If you are one of the many people who spend their working day desk bound, you may be at risk from repetitive strain injury. Here’s how to identify and prevent this common problem

Having a desk job may not seem hazardous, but it comes with its risks. Sitting in a fixed position while making small repetitive movements for eight hours a day or more can cause muscle fatigue, discomfort and aches and pains in the arms, neck and back – a condition commonly known as repetitive strain injury (RSI).

However, according to a report in the British Medical Journal, the term RSI is misleading because it’s not just repetitive movements that put us at risk of developing these aches and pains. Factors such as posture, stress and bad working habits also play a big part. Experts prefer to call it ‘work-related, upper-limb disorder.’

‘RSI is an umbrella term given to 20 or more conditions affecting muscles, tendons and nerves,’ says Andrew Chadwick, director of the RSI Association. ‘It usually affects the upper limbs and neck but can affect any part of the body,’ he says. It starts off as aches and pains that go away when you stop working. After a while, if you don’t do anything to correct your working habits, the aches and pains may only go away at weekends. If you carry on, you may get to the point where the symptoms only disappear when you’re on holiday – and get worse when you return. Chadwick re-iterates that RSI says more about how you got your pains rather than the pain itself. ‘It’s not a diagnosis,’ he says.

For details on RSI treatment options, visit The Repetitive Strain Injury Association.

As ever, the best treatment is prevention. ‘Anything that encourages you to adopt the most relaxed posture when you’re working can help prevent RSI,’ says Chadwick. You can minimise your chances of developing aches and pains by setting up your workstation in a way that encourages better posture. You should also take frequent breaks and adopt a posture-promoting and stress-busting exercises such as yoga or the Alexander Technique.

Seating
Getting the right chair is the most important thing you can do in the battle against RSI. Poor seats can encourage or even force you into poor posture. By law, office chairs should have five legs in a star shape, be adjustable in height and have a seat back that is adjustable in height and tilt. 'Your seat should be angled slightly forward so that your thighs tilt downwards and your feet are flat on the floor. If they don't reach, you'll need a footrest,' says Glenn Bilby, a physiotherapist from ergonomic store Back2. Your legs should therefore be at an angle of approximately 95 degrees to your body, while your back should stay in its natural S-shape (see below), making a good lumbar support useful in preventing slumping into an unhealthy C-shape.

BackCare, the National Organisation for Healthy Backs based in Teddington, Middlesex, recommend good lumbar support to help keep the spine's natural S-shape. If your chair hasn't got one, use a cushion or a small rolled up towel instead. Better still, invest in an ergonomic chair, available from Back2 (020 7935 0351). Prices range from £140 to £1600. For more information, visit the Campaign for Better Seating's website at www.betterseating.org

Monitor
'Because your body tends to follow your eyes, a monitor that is too low will encourage bad posture,' says Bilby. 'Your eyes should be level with the top of your display screen. If it's not, prop your monitor up with some yellow pages if necessary.' He adds that 'if the screen is too close, you may get eye fatigue, visual disturbances and headaches.' He recommends keeping your screen an arm's length away.

Keyboard
Your computer screen and keyboard should be directly in front of you so you don’t need to twist or turn to reach them. ‘Rest your fingertips on the middle row of keys and tap the keys lightly,’ says Bilby. Keep your forearms parallel to the desktop, your wrists straight and your elbows at right angles. A friction-free wrist rest (around £20 from Back2) will also help keep your forearms in a horizontal position and allow your hands to glide across the keyboard, putting less strain on your wrists. If you want to give your hands a complete break, Chadwick recommends you try some voice recognition software, allowing you to dictate to your computer which transcribes the words into text on your computer.

Mouse
Researchers at San Francisco State University found that reducing the arm extension for your mouse can minimise muscle tension in the wrist. It is also important as reaching out puts twice as much stress on your neck, arm and shoulder muscles as using a trackball. Try to keep your mouse within easy reach so you don’t overstretch your shoulder, arm or fingers to use it. A wrist-rest for your mouse will help keep your forearm horizontal and costs £19.50 from Back2. To keep the mouse within easy reach, it is best to place it in front, beside or in between your keyboard – where you put it will depend on what kind of keyboard you have (i.e. a smaller one without the number pad on the right hand side or a split keyboard with two halves.) Laptops which have a built-in mouse pad, are a good option as well.

Other tips for preventing strain include moving your whole arm when you move your mouse and not just your hand. Also, Chadwick suggests using shortcut keys to reduce the use of your mouse. For example, press Ctrl and P to print, or Ctrl and N for new document.

Phone
Physiotherapists recommend a headset if you use the telephone for more than two hours a day, as wedging the phone between your ear and shoulder can increase your risk of developing back and neck problems. Headsets help you keep your head in line with your spine and reduce muscle tension. They cost from £80 upwards at Back2. In the meantime, change your phone from ear to ear during long calls.

Take a break
'If you've got a static posture, you're not keeping the blood flowing so tendons inflame and seize up,' says Chadwick. 'When people ask me what posture is best for working, I say - the next one.' So even if your office is set up perfectly, it's still important to take regular breaks. Ideally, you should try to arrange your work so you achieve a mix of sitting still and moving around. You should also take 'micro breaks' - that is, stop working for a second every minute and drop your shoulders to let go of tension.

Exercise
Any type of exercise that improves your posture will minimise the chances of developing RSI. The Alexander Technique teaches you exercises specifically designed to undo all your bad postural habits that you've developed over the years. For details of your nearest teachers, see the website for the Society of Teachers of the Alexander Technique at www.stat.org.uk. Other posture promoting exercises such as yoga and Pilates can also help.

Stimulate blood flow
By correcting bad posture, you're simply helping blood flow more easily through the body, supplying nutrients to the muscles and tendons. Anything that improves circulation, such as regular exercise and staying hydrated, will help prevent problems. As Chadwick explains, 'Dehydration makes blood more difficult to flow, so drink at least eight glasses a day.' She adds, 'Minimise things that restrict blood flow such as smoking, excess caffeine, excess alcohol and stress.'

While not everyone who spends all day at a desk is prone to RSI, it can be triggered unexpectedly. 'Some people type all day and get no problems,' says Chadwick, 'but there are many potential straws that can break the camel's back - such as a colleague going on holiday or a new boss who's an ogre.' At the end of the day, most people don't need to be convinced that taking a break is a good thing.

Contacts:

1. RSI Association. Visit their website at www.rsi.org.uk or call their helpline on 0800 018 5012.
2. For a copy of a leaflet with recommended stretches, send an A5 s.a.e. marked 'Fit to Work' to Communications, Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED.
3. BackCare, 16 Elmtree Road, Teddington, Middlesex, TW11 8ST. Tel 020 8977 5474 or visit their website at www.backpain.org.
4. Back2, 28 Wigmore Street, London W1U 2RN. Tel 020 7935 0351 or visit their website at www.back2.co.uk