Sitting the correct way can help prevent pains in the limbs

In the last 12 months alone at least two British employees successfully sued their employers for cases of "diffuse" Repetitive Strain Injuries (RSI). In one case, the employee was awarded £155,000 against a high street bank.

In another recent British RSI case involving "tennis elbow", an employee was awarded £186,000.

Mr Peter Kilbride of the RSI Association, a London-based charity that provides help and information for RSI sufferers, says the number of cases that get to court is relatively few because insurance companies prefer to settle out of court.

This view is echoed by Mr Richard Wynne of Dublin's Work Research Centre who suggests insurance companies are unwilling to allow an Irish precedent to be set.

Last Saturday the Financial Times reported a "legal test case" in which part-time workers are suing Midland Bank for diffuse RSI, that is where the specific location of the injury is difficult to pin down. The plaintiffs allege that their injuries were caused by keying material into computers against strict deadlines.

But Mr Kilbride says the precedent of successful litigation in cases of "diffuse" RSI has already been set. RSI is a loose term which, in practice, is often used interchangeably with work-related upper limb disorders (WRULD).

Localised - as distinct from diffuse - RSI includes: tenosynovitis (inflammation of a tendon sheath); tendinitis or tendonitis (inflammation of a tendon); epicondylitis (inflammation of the muscle and tissues surrounding the elbow); bursitis (inflammation of the connective tissue surrounding a joint) and carpal tunnel syndrome (a painful disorder of the wrist and hand).

Studies have shown that workplace efficiency can be improved by as much as 25 per cent by ergonomically redesigning workstations. For instance, inexpensive ergonomic changes at Singapore airlines - like improved lighting and the use of copy holders and foot rests - dramatically increased efficiency and reduced typing errors and musculoskeletal injuries in staff.

Mr Andrew Wilson, a former president of the New Zealand Register of Osteopaths, in his excellent book Are You Sitting Comfortably? takes issue with many experts who maintain that the ideal sitting position consists of a series of right angles, whereby the thighs are at a 90s0] angle to the back.

He says it's difficult to hold that posture for more than a few minutes and suggests the best sitting position is in an office chair where the seat has a forward tilt mechanism.

Mr Wilson says such a position more closely approximates to the most usual sleeping position and to the angle of the thighs to the back while horse riding.

He holds that a forward-tilted seat helps to keep the back straight without the strain of the idealised 90s0] angle. When office chairs don't include this mechanism, a similar effect can be achieved by placing a rolled-up towel to the rear of the seat, raising the buttocks above the height of the knee.

Recommendations for working at a desk

Chairs, keyboards, screens and, if possible, work surfaces should be adjustable.

Chairs should permit forward-tilt or be so adapted with a towel. Avoid pressure under the thighs. A variable tilt chair is better than a fixed tilt mechanism. Adjust the chair height so its front edge is level with the upper part of the kneecaps. The chair should swivel, be height adjustable, upholstered in cloth, have a contoured front edge and castors on a five-star base. Arm rests should not interfere with the movement of the arms or shoulders.

Arms should be kept by the sides. Don't overreach to the keyboard.

Reduce screen reflection or glare.

The work surface should be about 5 cm above the bottom of the elbow. When typing, the work surface should be at the height of the elbow while the height of the keyboard brings the keys to that 5 cm above the elbow.

If the work surface can be adjusted, design the height of both chair and desk starting from your feet up.

Plan work to avoid continuous typing. Punctuate it with non-keyboarding tasks and breaks.

Shoulders should be relaxed, not elevated.

Don't cross your legs while typing. Place feet flat on the floor or on a footrest if the chair is too high.

Report any upper limb discomfort to your employer or the designated health and safety representative immediately. RSI can quickly develop from mild to a chronic condition.

Prevention is the key strategy.