In the past few months, countless people in the United States and around the world have been thrust into new work routines due to COVID-19. For some, this has meant suddenly working from home, often with little notice or any idea — at least at first — of how long this new routine might last.
Many have been forced to improvise, working all day on a personal computer that may be less than ideally situated in the home. At the same time, the lack of regular office routines may mean finding yourself hunched over the computer for longer stretches of time than previously.
These factors can lead to poor posture that can be especially harmful to people with ankylosing spondylitis. This form of arthritis, which is characterized by inflammation of the spine and sacroiliac joints at the base of the spine, can lead to back pain as well as pain in other joints, including in the hips, shoulders, and sometimes arms or legs.
“With ankylosing spondylitis, one of the main challenges is back pain,” notes Karen Jacobs, an occupational therapist who is a clinical professor and associate dean for digital learning and innovation at Boston University’s College of Health & Rehabilitation Sciences: Sargent College. “If we’re working at home, we want to be mindful of our work environment. A lot of us pivoted to working at home without some of the ergonomic chairs, desks, and footstools that we had in our offices.”
But even if you don’t have access to expensive office furniture, there are ways to adapt your workspace and routines to help reduce ankylosing spondylitis–related back pain. Here are some of the most important considerations.
Setting Up a Computer Workstation
If you’re working from home, you’re likely sitting in front of a computer much of the time. This may be a laptop, which can lead to worse posture than when working at a traditional desktop computer. To help improve your posture, start with how you’re sitting.
“The chair, to me, is the most important aspect of the whole computer interaction,” says Jacobs. “At home, we don’t necessarily have a chair that’s on wheels or adjustable.” To adjust the height of your seat or the angle of your back, you may need to use pillows.
Jacobs recommends using a pillow to support your back, so you’re sitting upright when your back is fully against it. She also suggests placing a pillow on your seat if your chair doesn’t have any cushioning or you need to sit higher because of other aspects of your workstation.
Even if you have the right chair and pillows, make sure you’re not folding your body forward to see the screen, says Jacobs. “It’s extremely important that your back is at the rear of the chair.”
The next element to focus on is your computer. “If you can get an external keyboard and a mouse, that would be ideal, so that you can raise your notebook computer up to eye height, looking down just a little bit,” says Jacobs.
Your computer screen should be about an arm’s length from your head, at or slightly below eye level. And when you’re typing, your elbows should be close to a 90-degree angle, with your upper arms as close to your body as possible.
Depending on the height of your chair, the ideal height for your keyboard — one that allows your arms to be in the correct position — may be lower than your desktop or tabletop. In this case, an old-fashioned keyboard drawer may do the trick.
If you’re working on a notebook computer with an external keyboard, you can raise the screen to eye level by placing the computer on a box or stack of books. Or, if you’re looking for a more stable solution, you can buy a stand designed to raise the screen. But remember that both of these setups can make your posture worse if you aren’t using an external keyboard.
When you’re reading or scrolling, as opposed to typing, you can lean back at a slight angle in your chair, if possible, says Jacobs. When doing this, it may be more comfortable to slightly raise your feet using a box or similar item. “My yoga blocks are my footrest now,” she notes.
Scheduling Breaks and Movement
As important as it is to have good posture while you’re working, it’s even more important to change your posture frequently. “I think the number one thing that we want to do is take breaks on an absolutely regular basis,” says Jacobs, “and include, with your doctor’s approval, light exercise.”
This can mean simply walking around your house, doing some stretches or yoga poses, or dancing for a couple of minutes to a favorite song — all of which might have been more difficult to do without feeling self-conscious or disruptive in a traditional office. This is one area where working from home can be an advantage, so it’s important to seize that opportunity, Jacobs notes.
As a rule of thumb, Jacobs advises taking a break about every 30 minutes. You can set reminders or a timer on your phone to help ensure you don’t forget; just make sure you actually get up when your phone goes off.
Breaks are important not only for movement but also to help reduce work-related stress, says Jacobs. “I’m a big advocate of making sure that you build stress reduction into your life. I think we’re all very stressed.” . In addition to yoga, she recommends tai chi, meditation, or guided mindfulness — anything that lets you relax and breathe rather than focus on finishing your next task.
It’s also worth considering whether you can move around while you’re working, at least some of the time. For example, “If you’re on a conference call for an hour and a half, and it’s not on Zoom, maybe you can walk around while you’re hands free on the phone,” says Jacobs.
If you have the resources and inclination, you can look into setting up a workstation that incorporates a treadmill for slow walking, but for many people, this isn’t feasible. Almost anyone, though, can alternate between sitting and standing when working at a computer, especially if you use a laptop.
“Throughout the day, move your notebook computer with the external keyboard and mouse, put your computer on a box to raise it up, and stand for a little bit” at a counter that’s higher than a desktop, Jacobs suggests. But, she adds, “The verdict is out on how much time you should be sitting or standing.”
If you stand for prolonged periods while working, listen to your body to ensure you’re comfortable. “Make sure you have good footwear and you’re on a stress reduction mat on the floor,” Jacobs advises.
As part of varying your posture or to ease strain on your back, it’s even acceptable to lie down on your bed for brief periods with your computer or phone, says Jacobs. “I don’t encourage it, but if that is where you’re comfortable for a while, be in that posture and then get up, stretch, and go to another location.”
Getting Your Body Ready for Work
Avoiding back pain while working from home depends on not just your workspace and taking breaks, but also what you do in your downtime, says Jacobs. That means taking care of your body when you’re not working.
“In the morning, on a regular basis, consider doing some light stretching before you start your day,” she suggests. “Think of yourself as an athlete working from home.”
Speaking of being an athlete, you should also strive to get enough dedicated physical activity outside your breaks and movement throughout the workday — within the bounds of your doctor’s recommendations, of course. Swimming and range-of-motion exercises can be great for people with ankylosing spondylitis, says Jacobs, because they can improve both cardiovascular fitness and your back’s flexibility.
And don’t forget the importance of a varied, healthy diet and weight management to improve your overall health and energy level. “Those are really important,” Jacobs notes.
Ultimately, doing right by your body when working from home means listening to it, says Jacobs. You should be as active as you can, but “If you’re in discomfort or pain, you need to cool down and take a break,” she emphasizes.
If you’re having back pain while working from home, don’t hesitate to reach out to an occupational therapist for help. When it comes to working with people who have ankylosing spondylitis, “We’re really experts in that area,” says Jacobs.