We are the first generation of human beings to spend so many hours sitting in limited postures doing small movements under stress as part of our daily work routine on such a large scale. Already, estimates are that nearly 50 million people have computers on their desks at work. The number is growing steadily. By now almost everyone has heard of Carpal Tunnel Syndrome as a computer-related problem. The seemingly sudden appearance of these "cumulative trauma injuries" is directly related to the evolution of desktop computing in the modern workplace.

The United States bureau of Labor Statistics reported more than three hundred thousand cases of cumulative trauma in American business in 1993, up from a steady annual rate of around seventy thousand in the early 80s. Some of those include work settings with a history of the problem such as meat packing houses, grocery clerks, sign interpreters, and others. But looking at the numbers it is clear that the level of reported cases has dramatically increased beginning in 1984 when desktop computers began to appear. As processing speed increased, prices came down, and the software market matured, computers spread into our work environment at an amazing pace.

So, unfortunately, did cumulative trauma injuries.

What's happening now is typical of the appearance of any new technology in human history. It took the industrial revolution for us to learn that as a society we wanted safe places to work, free of the dangers of falling into vats of molten steel or having to breathe toxic chemicals. At first, most people didn't give it much thought until the scale of the injuries became clear.

It may seem strange to compare the current situation to the industrial revolution, but the analogy makes sense. Once again we have jumped into a new technology and allowed our economy to rely on it, and now we have some lessons to learn from the first generation of users. Just as the captains of industry discovered that it made business sense to protect workers in the factory, so must executives and managers learn the lesson today.

There is risk in the very nature of extended computer use. To not respect these inherent boundaries is to risk losing the most dedicated and hardest working employees, to pay out exorbitant costs for insurance, overtime, rehiring and retraining, and be required to pay for accommodations - sometimes under enforcement of the Americans with Disabilities Act. It means to lose productivity and creativity from people who are unnecessarily working with discomfort and pain.

People have been using typewriters for a long time. Why didn't they get injured?

Well, some of them did. But it is happening to more computer users for some very clear reasons.

A typist would push the carriage return over, change the paper, stop to correct mistakes, and get up to go to filing cabinets. These small breaks in the nature of the work and the opportunity to get up and move around served to protect people from injury because it allowed the body to replenish itself throughout the day. These breaks are crucial to the health and resilience of our tissues.

Using a typewriter also involved more movement of the arms and hands because of the extra pressure typically needed to press the keys. This meant that more and larger muscles could share the work. Now, the light touch of computer keyboards require only movement of the fingers putting the load on fewer, smaller muscles.

Far too many people have already in hurt from computer work. Many have been dealing with chronic pain for years, some are so disabled they are unable to work - or at least not with computers. While they are the minority of all computer users, their numbers are significant. So that you don't take this for granted, I'm going to describe what it's like not to be able to work while living with pain every day.

I have had my own experience with this problem, and when I approached a period of disability I grossly underestimated the unpleasantness of the experience. I thought I would take three months to recover and return to my previous career. I thought it would be a sort of vacation, catching up with friends, reading, enjoying the relaxed pace. One year later I was still in pain and facing beginning a new career, unable to go back to where I was injured.

During that time I learned a lot about the importance of work in our lives. Our self-esteem is deeply connected to our work. We need to feel we have something important to contribute, and it is the place where we get to experience our ability and creativity.

Other endeavors in your life may be seriously curtailed, such as hobbies, sports, or other pleasures. These things are not only fun, they are a way of processing emotions and giving balance to our lives.

Imagine being unable to cook for yourself, drive a car, or do the laundry. It is natural to avoid many of these essential daily activities simply believing they might interfere with the process of recovery. The result is dependence on friends and family. While at first it is a wonderful thing to experience their loving support, it gets old pretty fast to have to rely on others, to have to take more than you can give.

Chronic pain itself has some serious psychological effects. The pain doesn't have to be very severe to become quite terrifying and depressing once it has continued for a period of months. It is another form of water torture, and can be quite insidious. There may be a day or two of relative improvement, luring you into the feeling that you could do a bit more, only to have the pain return. And a wave of deep despair along with it.

The psychological ramifications of the problem are badly underestimated. Since this is not a very visible injury, it is often taken for granted by others so that the injured person fears they may not be in enough pain to be entitled to the treatment and benefits they truly need. These injuries often become disabilities exactly because someone delayed speaking up at the early stage when the problem could be effectively addressed. Now we have the added regret of feeling responsible for the severity of the problem. Often someone will carry all of this inside of themselves, only adding to the stress and interfering with the very process of recovery.

This is no way to get rich. Suffice it to say that disability benefits are limited and some people find it very difficult to support themselves. Some even have to battle insurance companies which have been known to deny benefits to people clearly living with a chronic, painful condition.

No, not really. What's scary is what happens when we use them incorrectly and ignore early signs of possible injury. None of this need happen. By learning the principles of ergonomics, how to sit properly, and by adopting some common sense work habits, we can take advantage of this miracle of human ingenuity and progress safely and productively. All of this is not to scare you away from computing, but simply to emphasize that there is another set of skills required to use it - the most important skills, in fact, because your quality of life and the future of your career depend on it.

Other Ergonomics Articles by Gary Karp