Your neck hurts and your shoulders are tight. Going to the gym helps but the symptoms keep occurring.

You search for answers, looking at all aspects of your life except for one, your workplace. What you may not know is that your computer work station setup is the culprit and there are plenty of local experts who could have helped.

They deal in computer ergonomics, the science of avoiding neck, shoulder, back and wrist injuries by setting up a work station properly. Many people have no clue about how to do that, and they end up in the offices of doctors, physical therapists, chiropractors and massage therapists.

"I see them all the time," said Dr. Christina Lasich, an occupational and pain therapy physician in Grass Valley. "Mainly it's upper extremity numbness, tingling and pain and carpal tunnel syndrome," in the wrists.

Lasich has three main things in mind when dealing with ergonomics patients:

• Preventing the repetitive-use injury.

• Supporting proper posture.

• Reducing lever arm forces.

"People do a lot of reaching," Lasich said of lever arm forces. "It hurts the neck and shoulders."

How can you avoid it? Try just moving things closer to you. The Mayo Clinic suggests moving your coffee cup, pens and telephone to within 10 inches of your body.

For proper posture, "you have to have your feet flat on the ground," Lasich said. "Get a chair with a lot of adjustability, eight or 10 adjustments because one chair doesn't fit all."

Repetitive-use injuries occur because the body is not given enough time to recover during a day, Lasich said. For many, it means the pectoral muscles in the upper chest tighten, which brings the head forward, straining the neck and shoulders.

To deal with that, Lasich said, two stretching exercises are key. In the first, "stretch the front of your chest out by putting your arms behind you." In the second, "squeeze your shoulder blades together."

Lasich also works with physical therapists to do work station evaluations. The idea is to adjust certain motions to avoid the repetitive injuries.

Gary Truebell is a physical therapist at the Sanderson Physical Therapy Center in Grass Valley. Doctors often refer computer injury patients to them and the center does an hour-long evaluation with them initially.

"The therapist looks at the patient's strength and range of motion and they try narrow down the problem and the mechanical cause behind it," Truebell said. As part of the therapy, the center uses a machine that simulates the repetitive motions and tells therapists what exercises to prescribe.

"We retrain them to utilize (the repetitive motion) differently and strengthen the muscle groups they use in their jobs," Truebell said. "And we spend a ton of time on educating the patient."

Treatments include ice, ultrasound, massage, stretching and exercise, Truebell said.

Chiropractor Dr. Darwin Leek of Grass Valley uses spine manipulation and massage to help his computer injury patients.

"They sit too long at computers and I instruct them to take frequent breaks, Leek said. "Get up, walk around, most people in computer work get locked in."

Leek prescribes "yoga-based stretching without the mantra. I do lots of computer work myself and that's what works for me.

"Ice is good for most inflammatory problems and then moist heat and massage," Leek said.

Leek suggests using a search engine on a computer to find out more about proper computer ergonomics. By simply typing "office ergonomics" in the search window, computer users can find a wealth of Web sites with information from The Mayo Clinic, state health organizations and the United States Occupational Safety and Health Administration.



Ergonomic tips for safe computer use

Seating

• Feet should be flat on floor or footrest.

• Knees bent at 90 degrees in line with hips.

• Thighs on seat parallel to floor.

• Arms and hands pointing straight to computer table, not up or down.

• Place back firmly against chair or have pillow to support you.

Monitor

• Top of screen should be at eye level or slightly below.

• Place screen 20 to 40 inches from eyes and level head.

• Put screen directly in front and not to side of user.

Mouse

• Keep it close to keyboard, do not reach too far.

• Use keyboard short cuts to use mouse less.

• Switch sides and alternate hands you use mouse with.

Keyboard

• Align with enough room to keep wrists off table corner.

• Do not pound on it.

In general

• Use mouse and keyboard pads.

• Do not bend toward the computer.

• Sit up straight.

Sources: Stanford University and U.S. OSHA.

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To contact senior staff writer Dave Moller, e-mail davem@theunion.com or call 477-4237.