An updated Cochrane review has found that ergonomic interventions show no meaningful benefit for pain, function, recovery or sick leave in workers with work-related complaints of the arm, neck or shoulder (CANS), compared with no treatment.
CANS covers disorders that develop from repetitive movements, awkward postures or external forces such as vibrating tools. They significantly affect working populations worldwide.
Workplaces heavily invest in ergonomic interventions, such as office furniture changes and biomechanical or ergonomic education, to help office workers with CANS.
No clear benefit for pain, function or sick leave
Led by researchers from the University of Technology Sydney, the review analyzed 20 trials, 16 of which looked at non-specific CANS, involving a total of 2,478 people with work-related CANS. The participants included workers who frequently use computers in their job.
The review found that, compared with no treatment, usual care or placebo, ergonomic interventions may make little to no difference to short-term pain. They probably make little to no difference to functional status, sick leave or recovery.
Low-certainty evidence points to possible benefits for quality of life and health care use. Results were mixed, however, and one analysis showed a reduction in health care consumption while another showed little to no difference.
Overall, ergonomic approaches appear less effective than exercise, though small benefits may occur in specific subgroups, such as people with rotator cuff tendinitis.
"When we pooled the best available trials, ergonomic interventions made little to no difference to pain, function, recovery or sick leave compared with no treatment. The certainty of that evidence ranges from low to moderate, so this is a clear signal that the case for these interventions is weaker than many people assume," says Dr Poonam Mehta, lead author from University of Technology Sydney. "We'd need more evidence to confirm this, as there is not much high-quality research in this area."
A big investment for companies
Many companies push for and invest heavily in ergonomic interventions. Some examples include ergonomic training, sit-stand desks and specialized equipment such as mouses and ergonomic keyboards.
Repetitive strain injuries can lead to worker absenteeism, a higher turnover and more compensation claims. Workers can also be less productive when they're in pain.
"Ergonomic interventions can be a big financial burden for organizations," continues Dr Mehta. "Our findings suggest that, on current evidence, these measures alone shouldn't be expected to reduce pain or sick leave in the short term. Employers may want to weigh that against the cost."
Co-author Dr Peter Stubbs also stated that "the methodological flaws and high risk of bias downgrade the confidence in the results."
No data were available on recurrence of injury or complaint, and little data on work-related outcomes beyond sick leave.
Ergonomic strategies may still have value in specific subgroups, or as part of a broader workplace or rehabilitation program, but supporting evidence is limited and uncertain.
The authors call for high-quality, well-designed trials to establish the role of ergonomic strategies in managing CANS.
