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Working From Home Is Taking Its Toll On Our Bodies: Dealing With Backaches And Sprains

As convenient as it is to “get to work” these days (roll out of bed, switch on your laptop and voila!), at this point in our pandemic-stricken work lives, many would undoubtedly be experiencing other painful issues.

Using a low coffee table as your desk, typing on the laptop in bed, sharing your child’s crowded study desk to keep an eye on his home-based learning while you reply emails … those are some of the positions we find ourselves in nowadays.   Dr Koh Kim Hwee, the clinical lead for SingHealth Polyclinics’ Musculoskeletal Workgroup, shared that Singhealth Polyclinics across the island see over 1,000 patients with backaches or sprains every month. “Such injuries may be common in workers with deskbound jobs due to fixated working postures, prolonged sitting position and repetitive work.”

Senior principal physiotherapist John Abraham from Rapid Physiocare has also noticed a similar trend. “There has been a significant increase in the number of WFH injuries since the start of the circuit breaker period,” he said, adding that he has noticed that the number of such patients “has been far more than the normal average I used to treat”. Poor ergonomics aside, telecommuting has also presented another problem: An even more sedentary lifestyle. While you used to have to walk from the MRT station to your office building – or make those trips to the pantry and washroom – you now take much fewer steps. And it’s not good for you.

“Sitting is the new smoking,” said Dr Koh. “Prolonged sitting is considered sedentary and sedentary behaviours are associated with the increased risks of diabetes and cardiovascular diseases.”

WORKING FROM A LOW COFFEE TABLE OR BED The good news is, creating a more conducive workstation doesn’t require expensive keyboard stands or lumbar-support chairs. For starters, ensure that your desk is large enough to comfortably accommodate your equipment and stationeries, said Dr Koh.

“Frequently used items should be arranged accessibly around the workstation to minimise awkward overstretching.”

When using the computer, your head and neck should be relaxed, and chin held parallel to the floor, he said. That is easier to accomplish if you’re working on your dining table. But what if you have to work off a low surface such as a coffee table while seated on the edge of the sofa, or even the bed while sitting on the floor?

“Consider sitting on the floor with the back against a supported surface such as the sofa. Depending on the height and design of the coffee table, a low stool or chair may also be used,” suggested Dr Koh.

If the surface is too low, use a stack of books to raise the height of your monitor so that it reaches your eye level, said Abraham. “By doing so, you won’t have to look down and thus, eliminate neck pain.”

He also recommended using a small pillow or rolling up a small towel to use as support for your back. “This will reduce stress and friction on bones and muscles while sitting.”

Sitting is the new smoking. Prolonged sitting is considered sedentary and sedentary behaviours are associated with the increased risks of diabetes and cardiovascular diseases.

However, Changi General Hospital’s principal physiotherapist Elsa Leung said it is best not to use a low surface. “If there is no other alternative, a regular change in posture and doing simple stretches periodically are recommended to help to reduce tightness and stiffness of the user’s muscles and joints.”

As for working in bed, sitting up against the headboard isn’t ideal either as it is difficult to achieve proper back support, said Dr Koh. “The screen may not be able to adjust to your eye level. In addition, the lighting in the bedroom may be too dim, which would further strain your eyes.” If you absolutely have no other option, Dr Koh said to keep your working duration in bed as short as possible. “Add a small pillow to provide lumbar support. Positioning the laptop to the eye level is encouraged, if possible.”

DO THOSE STANDING DESKS REALLY HELP? You may have heard of standing desks and wonder if they are truly better for your posture. “When you sit, the pressure on your lower back increases, thus increasing your risks for severe back pain. However, the risk for this condition is greatly reduced when working with standing desks,” said Abraham. Standing is also a good way to reduce sedentary behaviour, said Dr Koh.

And this will certainly clinch the deal for many: “For every minute you stand, you will burn 0.15 calories. That means standing reduces obesity,” said Abraham. However, these desks aren’t without their caveats. “Prolonged standing may be associated with health issues including venous insufficiency, as well as back and lower limb discomfort,” said Dr Koh. “It is always better to have both sitting and standing options for the purpose of movement, and to prevent an extensive long period of a stationary position.”

Even if you don’t have a standing desk, you should make it a point to get up, stretch and walk around for a few minutes every hour, said Leung. “Ultimately, it is important to avoid holding any posture for many hours at a stretch as this will increase muscle tension, discomfort and fatigue,” she said. HOW TO TWEAK YOUR HOME SETUP Here’s a look at the other aspects of your desk setup and what you can adjust to make WFH more comfortable.

Laptop position The best way to set up your laptop is on a table – and not balanced on your lap. “As laptops are generally smaller, the monitor tends to be too low, causing the user to look down,” said Leung, who added that the monitor should be at or slightly below eye level. Abraham suggested raising your laptop by 5 to 10 inches (13cm to 25cm) with paper reams or laptop raisers to achieve the proper height. What about those pull-out laptop trays that some desks have? They are generally not recommended as they do not allow adequate thigh clearance, said Leung.

Monitor If you’re using an external monitor or have two freestanding monitors at home, make sure they are of the same size and height, said Abraham. And place the monitors directly in front of you to avoid vision and neck problems, said Dr Koh. “One should position the monitor at least an arm’s length away (about 45cm to 70cm) at eye level.” “If you use dual monitors, angle them in a slight outward V shape directly in front of you,” said Abraham. “If one of the monitors is used as the primary monitor, let it be positioned directly in your front and place the secondary monitor to the left or right at about a 30-degree angle to the primary monitor.”

Keyboard and mouse Leung suggested using a separate keyboard and mouse when using a laptop – preferably a low-profile keyboard not more than 3cm high and with an incline angle of less than 15 degrees to maintain your wrists’ neutral position. As for your mouse, Dr Koh said it should fit your palm and be kept close to the keyboard. When it comes to your keyboard’s position, “there should be some space between the table’s edge and keyboard for wrist support”, said Dr Koh.

Leung added: “The keyboard should be placed at about elbow height. When typing, the elbows should be maintained at a 90-degree-to-120-degree bend with the forearms resting on the table or armrest. The elbows should also be kept close to the body”.

Wrist support

What about those gel-filled wrist pads versus the wrist rests found on the armrests of some chairs? Which is a better bet?

Wrist rests help to prevent tension in the neck and shoulders, said Abraham, but when used for long, they can put a lot of pressure on the undersides of the wrists that may lead to carpal tunnel syndrome. “It's much better to use gel pads rather than wrist rests,” he said.


Are regular chairs such as your dining chairs adequate for your WFH needs? Here’s where the experts deviate in their opinions. Abraham said that a regular chair may cause incorrect posture and increase the risk of neck problems and back pain.  On the other hand, Leung felt that regular chairs are adequate as long as your posture is maintained in a neutral spine position. If you’re on the lookout for an ergonomic chair, Abraham said to keep these in mind: Adjustability, ease of rolling, durability and your budget. If you don’t wish to splurge, Dr Koh suggested getting a cushion or lumbar support for your regular chair. “The support should not overly accentuate the inward curve, nor should your back feel unsupported. Sometimes, a simple rolled up towel or small pillow can also be used.”

But no matter what chair you use, it should be stable and adjustable (a five-castor swivel version is preferred) so that your knees and hips are kept at 90 degrees, said Dr Koh. Use one with armrests, a backrest, and enough height for your feet to lay flat on the floor or be supported by a footrest to reduce pressure on the thighs, he said.


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