Question
What are some ergonomic interventions for pain?
Answer
Most ergonomic interventions have been focused on computer-based interaction. This is probably why we see so much evidence around these kinds of interventions. Something that is interesting about the management of chronic lower back pain is that there is a difference in behavior or the way that we interact with the environment. While the built environment is very important, the other really important aspect is behavior within the built environment. These two things cannot really be thought of a separate. Many times in traditional ergonomic interventions, there is a very clear focus on the environment instead of the interaction between the environment and the behavior. For example, certain conditions within a typical computer workstation result in people experiencing more pain. The most typical variable is the height of the chair. If you are sitting in a chair that can raise and lower, this is one of the factors that you adjust to make it more or less comfortable. The height and position of the armrests and the position of the backrest also can contribute to pain.
We know that ergonomic intervention results in decreased pain and in the number of sick days. Anytime that I see those two things, I also wish that there was some sort of measure of the quality of life as this is an important factor. If you start to look at things like numbers and worker's compensation claims, ergonomic interventions are part of workplace wellness offerings. Based on the numbers, they have a return on investment that is estimated anywhere from $2 for every $1 spent up to $10. These numbers depend on what particular type of intervention is put into place.
There are many ergonomic interventions that are available. And often, there are some behavioral components that we can layer in without changing anything. One example is getting people moving more frequently. I like to recommend movement every 30 minutes or so. At first, that seems surprising to people. Cueing devices such as timers, alarms, and things can be set up on mobile devices or a computer to get that periodic movement going. I also like to teach people a handful of stretches to break up any of that muscle tension that builds up throughout the course of the day.
Education is also important. Teach people about their bodies and to start to pay attention to those internal cues and things within the physical environment itself. I already spoke a little bit about behavior. Much like smoking cessation, they have studied the intersections between stages of change and ergonomics. People have different levels of readiness to adopt changes to their behavior. By paying attention to where someone is at and being responsive to that in the delivery of our intervention, we can help to move them along in order to introduce some of these changes like periodic movement and stretching. This also emphasizes why ergonomics should not be performed in a one-and-done sort of situation. It should be something where there are touchpoints throughout the course of time so that as people become ready to make changes, they have the necessary supports.
We also know that if people know the potential outcomes of not making changes, they are more likely to make those behavioral changes that are necessary. This is where that educational component really uplifts the whole process. You can teach people about repetitive stress injuries and what might look like down the line. I love being able to do workshops for groups of workers because that allows for reinforcement. It also gives a little bit of time for people to think about what it might look like five years from now if they do not make changes to their positions like making contact with their backrests for adequate back support and things along those lines.