referring to is when the vehicles are parked and turned off.  Not by any means should a computer ever be used while a vehicle is in operation. 

Computers are used in vehicles by workers on the road for delivery or monitoring, e.g. police, firefighters, home care professionals, couriers, etc.  Information related to the delivery or monitoring usually needs to be entered as soon as possible into a laptop or tablet.  And while this is a timely and efficient way to input data, it unfortunately results a poor ergonomics setup.  So while an “office-in-a-vehicle” can never be completely ergonomically designed, improvements can be made.

In terms of where to put your laptop or tablet while in your vehicle, we can look at a study from Marquette University in Wisconsin where researchers tested out four different scenarios for mounting a laptop in a vehicle.  Results were as follows “Placing the mobile computer closer to the steering wheel reduced low back and shoulder muscle activity. Joint angles of the shoulders, elbows, and wrists were also closer to neutral angle. Biomechanical modeling revealed substantially less spinal compression and trunk muscle force.” (Biomechanical Effects of Mobile Computer Location in a Vehicle Cab;  So instead of placing your laptop on the passenger seat, it is much better to have it mounted beside the steering wheel to reduced twisting and awkward postures.

Here are some other tips for working in the car/truck:

  • Pull your shoulders back and keep upper back straight and flat (to reduce strain to back and shoulder muscles)
  • Sit with your back against the car seat (to provide support to your back muscles)
  • Relax shoulders – avoid elevating or “hunching” shoulders (to reduce strain on neck and shoulders)
  • Relax elbows close to torso – do not extend your arms in front of you (to reduce strain on your shoulders)
  • If present, adjust the lumbar support in your seat (the lumbar support should rest at the curve of your low back).
  • Use a laptop or tablet stand on your lap if your laptop or tablet is not mounted (to reduce neck strain)
  • Use headset or speakerphone at all times (to reduce strain to the neck and shoulders from cradling the phone)
  • Keep wrists neutral when keyboarding and mousing, i.e. keep wrists straight (to reduce wrist strain)

And finally, keep data entry in the vehicle to a minimum.  Save longer tasks for when you’re in the office with a better ergonomic setup.  Mobile computing is useful and important, but it shouldn’t leave with you ergonomic injuries.

Designing on a dime

Cost is always a concern when implementing ergonomics changes.  The important thing to remember is that many changes can cost nothing if they are procedural (alternating tasks more often to give muscles a break) or postural  (changing the way you keyboard to reduce stress on the fingers, hands, and wrists).  And that even when workstations need to be redesigned or equipment needs to be provided, costs can remain low.

This article recently caught my eye: Participatory ergonomics and new work:  Reducing neck complaints in assembling; S.A. Migueza, M.S. Hallbeckb, P. Vinkc.  This study was conducted at a cell phone assembly plant in Brazil.  There were complaints of neck pain from the workers and it was decided that ergonomics intervention was required.  The main ergonomic risk factor that was identified was neck flexion as a result of non-adjustable table height when assembling the cell phones.  It was determined that a raised horizontal “counter” would be best for the screw driving assembly task, and a sloped counter was best for the soldering task.  Height adjustable tables were not an option due to constrained finances, so the ergonomics consultants needed to fabricate these small counters from existing material at the plant.  They used PVC pipe and MDF boards found in the company waste.  Check out photos of the counters here:  These counters were quite successful, and resulted in a reduction in ergonomic complaints.

 As an aside, another great thing about this ergonomics intervention study was that the ergonomics consultants used a prototype counter first.  They then questioned the workers who reported compression points along their forearms from the front edge.  The counter was redesigned by removing the raised front edge and complaints decreased.  It is always important to get the opinions of the workers.  If they do not find benefit from the new ergonomic equipment, they will not use it.  And if it’s flawed, it could cause new or aggravated injuries.

Ergonomics intervention does not have to be costly, but it does need to be creative and it always needs to be tested for success.  If it’s successful, it will end up saving money on costs associated with injury.  It will also keep employees happy and healthy which is what everybody wants at the end of the day.

How to use your iPad ergonomically

The iPad is a wonderful device which allows you quick access to the internet anywhere along with thousands of apps to keep you entertained and informed.  But ergonomically, there are some pitfalls.  The main problem is that iPads are like laptops, but on an even smaller scale.  When you can’t separate the keyboard from the monitor, you either feel it in your neck from looking down at the screen or in your shoulder, elbows, wrists, and hands from raising your arms to type and mouse.  But as long as you use your iPad with care, you can reduce the risk of injury.  Here are some tips to help you enjoy your iPad experience with greater comfort:

  1. Placement – Ideally you would not grip your iPad with one hand while using it with your other.  The ergonomic risk factors of pinch grip force and awkward posture of your hand and wrist put you at an increased risk for injury.  You would also not want to put the iPad on your lap or even flat on a table.  This increases neck flexion which could in turn cause neck and shoulder problems and possibly headaches.  There are some good devices on the market that do alleviate some ergonomic risk factors.  One holds your iPad at the height and tilt you want it while clamped to a table or desk (iWare).  Others are tilt adjustable stands that sit on a table or desk for a cheaper option (Griffin A-Frame).  Or there are hand attachments for the back of the iPad that eliminate the pinch grip requirements (Hand-e-Holder).
  2. Reduce frequency of use – The iPad is not a device that you would want to use for hours.  The neck flexion and raised arms put you at a greater risk of injury than a desktop computer.  If you want to spend hours, you should be at a properly designed ergonomic workstation with a monitor, keyboard, mouse, and keyboard and mouse tray.  As a rule of thumb, try not to use the iPad any longer than 20 minutes without a break of at least 5 minutes or longer.
  3. Mix it up – Try not to use one finger or your thumbs continuously.  Use a mixture of hand positions and swipes to reduce repetitive motion.
  4. Task dependent – If you are using your iPad to read, place it higher so that your neck flexion is reduced.  If you are using many applications with lots of swiping and scrolling, place your iPad at a lower level to reduce awkward postures in hands and wrists.
  5. Change hands – Try alternating your hands, e.g. use your left hand to swipe and scroll, and your right hand to hold (don’t give up on this too easily– you will get better with practice!)
  6. Use both hands – Don’t hold and swipe/scroll with one hand.  This combines a myriad of ergonomic risk factors increasing the risk of injury considerably.
  7. Swipe, scroll or click? – Clicking is the best, followed by swiping, and scrolling last.  Scrolling has more awkward postures and more force is required.

The proper postures and movements, combined with regular rest breaks and non-continuous use, will allow you to have a great iPad experience with minimal repercussions from injury.