Laugh Now, Cry Later

If you don’t minimize risk factors that can lead to chronic musculoskeletal pain, you may laugh now; but you will be crying later if you end up wth a musculoskeletal disorder (MSD) that could have been prevented.

Ergonomic risk factors that can lead to musculoskeletal disorders and pain include:  Repetition, force, awkward postures, static postures, contact stress, motion of body segments (shear), compression and vibrations.

We reviewed medical studies dating back to the 1880’s implicating poor ergonomics in the development of musculoskeletal pain.

Pain that is believed to be caused by poor ergonomics could be caused by some other medical condition.  If you are experiencing pain, the earlier you seek treatment, the better.  Self-diagnosis can prove to be very dangerous.  The information on this web site is not a substitute for professional medical advise and should not be used for self-diagnosis.


Musculoskeletal disorders (MSDs) are also known as Cumulative Trauma Disorders (CTDs) which are also known as Repetitive Motion Disorders (RMDs).

Cumulative trauma disorders (CTDs) are injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibration, mechanical compression (pressing against hard surfaces), or sustained or awkward positions.

Cumulative trauma disorders (CTDs) are also called repetitive motion disorders (RMDs), overuse syndromes, regional musculoskeletal disorders, repetitive motion injuries, or repetitive strain injuries

“Carpal Tunnel Syndrome – a compression of the median nerve in the wrist that may be caused by swelling and irritation of tendons and tendon sheaths.
“Tendinitis – An inflammation (swelling) or irritation of a tendon. It develops when the tendon is repeatedly tensed from overuse or unaccustomed use of the hand, wrist, arm, or shoulder.
“Tenosynovitis – An inflammation (swelling) or irritation of a tendon sheath associated with extreme flexion and extension of the wrist.
“Low Back Disorders – These include pulled or strained muscles, ligaments, tendons, or ruptured disks. They may be caused by cumulative effects of faulty body mechanics, poor posture, and/or improper lifting techniques.
“Synovitis – An inflammation (swelling) or irritation of a synovial lining (joint lining).
“DeQuervain’s Disease – A type of synovitis that involves the base of the thumb.
“Bursitis – An inflammation (swelling) or irritation of the connective tissue surrounding a joint, usually of the shoulder.
“Epicondylitis – Elbow pain associated with extreme rotation of the forearm and bending of the wrist. The condition is also called tennis elbow or golfer’s elbow.
“Thoracic Outlet Syndrome – a compression of nerves and blood vessels between the first rib, clavicle (collar bone), and accompanying muscles as they leave the thorax (chest) and enter the shoulder.”
“Cervical Radiculopathy – A compression of the nerve roots in the neck.
“Ulnar Nerve Entrapment – A compression of the ulnar nerve in the wrist.”
PEOSH (1997) further states: “These disorders can also be aggravated by medical conditions such as diabetes, rheumatoid arthritis, gout, multiple myeloma, thyroid disorders, amyloid disease and pregnancy.”

Can they be Prevented?

“My wrists are starting to hurt.”  


Following is a list of symptoms of MSDs, CTDs, or RMDs, which may involve the back, shoulders, elbows, wrists, or fingers:

  • Numbness
  • Decreased Joint Motion
  • Swelling
  • Burning
  • Pain
  • Aching
  •  Redness
  • Weakness
  • Tingling
  • Clumsiness
  • Cracking or popping of joints


Careful positioning of the body while working with your device can reduce the likelihood of injury.


Ergonomics is important for stenographers
  •  Wrists should be in a neutral position, not flexed or dropped.
  •  Use the least amount of pressure when striking the keys.
  • Feet should rest on the ground or a foot rest to relieve pressure on the lower back.
  • Dangling legs add pressure to the thighs and could cut off blood flow to the legs.
  • The head should face forward in order to put the least demand on the neck and shoulders.
  • The forearm should not be raised too much to avoid neck and shoulder pain.
  •  Support the lower back and rest it by leaning back frequently and by supporting the arms.
  •  Ensure adequate clearance for thighs and feet by keeping areas under the desk clear and by using desks or tables that are high enough as free movement is important for supporting the back and for circulation in the legs
  • Do not stay in one working posture. Shift positions so no muscles are tensed in the same position for too long.
  • Stand up and take breaks from your device at least once every hour.


