Many office-based employees find themselves still working from home a full year after the COVID-19 (coronavirus) pandemic forced work as we knew it to change dramatically.
The shift toward more remote work played a key role in helping limit the spread of the virus, Cedars-Sinai experts say, and provided much-needed flexibility for many families as they faced the challenges of living through a pandemic.
But the experts also warn there could be hidden, long-term hazards to working from home.
“While the flexibility to work from home has been an important tool in the fight against COVID-19, we all need to balance our health needs and make sure that this new lifestyle doesn’t create different health concerns,” said Richard Riggs, MD, senior vice president of Medical Affairs and chief medical officer.
Pain due to long hours sitting at a desk isn’t new, according to Sang Kim, MD, who specializes in neck and spine surgery.
“Even before the pandemic, spine, neck and back problems were some of the most common reasons why people sought physicians,” he said. “They’re also some of the most common reasons that people are out of work on disability.”
Kim said those ailments are increasing, and Eugene Tsai, MD, who specializes in hand and wrist health, says the same is true when it comes to hand and wrist complaints.
“I’ve definitely seen a major uptick of patients coming in with overuse type issues or wrist pain,” he said.
The culprits, according to Tsai and Kim, are the makeshift workstations people are setting up in their homes at their dining table, couch or even in bed. Those workstations, however cozy they may be, can cause some serious problems.
“The most common setup that I’m hearing about is patients working at their dining room tables, and most often, it’s on a laptop,” Tsai said.
“The problem is that a standard dining room table and chair are really not made for long periods of work or for comfort, and laptops, especially the really small ones, can force your wrists into positions that are not good for long-term use.”
As a first step to addressing these issues, Tsai recommends patients enlist another member of their household to help assess the workstation.
“I think it’s very hard for us to objectively assess our workstation,” Tsai said. “I recommend having someone take a picture of you from a profile angle while you’re sitting at your workstation.
That way, you can really look at the angles of your elbows, wrists and neck, and where the screen height is in relation to your eyes.”
Tsai then recommends comparing that photo to an ergonomics diagram that shows proper workstation setup and adjusting accordingly.
A proper setup is one that allows the worker to have a straight back, feet flat on the floor or on a footrest, and knees, hips and elbows at 90-degree angles.
The keyboard should allow for straight wrists and the computer screen should be at eye level.
Adjustments can be made with everyday objects, like using stacked books to elevate a computer screen, or by purchasing specialized tools like an ergonomic keyboard.
While it’s important to have the right home office setup, both Tsai and Kim recommend taking frequent breaks to stand up, stretch and move around.
Even workstation modifications and frequent breaks may not be enough.Tsai warns that ergonomics isn’t “one-size-fits-all,” and recommends reaching out to a workplace ergonomics expert or occupational therapist to get help creating a personalized setup.
Physical therapy can help strengthen muscle groups and ease some of the pain associated with sitting for long periods of time, whether at home or in the office.
“The reality is, especially if it’s something that’s getting worse, you always want to rule out other problems,” Tsai said.
“That does mean being evaluated by a medical professional, someone who can make sure that there isn’t something else going on that should be treated. So don’t ignore symptoms. Seek out help, particularly if you have symptoms that are getting progressively worse over time.”
With the refrigerator just steps away from the home office, it can be tempting to spend those frequent work breaks browsing the snack selection, and with gyms still closed in many parts of the country, it can be hard to work off those extra calories.
Weight gain due to increased calorie intake and decreased activity levels can lead to a condition called nonalcoholic fatty liver disease, a buildup of fat in the liver, according to Mazen Noureddin, MD, director of the Fatty Liver Program at Cedars-Sinai. He calls the disease “a silent pandemic in itself”—it affects as much as 25% of the U.S. population.
“We’re seeing more patients with weight gain due to inactivity, and that can lead to inflammation and scarring of the liver,” he said.
As with many health conditions, diet and exercise are always the first steps in starting to reverse damage, Noureddin said. He recommends that people over the age of 40 who have Type 2 diabetes or metabolic syndrome get screened for fatty liver disease.
“At Cedars-Sinai, we have advanced testing that can provide accurate diagnosis and staging of fatty liver disease, and we’re running more than 30 clinical trials for treatments,” he said.
One of the prime culprits that Noureddin suspects is causing that increase in fatty liver disease is people reaching for food for comfort in a year that has seen a marked decline in mental wellness.
Itai Danovitch, MD, chair of the Department of Psychiatry and Behavioral Neurosciences, is researching some of the effects that the pandemic has had on mental health and access to mental health services.
Preliminary data from his studies show an increase in anxiety, depression and substance use. Working from home, he said, could be a contributing factor.
“The isolation and disconnection due to working from home has really had a significant impact on people,” Danovitch said.
On the flip side, the move to virtual spaces has increased access to critical mental health services for many and has allowed for more workplace flexibility, a key in building good mental health.
“We know that working from home, as challenging as it is, has a lot of silver linings to it,” Danovitch said.
“There are many professions where working from home creates an opportunity for people to work who wouldn’t have been able to, or an opportunity for people to manage work-life balance with other responsibilities, such as taking care of kids, taking care of parents or managing different family needs.”
Danovitch hopes that, as the pandemic fades, the new normal includes a “mixed portfolio” with both the intimacy of in-person connections and the flexibility created by virtual ones.
The Complete Picture
Chief Medical Officer Riggs said that, taken as a whole, working from home should be seen as a positive change.
He recommends that remote workers use strategies to create balance in what, for many, has been an overwhelming time.
“The most important part of working from home is to establish a routine,” Riggs said. “Whatever your prior commute was, you should take that time for yourself.”
That time, he said, is well spent doing a healthy activity, like exercise, meditation or a long walk.
“Although this pandemic year has been challenging for all of us, making healthy choices for ourselves and our families can help us find moments of renewal and joy,” Riggs said.