Exercise better for upper body pain than ergonomics?
Little proof that ergonomic equipment helps
Many conservative methods used to treat work-related complaints of the upper body have only limited effectiveness, according to an updated systematic review by researchers in the Netherlands. There's more proof in the literature that exercise is beneficial than there are studies showing that ergonomic equipment helps, particularly for hospital and industrial workers, the review shows.
Despite little scientific evidence supporting the use of special keyboards and other ergonomic equipment, "conservative interventions such as physiotherapy and ergonomic adjustments play a major role in the treatment of most work-related complaints of the arm, neck or shoulder," says Arianne Verhagen, PhD, a physical therapist and epidemiologist at the Erasmus University Medical Center in Rotterdam and lead author of the study.
Verhagen updated a review published in 2003 that included 15 trials. She added six new trials, for a total of 2,110 adult participants. Most were industrial workers or hospital staff members who suffered with chronic complaints varying between three and 12 months. Workers with inflammatory or neurological diseases were not included.
The randomized and nonrandomized controlled trials evaluated more than 25 conservative interventions including exercises, relaxation, ultrasound, biofeedback, myofeedback, and workplace adjustments.
Verhagen says she was not surprised that exercise appeared to be most helpful to people suffering from chronic complaints of the arm, neck or shoulder.
Orthopedic surgeon Nicholas A. DiNubile, MD, a clinical assistant professor at the University of Pennsylvania, agrees that there is limited scientific proof that conservative interventions are effective for these injuries.
"It's not that they are not effective, though," he adds. "There is an important difference."
An orthopedic consultant for professional athletes and dancers, DiNubile says he is a great believer in physiotherapy interventions, such as exercise and stretching, as well as ergonomic workplace adjustments and taking breaks.
Verhagen says she does not believe that workers with chronic pain would report that a particular intervention was not effective if, in fact, it worked, adding, "I think normally, people would like to go back to work."
She says that with a rapidly increasing incidence in work-related disorders, the need "to determine whether these interventions have a significant impact on short-term and long-term outcomes" becomes more important.
In particular, she observes, research is needed on the effectiveness of ergonomic adjustments in the workplace, with studies looking at placement of chairs, computer monitors, and computer mice, and whether ergonomic keyboards are effective. Thus far, her review found, there have been very few studies in this area, but employers and individuals are investing heavily in making ergonomically correct changes in their workplaces.
"We have ongoing workplace adjustments in the Netherlands, for example, that are very expensive," she says. "Most of these have not been evaluated regarding their effect. The costs associated with these disorders are high — more than $2 billion of direct and indirect costs estimated annually in the United States alone."
The report by Verhagen's group is found in the Cochrane Database of Systematic Reviews.
Many conservative methods used to treat work-related complaints of the upper body have only limited effectiveness, according to an updated systematic review by researchers in the Netherlands.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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