Risk factors for persistent elbow, forearm and hand pain among computer workers

OBJECTIVES: This study examined the influence of work-related and personal factors on the prognosis of "severe" elbow, forearm, and wrist-hand pain among computer users. METHODS: In a 1-year follow-up study of 6943 computer users, 673 (10%) participants reported "quite a lot" or more trouble due to elbow, forearm, or wrist-hand pain during the 12 months preceding the baseline questionnaire. Pain status (recovery versus persistence) at follow-up was examined in relation to computer work aspects and ergonomic, psychosocial, and personal factors by questionnaire. In addition, data on objectively recorded computer usage were available for 42% of the participants during the follow-up, measured by means of a program (WorkPaceRecorder) installed on their computers. RESULTS: During the follow-up, two-thirds of the baseline cases improved to some degree, but only one-third experienced substantial improvement. The prognosis was not influenced by mouse or keyboard work (time, speed, micropauses, and average activity periods) or ergonomic workplace conditions. Keyboard times, however, were very low. Pain in other regions was a predictor of persistent arm pain. Except for time pressure, female gender, and type-A behavior, the prognosis seemed independent of psychosocial workplace factors and personal factors. A few cases with severe pain were affected at a level which could be compared to clinical pain conditions. CONCLUSIONS: Our results do not support the hypothesis that computer work activity or ergonomic conditions influence the prognosis of severe arm pain. This result is somewhat surprising and should be tested in other studies. Pain in other regions implies a poorer prognosis for arm pain.