Nichola Adams has a masters in health ergonomics, and through her company, Inspired Ergonomics, she's spent the past 14 years helping hundreds of firms in her home country, the UK, and also abroad, providing Workplace Assessments for over 3,000 employees.
In lockdown, Nichola's hosted countless group online workshops and one to one video consultations with clients and companies, advising them on how to manage their pain. She’s keenly aware that for many chronic pain sufferers, being forced to stay cooped up at home is even harder to cope with.
Nichola has had her own experiences of back pain, with sciatica flare ups for many years, a piriformis injury, giving her a window into how hard it is to struggle with limited mobility. She understands, that when a back is sensitive, small changes can make an enormous difference in our comfort levels.
How ergonomics helps to improve working lives
As a health ergonomist, specialising in back pain, I often get asked to provide expert ergonomic consultations for those struggling with work. An employer will ask me to assess what can be done to improve an employee’s comfort levels when working, particularly if that person is struggling with a musculoskeletal pain issue. As an ergonomist, it is my job to assess what the underlying issues are and then find the best solution that will improve their overall comfort and wellbeing, reducing pain and tension build up. There is always something that can be done to change the risk levels, no matter how big or small that change is.
I see people with a huge variety of conditions, from general postural pain, recovery from injury or surgery, to those struggling with more long term complex conditions such as strokes, slipped discs, fibromyalgia, scoliosis, ME, arthritis, RSI and recovery from cancer. Whilst these are hugely diverse in their symptoms and prognosis, the approach is the same – to find what is affecting their ability to work to their best ability and address it in the best way that we can. Our rehabilitation process includes correcting working postures (to offload tension in the body), providing movement advise (to keep muscles and tissues healthy) or sign posting on to other key specialists (such as a physiotherapist or nutritionist). It is often difficult to find the true cause of back pain with many struggling for years. We aim to address all the potential contributing risk factors, to try and stop the cycle of pain.
Work from home boom, removing barriers to homeworking.
Many are now working from home for first time, with their normal lifestyles being limited, often exercising less and experiencing pain and discomfort for the first time. Never has wellbeing had a bigger focus, with the need to educate people on how to eat and live well to optimise their health. Thankfully, all the research is now showing that people can be just as productive working from home. The advantage of this is that it should hopefully open up employer’s eyes to possibilities of employing those less able to travel. People now realise that meetings no longer need to be face to face with online meetings saving travel costs and time (and the planet).
Working with Chronic Pain Tips
For those living with chronic pain, the worry of being able to work and the affect on their everyday lives is immense. Back pain and other chronic pain conditions are affected by stress and vice versa, so do take advantage of the ability to work from home and to practise self care following the tips below:
How to reduce your pain levels when working at the computer
Take a moment to set up your workstation properly. The essential messages of this are:
Raising your laptop to eye level height and using a separate keyboard and mouse
Doing this can make a world of difference in reducing shoulder, neck, lower back pain and headaches. This is because, if we use the laptop flat on the surface, the screen is too low so we start to slouch or bend our neck down to read it. Over time, this causes pressure build up in our back, neck and shoulders and can even cause headaches. So just raising it up to eye level height instantly encourages you to sit up to reduce this pressure. Of course, then you need to use a separate keyboard and mouse so you don’t have to reach up to use the one on the laptop. A simple and economical way to make a huge difference to your comfort levels. If you are using monitor screens, also ensure these are at eye level height. You can use books or boxes or special risers to raise laptops and monitor screens, but I personally use the Nexstand laptop stand as it is allows you to raise the laptop higher than most risers, so it really can be at eye level height.
Always sit with your arms level with the top of the table
If you are sitting with your elbows below the table, you will either have to hunch your shoulders up or flick up your wrists to use the keyboard. Just sitting at the right height will reduce shoulder and wrist tension build up. If you don’t have a height adjustable chair, just use an extra cushion or two to raise yourself up.
Try using dictation software
If you are struggling to type, either because of pain in the wrists and arms, or lack of strength, Dictation software is extraordinarily helpful.There are actually many dictation apps available on your phone or computer or try Dragon, the tried and tested dictation software.
If you are experiencing pain in the wrist, try a vertical mouse which changes the position of the hand into a hand shake one, reducing tension build up in the wrist by ensuring it stays in a neutral position.
Lastly, always support your lower back curve, where-ever you are sitting.
This will help to encourage an upright, healthy S shape in your spine and relieve sensitivity in the area. If you are using a chair without an adjustable lumbar support, I would always recommend inflatable lumbar supports that strap on to your chair, as these allow you to adjust the depth of support to your own lower back curve – it should feel gently supportive but not push you forward.
The brain actually has a far bigger say in our bodies ability to heal than you might at first think. It is really important, when recovering, that we try and reduce danger signals to the brain. A big part of that is trying to reduce your stress levels. Simple breathing techniques to slow your breath are highly effective in reducing cortisol levels, you only need to do 5 deep breaths at a time to benefit (it is amazing how we can forget to breath properly when we are stressed). Try and stay proactive in your healing process.
Our bodies love moment, our tissues and muscles all need oxygen and nutrients to stay healthy, which flows more easily when we move. However, with chronic conditions it’s all about pacing and being kind to yourself. I realised the power of the 10 minute walk when recovering from surgery recently. So try and do steady amounts of exercise daily and know that, in fact, 3 lots of 10 minutes of exercise are just as good as 1 stretch of 30 minutes. Try and get out for a walk outside in the morning, and getting outside before 11 am helps to set the circadian rhythms and normalise our sleeping patterns. It also ensures that we don’t forget to get out as we become busy during the day, and gets all the nutrients starting to flow through your body after a long period of lying down.
In light of this, a new rehabilitiation programme for chronic pain sufferers is being implemented. Escape pain an evidence based group rehab programme for people with chronic pain specifically back, knee and hip. Designed to increase physical function and quality of life it integrates education, self management, coping strategies and personalised exercise program. For more information visit Escape-pain.org. This strategy is also supported by NICE. In their latest guidance, anti-depressants now being found to be more effective than opioids.
Breaks from work
It is essential to take regular breaks from work, and from sitting, throughout the day, for both body and mind. Research has shown that, if we can work interrupted for 90 minutes we should then take a 20 minute break to reset our minds. Work will feel less intense and stressful and should help maintain focus throughout the day. You should also aim to stand and move around at least every hour, even if it is only for a minute or two, to keep our backs and bodies healthy.