Editor's note: This popular story from the Daily Briefing's archives was republished on Jan. 19, 2021.
As the coronavirus epidemic forces millions of Americans to work from home, health care providers are reporting a surge of patients seeking help for injuries linked to unexpectedly long-term, makeshift workspaces.
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According to the New York Times, the American Chiropractic Association in April conducted a Facebook survey that found 92% of the 213 chiropractors who responded said their patients were reporting more back pain, neck pain, or other musculoskeletal issues since states across the country began implementing stay-at-home orders amid the epidemic.
Chiropractors say the spike in injuries is the result of millions of Americans swapping their ergonomic office spaces with less comfortable kitchen counters, beds, and sofas as they started to work from home in March.
According to the Times, these patients have a similar pattern of behavior: When first required to work from home, they thought the shift was temporary, so they weren't concerned about hunching over a laptop in their kitchens, beds, or sofas. However, as that short-term expectation morphed into long-term—and occasionally permanent—work-from-home conditions, the mild discomfort associated with a few weeks of being hunched over laptops and sitting in slouched, hunched positions has turned into sharper pain.
A significant part of the problem, according to Nikki Weiner, an ergonomics consultant, is that because people use their kitchen stools or sofas as desk chairs, they cannot sit in what she called the "neutral position"—with their arms at their sides, forearms parallel to the ground, feet on the floor, hips slightly higher than their knees, and necks straights—to avoid straining their bodies.
Karen Erickson, a New York-based chiropractor, added that laptops also are a big issue, because they force people to look down at their screens, putting them in a "forward head position." That position causes muscle imbalance in the neck and places pressure on a person's discs and joints of the spine, Erickson explained.
Over time, these positions can turn into "overuse injur[ies]," according to Michael Fredericson, a professor of orthopedic surgery at Stanford University. "It's kind of like when a tire blows out on you. It wasn't necessarily one incident; the tread was wearing down over time," Fredericson said.
In addition, chiropractors say people are experiencing more pain and injuries because they're moving less as they work from home. They no longer need to commute to their offices, walk across the hall for a meeting, or cross the street to grab coffee.
"The body needs movement," Heidi Henson, an Oregon-based chiropractor, explained. "Even if you have perfect, perfect ergonomics, if you're in the same position for too long, your body is not going to respond well."
And while these issues aren't new problems—as people have long experienced pain linked to how they position themselves around screens—Erickson said the dramatic increase in the amount of screen time people are logging amid the coronavirus epidemic has made the problems far more common.
Put another way, Scott Bautch, president of the American Chiropractic Association's Council on Occupational Health, said the increase in screen time means Americans are at a higher risk of "Text Neck" and "Selfie Elbow."
Chiropractors aren't the only health care providers seeing a spike in injuries, the Times reports. Dentists are noticing an increase in cracked teeth.
For instance, Tammy Chen, a prosthodontist and the owner of Central Park Dental Aesthetics, in a Times opinion piece wrote that she's seen more patients with tooth fractures in the past six months than she has in the past six years.
According to Chen, this increase is driven largely by stress. "From Covid-induced nightmares to 'doomsurfing' to 'coronaphobia,' it's no secret that pandemic-related anxiety is affecting our collective mental health. That stress, in turn, leads to clenching and grinding, which can damage the teeth," she writes.
But there are other factors at play as well, including the poor ergonomics driving increases in injuries among chiropractic patients. As people spend hours hunched over, their poor posture during the day may be resulting in teeth grinding at night, Chen writes. In addition, "[b]ecause of the stress of [the new] coronavirus, the body stays in a battle-ready state of arousal," Chen writes, which means that "instead of resting and recharging" while we sleep, "[a]ll that tension goes straight to the teeth"—and leads to grinding.
But there are "simple and cheap" steps people can take to help avoid these telework-related injuries, the Times reports.
For example, Chen writes that people who expect to work from home for the foreseeable future should "set up a proper work station." Specifically, "when seated, your shoulders should be over your hips, and your ears should be over your shoulders," Chen writes. "Computer screens should be at eye level; prop up your monitor or laptop on a box or a stack of books if you don't have an adjustable chair or desk."
In addition to propping up laptops on stacks of books to make the screens eye level, experts recommend that people use a footstool to allow their feet to rest on the floor if their chairs are too high or add pillows to their seat if a chair is too low, and that they buy an external keyboard and mouse so they don't have to hunch over their laptops.
Experts also say people can reduce their risk of injuries by taking more breaks and moving more.
For instance, Bautch recommends people set up a timer for every 15 to 30 minutes to remind them to move. He also suggests that people take three different types of breaks during their workdays: frequent "microbreaks," in which you take five seconds to put your body in the opposite position it's usually in (i.e.: if you're looking down at your screen, look up at the ceiling for a few moments); "macro breaks," during which you take three to five minutes to breathe deeply and stretch your shoulders; and a "big workout" break, which involves at least 30 minutes of exercise.
"It doesn't always take that much," said Fredericson. "It's really the simple things. Get out. Take a walk" (Chen, New York Times, 9/8; Wilser, New York Times, 9/4).
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