With BBC’s Panorama this week pointing to the supposed dangers
of wi-fi technology, back experts are pointing to a much more immediate
danger from laptop computers. They say that they are creating a nation of
slouch potatoes.
While most British scientists believe that the risk of harm from wireless
technology is theoretical, the risk laptops pose to our backs, shoulders and
necks as we lean over them on the train, at home and at work is very real.
Because they encourage bad posture, they’re causing an epidemic of
musculoskeletal problems.
It’s all being driven by plummeting laptop prices and the increasing
availability of wireless technology. Sales of portable computers increased
by more than 25 per cent last year and they already outstrip desktop
computer sales, according to PC World.
Michael Durtnall, a leading chiropractor, is one of a growing band of
back-care specialists who say that something has to be done before children
and young adults do irretrievable damage to their joints. He estimates that
about 80 per cent of the patients at his three London clinics – mainly
students, office workers and City types – have chronic nerve pain as a
result of poor posture induced by working on a laptop. A recent British
Chiropractic Association survey indicated that 50 per cent of 16 to
24-year-olds were suffering from back pain, compared with 18 per cent three
years ago. Durtnall believes the simultaneous rise of the laptop is no
coincidence.
“Mothers bring in their 12-year-old daughters suffering back pain and when
they arrive I can see their slumped posture straight away. I also see many
people in their twenties and thirties with early dowager’s hump, a rounding
at the base of the neck after only a few years of looking down at a small
screen while sitting slumped on a chair for long periods,” he says.
Rishi Loatey, a chiropractor from Wembley, North London, says he is seeing
more patients whose back and neck pain arises from the use of laptops at
home, and in cars and trains, as well as being stuck in front of a screen at
work.
It’s not only chiropractors who are worried. Nicola Hunter, a physiotherapist
and occupational health expert, is concerned by the RSI-type hand and arm
pain that is easily induced by resting your wrists against the edge of a
laptop for long periods. “There’s evidence that it stops the nerves and
tendons moving as they normally would, and this can cause nerve injury,” she
says. “In my clinic I’ve seen many people with persistent pins and needles
in their hands as a result of laptop use.”
The problem is largely unacknowledged by statutory bodies or in research
because it has arisen so quickly. The Health and Safety Executive (HSE) last
issued guidance on computer use in 2003, when laptop concerns were dealt
with briefly. The HSE published in 2000 one of the few research studies on
the safety of laptop computers, which pointed out that the main problem with
laptops is one of ergonomics: the lack of physical distance between screen
and keyboard means that neither can be positioned comfortably. The HSE
pointed out that research suggested that this gave rise to “pronounced head
tilt and neck flexion” among users, recommending that manufacturers provide
a means of separating screen from keyboard.
But the basic design of laptops has remained unchanged, and studies into the
effects of prolonged laptop use are scarce. There have, however, been
isolated studies. A survey of computer users in the journal Applied
Ergonomics this month indicated that laptop keyboards are more
uncomfortable to use and more likely to induce a strained arm position. And
a paper this week in The Lancet medical journal called for a better
understanding of repetitive strain injury, commonly caused by bad computer
posture.
Dr Keith Palmer, from the Medical Research Council Environmental Epidemiology
Unit, says: “You’ll find that laptops often don’t comply with the work
regulations for desktop computers. It seems a bit of an omission. There are
obvious theoretical reasons why using a laptop might be more problematic,
such as working in a cramped position.” Durtnall believes that he knows
exactly what’s happening; he has seen it in the dozens of X-rays he’s taken
of the necks of regular laptop users. “You can see the signs of joint
degeneration,” he says. “The facet joints between the vertebrae become
clamped together. Because your neck is tensed and held still in an awkward
position for such long periods, you don’t get enough lubricating fluid
between the joints, and the result is that you get deposits of calcium,
which form new bone.”
So what’s to be done? The HSE says it has no plans to examine laptop use and
the postural effects in more depth. According to Matthew Birtles, a senior
ergonomist at the HSE’s scientific agency, the most important thing is to
follow the current advice for all computers: take regular breaks and get up
and stretch.
“I’d say that with a laptop your breaks should be more frequent than a desktop
computer, say a minute every quarter of an hour,” he says. “There are
obvious risks about laptops not being set up correctly, and it does have to
be about self-regulation.”