First blog post – ErgoNews

Following is an ErgoNews article I wrote on January 5, 2002:

A coalition of business groups and other employers sued the state of Washington over new ergonomic rules designed to protect workers from injury. (1)

“This is clearly a case of a state agency abusing its power and pushing through a rule based on political agendas,” said Tom McCabe, president of the Building Industry Association of Washington. (1)

“Musculoskeletal disorders are believed to be a major cause of time lost from work and long-term disability.  Payments for Workers’ Compensation claims for these disorders have risen rapidly.” (5)

“Because musculoskeletal pain is a major source of suffering, healthcare and utilization of compensation, there is a definite need for prevention.” (2)

“Research on risk factors indicates that although medical and workplace factors are obvious, psychosocial variables are central to the transition from acute to chronic pain.  The early identification of ‘at risk’ patients is a key to allocating resources and initiating secondary prevention.” (2)

“If only we could prevent disability due to chronic pain from occurring, tremendous suffering and monumental costs would be saved. . .Yet, while disability consumes huge amounts of resources, only a small fraction of the amount of these sums is available to prevent chronic pain problems.” (2)

State officials contend the regulations are long overdue and could prevent thousands of injuries per year.  The labor and industries department has no plans to rescind or revise the regulations, Director Gary Moore said.

One study done in April of 1969 by the Aerospace Medical Research Laboratory, Aerospace Medical Division, Air Force Systems Command, Wright-Patterson Air Force Base, Ohio, states:

“The body posture of sedentary workers, especially in offices, and of school children has long been a concern of orthopedists and physiologists.  The increasing number of office positions, of seated factory workers, of people sitting in cars and airplanes, even of seated soldiers, has augmented the concern about ‘unhealthful’ sitting postures.  Complaints about lower back pains are widespread among people who commonly work in the sitting position.  Medical treatment of ailments thought to be connected with the sitting posture, sick leave taken by employees, and reduced work output highlight some of the economic aspects.” (3)

Businesses in industries that report the highest number of injuries must take steps to lower the risks by buying new equipment, repositioning existing equipment, and providing training on how to avoid injury (OSHA).

Major employer groups say the rules will cost them $725 million a year.  The lawsuit also challenges the effectiveness of the ergonomic techniques spelled out in the rules.  (1)

The Occupational Safety & Health Administration expects its workable, practical approach to prevent an average of 460,000 injuries annually and to save businesses $9.1 billion annually because of reduced workplace injuries and greater productivity; with a $27,700 savings in direct costs for each MSD prevented . . .90 percent of American workers are covered by the new OSHA regulation. (4)

FYI:  Ergonomic regulations were passed during the Clinton Administration; but President Bush and Congress repealed them shortly thereafter.

Eugene Scalia, the Labor Department’s top lawyer, has called the regulations “quackery” and “junk science.”

According to  Richard Trumka, AFL-CIO secretary-treasurer:  “The most important question – how we can protect workers from these crippling injuries – is not even being asked.”

At a forum addressing workplace safety in July, 2001, Labor Secretary Chao stated: “We can choose to do one of two things starting today. . .We can play politics, or we can protect workers.  We can engage in sideshows, or we can pursue safety.”


  1. “Business Groups Sue Washington State, Say New Ergonomics Rules Place Burden on Employers,” written by Paul Queary.

  2. “Prevention of Disability Due to Chronic Musculoskeletal Pain,” written by Steven James Linton.

  3. “Ergonomics in the Design of Office Furniture,” written by E. H. Eberhard Kroemer, Dr. Ing., Joan C. Robinette, Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, Ohio.

  4. “Is there Light at the End of the Carpal Tunnel?” written by Ann W. DeVoe, Esq., CBA Report.

  5. American Journal of Industrial Medicine 19:87-107 (1991), “Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs:  A Meta-analysis,” written by Susan Stock, M.D.