Posture and Comfortby Hugh Babington Smith
Dealing with postural discomfort and pain
If you are suffering from postural discomfort and/or pain, there are three immediate steps you can take to deal with the problem.
Mind and body are closely linked. In many instances we are, without realising it, in control of the conditions that are giving rise to pain and are therefore in a position to get rid of it. Once we understand this and consciously take control, we can achieve quite remarkable advances and be very much happier.
It’s as much a mental as a physical approach. We know a happy person when we see one – we talk of ‘a spring in their step, head up and chest out.’ We know instinctively what such a posture means.
Our brain controls our posture through the nerves. Our mind can control our brain. One way of implementing that control is to alter our posture positively. Try walking with a spring in your step, add in a little skip, your head up and chest out – you will probably feel a lift and may well have a smile on your face at the same time. That is the first step. Think positively about improving your physical posture.
There is no reason for anyone to be in ‘victim mode’, feeling that the world has it in for them, that there is nothing they can do. As many health practitioners will tell you, if you cannot bring such a person to believe that they can do something for themselves and get them to exercise some initiative, you cannot begin to change their pain. But once they have decided they wish to change, the results can be remarkable. When people understand why and how to take control, their health improves.
Listen to the body
The second step is to listen to the body.
Why do people ‘grin and bear it’? Because they are not listening. Discomfort and pain are telling you something. In particular, with musculoskeletal matters, they are telling you that something is not right, something is out of alignment, or something is moving in an incorrect way. Analyse the feeling, look for the root cause and seek ways of changing.
Pain is subjective. There are many cases of people with quite severe injuries that they hardly notice, while other people with less severe injuries in the same area may be in agony. It is noticeable that when a person is concentrating, they may even temporarily put themselves in the position of not feeling pain. Indeed, it can take a very long time for the body to ‘get through’ to the mind and make the point that something is not right. Unfortunately, all this time the damage is getting worse. So it is worth treating the messages of discomfort and pain positively, by listening to them.
The phrase ‘No pain, no gain’ is the enemy of musculoskeletal comfort. It derives from an intensive training regime whose practitioners believe that it is only when the muscles are in a particular kind of pain that they are getting stronger.
This does not apply at all to normal life. There is no merit whatsoever in working through pain and hoping it will go away.
Pain is a warning signal from the body and it is our job to do the detective work to discover the cause of the warning and do something about it.
The third step is taking action. There is nothing to be gained from inaction – from grinning and bearing it.
Both the employee and the manager can take action, and we touch on both sides in each of the subsections below.
Both employer and employee have their responsibilities. The employer has a duty of care, while the employee has a duty to comply with the employer’s health and safety policies, and these should include a requirement to report.
No employee should ever feel constrained from reporting pain and discomfort. As part of the employer’s duty of care, if an employee informs you that they are suffering pain or discomfort, this should always be taken seriously, even where you suspect that the employee is making trouble or being frivolous. Generally speaking, people are sensible when it comes to pain, and if they realise that something will be done, they will not exploit goodwill.
Prevention, of course, is the best action. This does not refer to the lazy form of prevention: expecting ergonomic equipment on its own to solve the problem, as anyone can habitually slump in even the best chair in the world.
The individual will be better at prevention if they have some knowledge, preferably from training, possibly also after treatment. The logic is clear: if taught how, one can sit and work on anything. As an employer, you can help your employees by giving them access to, or providing, training to give the requisite knowledge. This is described further under Health and Safety legislation.
You can also help by ensuring that the equipment provided for the job is ergonomically sound; see Management tools for reducing risk to posture.
Immediate action, if too late for prevention
If it is too late, the appropriate action will depend on the intensity of pain.
It is essential that if a person has tingling, pins or needles, numbness or discomfort in the fingers, wrists and/or hands, you should ask for expert medical opinion to be sought immediately.
It is not enough to rely on the opinion of someone who does not have this medical training. Even some General Practitioners do not yet recognise the importance of immediate intervention. The best contact is a member of the Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE), especially if they are prepared to come into the workplace.
The manager must understand that with this kind of symptom, early intervention is essential. The longer these symptoms are allowed to develop, the more difficult it is to get rid of them. There are very clear figures about the relationship between early rehabilitation and return to work; the principle of early intervention applies even if the employee has not been absent.
Further, the cause is not always obvious, and you should be prepared to facilitate some detective work.
If the pain is not intense, you can take the time to find a simpler solution. Many people play around with their equipment, layout and habits and find that a change removes the pain. Unwittingly, they have achieved the right result. If, however, symptoms get worse in the course of making alterations, they should be treated as needing immediate medical advice.
We have all met the person who is never comfortable, however much time and money is spent on adjustment and furniture.
In the longer term, such a person may need more information and training about their posture.
To change posture is more a mental than physical challenge. We all have our own posture ingrained in our brains as being ‘correct’. However, in cases in which posture is in fact incorrect, the brain needs to be re-programmed by training to accept the correct messages. To achieve this, constant reminders and repetitions are required in the early stages.
This need not be particularly time consuming. Complete postural re-education for people who have problems should, with weekly one-hour professional help sessions, take no more than four to six weeks. The good effects can last a lifetime.
Sometimes a person cannot be helped even by postural re-education. This may be because they have a physical impairment or psychosocial condition that means that a different approach is needed.