Many HR teams recognize the mental and physical toll that working from home has taken on employees. Stress, anxiety, lack of sleep and now a raft of physical ailments from poor ergonomics have led to exploding health care costs for some.
Those physical problems are expected to escalate this year, especially for remote workers, according to a new forecast from digital integrative care company Goodpath, which estimates that 2021 employer-paid musculoskeletal (MSK) treatment spending will be about 40 percent greater than in 2019. That represents an average of $5,687 spent per employee with MSK conditions this year, up from $4,272 spent in 2019.
At most employers, that's a painful increase.
MSK conditions typically are created by poor ergonomics, which is an applied science focused on designing and arranging tools and workspaces so that people interact with them efficiently and safely. Remote employees often work sitting at kitchen tables, on the edge of sofas and armchairs, or spread out across a bed or the floor. The result are aching backs, knees, necks, shoulders and more.
Unfortunately, few companies are focused on the physical ailments that might be occurring among their workforce.
"I've participated in many CEO roundtable discussions the past few months, and no one is talking about this," said Yuri Kruman, SHRM-SCP, managing consultant and CEO of HR Talent + Systems in New York. "That's a disservice and the reason why they should be concerned about it."
Attention to general physical and mental health continues to take precedence, said Kruman. "With everything going on COVID-wise, companies don't necessarily have the bandwidth to address these ailments. But they need to start thinking about it because of workers' compensation claims. Working from the couch or the bed is not healthy; it puts incredible strain on the neck and back and is bad for blood circulation. You see bad posture all the time when you are on Zoom calls with your co-workers."
Kruman said the way people use their cellphones also can be harmful. "The best advice is to not have your phone within your field of view. It can be in range to hear it," he said, but you don't want to be craning your neck to look at it through the day.
For desks, he said foldable, stand-up platforms for laptops are a help. They can be adjusted depending on whether you are sitting or standing, "and they can later be used back in the office, because when offices do reopen, with social distancing, there won't be a lot of people all sitting together."
Valerie Keels, SHRM-SCP, said that since the beginning of the pandemic, her company has allowed its employees to take their chairs to use in home offices.
"We haven't done anything about desks, but we did allow one staff person to expense a desktop lift to allow for standing while working," said Keels, head of office services for Gavi, the Vaccine Alliance, in Washington, D.C. "Our organization is being more reactive than proactive in this area, but also is very generous. If someone asks for an accommodation, they will generally receive it." (SHRM has written about recommendations for at-home office setups here.)
If Not Now, Later
"The HR departments we talk to all know that stress and anxiety related to COVID-19 is a problem," said Bill Gianoukos, Goodpath co-founder and CEO. "It's especially prevalent in women at home who are with children. They also tell us that even though they have valuable employee assistance programs, the number of employees who take advantage of them is low. We see a tsunami of costs coming to the employer from this."
Gianoukos said that when he explains to HR professionals how poor posture and nonergonomic-friendly work areas at home will lead to muscle and skeletal issues, they say, "Oh, that makes sense."
"Physical and emotional strains go hand-in-hand," Gianoukos said. "We're not sure which one comes first, but they do work in tandem. Those working from home are seeing increasing pain and difficulty in their shoulders, neck and lower back. This mostly stems from not working in a standard, well-designed office setting. Most at-home working areas are not set up properly for ergonomics."
According to the American Academy of Orthopaedic Surgeons, MSK conditions affect nearly half of all U.S. adults and account for the largest share of spending on health care nationally. In fact, MSK treatment spending is a significant driver of self-insured employers' benefits programs, so accurately predicting and managing these costs is crucial for any benefits program.
Worldwide, 126 million people experience back, neck and shoulder pain, many of whom are deferring care, Gianoukos said.
"The aftermath of that decision is two-fold: Symptoms worsen as patients dig themselves into a deeper hole medically, and employer costs skyrocket to address the need for critical care that's been delayed."
Employees complaining of pain while working from home should be advised to see a doctor and take sick leave or paid time off (PTO), said Stacey Berk, a managing consultant at Expand HR Consulting in Rockville, Md. "If they are eligible, they should be encouraged to complete the appropriate compliance-related forms to obtain doctors' notes" for potential leave under the Family and Medical Leave Act, short- or long-term disability, or possibly workers' compensation.
Goodpath's programs are designed to treat and prevent future injuries, Gianoukos said. Participating employees are given a 45- to 60-question survey about their lifestyles and health.
"We then provide a comprehensive, holistic program based on muscular and skeletal issues, digestion, and sleep created on an individualized basis," he said. The program also provides one-on-one digital sessions with health coaches.
"It's important for employees to understand what the best work environment is for both at home and in the office, because all indications are that many companies will soon be going with a hybrid work location schedule," Gianoukos said.
Where Does It Hurt?
Jason Fan, the CEO of Twic, a San Francisco-based benefits management platform designed to help HR teams select vendors, said MGK and ergonomics is a topic of interest among his clients.
"HR teams don't have time to develop these types of programs, so they rely on [third-party companies]," Fan said. "Education about the need for proper ergonomic workplaces is the key to getting started. Younger employees really don't pay attention or care about proper posture. It's hard enough to maintain the best posture and ergonomic best practices at the office, and it's even harder to do it from home."
Adding to the physical strain are hours spent sitting in front of a monitor. As a result, more companies are scheduling walking or outdoor meetings—anything to end the reliance on video conference calls and provide a physical break from the office, Berk said.
"At the beginning of the pandemic, it was so cool and fun to have Zoom happy hours with colleagues," Berk said. "Now the trend is to focus on activities that will get the employee off of the screen but still lend to the workplace culture."
In addition, many employers are telling employees to take vacation time this summer. "Some employees had a lot of PTO left over at the end of the year, and employers should encourage employees to exhaust that leave for their own well-being," she said. "Time away from the virtual or physical office is priceless right now."
The Goodpath medical team and coaches provide ergonomic assessments for its members with MSK pain. Its recommendations include:
- Sit on something other than the couch or bed for work. Those options make it easier for the body to be poorly positioned. When chairs aren't properly fitted to the person, the risk of MSK pain increases. For instance, working from your couch all day can cause you to slouch, which puts stress on your lower back muscles. If your laptop is too high in your lap, you might start tensing your upper back.
- Use more than just your laptop, if you can. Laptops weren't created for long hours of use on end. They were intended to be mobile. Instead of looking straight ahead with good posture, laptops force you to look downward which can lead to neck pain, sometimes known as "tech neck." Instead:
- Have an external monitor (separate from a laptop screen), so your gaze is ahead of you, and an external keyboard so your hand and wrist placement does not cause forearm or wrist injuries, such as carpal tunnel syndrome.
- If an external monitor is not an option, you can prop up a laptop on several books or boxes, then use an external keyboard and mouse.
- Use household items to adjust your workspace. If your chair is too high and your feet aren't touching the floor, put a short stool underneath the feet so that your hips and knees are level. A stool isn't available? Flip over a small trash bin or use a couple of old boxes. If you prefer to stand, set up a few boxes on top of a dresser or high table and use a laptop there.
- Have a dedicated workspace. Try to keep what you use most often nearby, which means within arm's reach while maintaining elbows bent at a right angle.
- Think about more than just ergonomics. Factors outside of the actual workspace can affect a person's pain. Stress levels have risen, and stress has a way of increasing pain. Try proven mind-body techniques such as progressive relaxation and yoga to manage stress, anxiety and pain.