Laptop do’s and don’ts
If you’re using the laptop at a desk, use a docking station, which lets you
link your machine to an external screen and keyboard. If you can, use an
external mouse with your laptop. This means that arms and shoulders will be
less tense. Buy an external keyboard. This means that you can raise your
laptop screen to the right level (your head should be slightly inclined
down) and type comfortably. Buy a portable laptop stand, which allows you
to raise your screen to a higher level when working on an external keyboard.
Your eyes should roughly be at the same level as the top of the screen.
One or two laptops do have height adjustments for their screens. If you’re
buying a laptop, ask about all the options. A lighter laptop will put less
pressure on your legs, and a well-spaced keyboard (without numeric pad) may
free your arms more. Online Ergonomics produces a range of goods that will
help you to use your laptop more safely. Visit www. online-ergonomics.co.uk.
‘I was always looking down’ Jennifer Malcolm, 32, is a
press officer and newsletter writer
While working for an environmental charity, Malcolm was at a keyboard all day
and worked on a laptop at home in the evening. Then, after a few weeks of
working hard to meet a deadline, her hand and wrist seized up.
“It was very sudden,” she says. “My hand had felt a bit twingey for a week
before, but then it just became an immobile claw. It was a bit of a joke in
the office at first, but in the end I had to take six weeks off. I saw a
chiropractor and a physiotherapist and, with their treatment, it improved.
But I’ve had to be careful ever since and I still see a chiropractor to make
sure that I keep mobile.”
She’s convinced that it was using the laptop at home that had precipitated the
trouble and had also caused the growing pains she had in her shoulders and
neck, which her physiotherapist also treated. “I think the biggest problem
was my posture. I was permanently looking down at the screen and I realise
that I should have my head up more.
“Now I try not to use the laptop so much, the mouse is fiddly, and your hands
are so close together. It’s inevitable that you become tense and hunched up.”
Speaking from the age of over sixty and having been typing for forty years I must say the back problem issue is more to do with how we set up our laptop working position rather than an intractable laptop typing problem.
Using a stand or spacers to lift the back of the laptop two or even three inches makes a world of difference to posture. Also buy a laptop with minimal distance between keyboard and front edge.
That the screen is connected directly to the keyboard is very good for minimum eye movement when typing. Very similar really to old fashioned typewriters where the paper came out directly above the keyboard.
From my own experience of posture height, looking down slightly, as we have been doing for centuries looking down to read on a desk, is far better than looking up, or looking directly ahead. Damage is as far as I can tell from fixedly locking into one position for too long periods. Start the day with physical exercise and that will make a world of difference.
Jeff Williams
Poole
Jeff Williams, Poole, England
As an Alexander Teacher, I see many people with back and neck problems exacerbated or set off by using laptops badly. And it's especially shocking when it's a teenager or student. It is often not realised that the postural habits adopted when using a laptop are frequently carried into other activities so that slouching (compressing and overextending the spine) becomes a way of sitting generally.
Catharine Gunningham, London, UK
"Michael Durtnall, a leading chiropractor,"
I almost stopped reading at this point. Cite a controlled experiment or two, and talk to some real doctors if you want to convince me of anything.
Back pain is quite poorly understood, given that most treatments do a horrible job at treating the condition, I am hardly convinced anyone knows for sure laptops are an issue.
Jesse, Ithaca,
As a management consultant who uses only a laptop and can touch type well, it is looking at the screen downwards that is the problem - not looking at the keyboard. I have ordered a stand and keyboard now, and hope this will be the cure of my mystery neck pains.
Kirsty, Beyton, UK
It seems to be a fundamental omission from Simon Crompton's article that he gives no consideration to the inability of many computer users to touch type. The "wrong" posture shown in the photograph is a good illustration of someone who has to look at the keyboard to see where to place their fingers. The constant up and down movement of a weighty head balanced on an incorrectly aligned spine must surely be a major contribution to the epidemic of back and shoulder pain. Touch typing is a key skill that all school children should be taught if we are to avoid the problems highlighted in the article. Not only is it better for the body but it produces faster and much more accurate work, reducing both physical and mental stress. Employers are avoiding their health and safety obligations by employing staff who are expected to use computers for many hours a day and who do not have the skills to do so without risking repetitive strain injury.
Liz Sargent, Bristol, UK
Are we crippling our children, even before they get into the workplace?
www.one-laptop-per-child.com
Greg, Austin, Texas