More and more people are working at the kitchen table, on the sofa, or for hours on end with a laptop—and their hands are increasingly paying the price. A recent study by the German Social Accident Insurance (DGUV) clearly demonstrates how working from home and prolonged screen use increase the risk of wrist and forearm complaints.
Tingling fingers after a long workday. A nagging pain in the wrist that no longer disappears in the evening. Difficulties gripping, writing, or opening a bottle—problems that were never an issue before but have become increasingly common since the rise of home office work. What many initially dismiss as temporary overuse may actually be the beginning of a chronic condition.
The reason is simple: biologically speaking, our hands are surprisingly poorly adapted to the demands of the digital workplace.
While keyboards, touchpads, and smartphones dominate modern life, millions of people spend many hours each day performing repetitive movements, maintaining static postures, and working in ergonomically unfavorable positions. The consequences are becoming increasingly visible in the practices of hand therapists, occupational therapists, and orthopedic specialists.
A recent study by the German Social Accident Insurance (DGUV) provides solid data and confirms what many therapists have observed for years: employees working from home develop musculoskeletal complaints more frequently than their colleagues in traditional office environments. Hands and wrists are among the most commonly affected body regions.
Working from Home in Germany: From Exception to the New Normal
What began as a temporary solution during the pandemic has become a permanent feature of modern working life. According to the Federal Statistical Office of Germany, approximately 25% of all employed individuals worked from home at least part of the time in 2025—nearly twice as many as before the pandemic in 2019. Germany now even exceeds the European average.
The implications are substantial: millions of people spend many hours each day at improvised workstations, often without ergonomic equipment, occupational health guidance, or sufficient opportunities for movement.
The kitchen table suddenly becomes a full-time office. The sofa replaces the office chair. The laptop screen forces the head into a prolonged downward position. And the hands remain under static load for hours at a time.
For hand therapists, this has created a new patient population with remarkably similar patterns of complaints.
The Most Common Conditions: When Digital Work Becomes Physical
Hand pain associated with computer work rarely follows a single, clearly defined diagnosis. More commonly, therapists encounter complex overuse syndromes involving muscles, tendons, and nerves simultaneously.
One of the most frequently observed conditions is Repetitive Strain Injury (RSI), often referred to as “mouse arm.” Rather than being a specific diagnosis, RSI serves as an umbrella term for work-related complaints affecting the upper extremity. Individuals typically report wrist, forearm, or elbow pain after prolonged computer use, tingling sensations in the fingers or hand, and gradual loss of grip strength.
A characteristic feature is that symptoms initially occur only during activity but may eventually persist even at rest. Importantly, RSI is currently not recognized as an occupational disease in Germany, meaning affected individuals generally do not qualify for statutory accident insurance benefits solely on the basis of this condition.
Carpal tunnel syndrome is another common complaint among screen-based workers. Prolonged wrist flexion—whether during keyboard use or while sleeping with the wrist bent—can increase pressure on the median nerve within the carpal tunnel. Early signs often include nighttime tingling, numbness, or the sensation of the hand “falling asleep.”
Classic tendinopathies and tenosynovitis caused by repetitive typing and mouse use are also frequently observed. Repeated side-to-side wrist movements performed thousands of times per day may eventually lead to pain, swelling, and reduced mobility.
In addition, many hand therapists report an increase in de Quervain’s tenosynovitis, involving irritation of the first dorsal compartment tendons. The combination of intensive smartphone use and keyboard work appears to be a significant contributing factor. Continuous thumb abduction during swiping and typing is often underestimated as a risk factor.
What current research shows
Some of the most compelling data come from the DGUV study published in 2025. Researchers examined 1,274 computer-based employees using standardized ergonomic assessments and validated questionnaires to investigate the relationship between home office work and musculoskeletal complaints.
The findings were remarkably clear.
Compared with traditional office workers, employees working from home demonstrated a higher risk of developing new musculoskeletal complaints. Of particular relevance to hand therapy, longer daily screen exposure was significantly associated with increased rates of hand and wrist symptoms.
The study also identified several concrete risk factors. The absence of external monitors, keyboards, and computer mice significantly increased risk. Poor screen positioning was likewise associated with worsening symptoms.
Interestingly, current evidence also highlights the limitations of ergonomics alone. A 2025 meta-analysis published in the Journal of Clinical Medicine confirmed that ergonomic interventions can reduce work-related musculoskeletal pain, particularly in the wrist, neck, and upper back. However, the overall effects remain moderate. Ergonomics alone is not enough.
This is precisely why active therapeutic approaches are becoming increasingly important.
Why Active Therapy Matters
A recent systematic review published in the Australian Occupational Therapy Journal demonstrated that combined treatment approaches produce the best outcomes. Interventions integrating splinting, targeted exercises, and ergonomic education appear particularly effective.
For wrist-related complaints, active treatment plays a central role. Tendon and nerve gliding exercises help maintain mobility of neural structures, reduce adhesions, and improve tissue tolerance. Strengthening exercises targeting the intrinsic hand muscles further enhance long-term stability—an aspect that is often underestimated in prevention.
Even simple measures can make a difference. Regular posture changes, short movement breaks, and stretching exercises for the wrist flexors and extensors can substantially reduce the effects of prolonged static loading.
The key message is straightforward: it is not a single break that protects the hand, but the cumulative effect of many movement interruptions throughout the day.
When Hand Pain Should Be Taken Seriously
Not every feeling of tension after a long workday requires treatment. Nevertheless, there are warning signs that patients and therapists should not ignore.
Persistent tingling, progressive loss of grip strength, visible wasting of the thenar muscles, or loss of finger control (such as dropping objects unexpectedly) warrant further evaluation. Pain that occurs independently of activity or persists despite several weeks of conservative management should also be assessed medically. The same applies to swelling, warmth, or neurological symptoms.
This is where hand therapy plays a particularly important role. Early intervention often determines whether a functional overload develops into a chronic condition.
What Hand Therapists Recommend
Modern prevention usually begins not with a splint, but with the workstation itself.
External monitors, ergonomic mice, and separate keyboards allow for more neutral joint positioning and reduce static strain. Vertical mice, in particular, have been shown to reduce muscular activity in the forearm. The monitor should ideally be positioned with the top edge at eye level and approximately 60–80 cm away from the user.
However, ergonomics alone is insufficient. Active interventions remain essential. Many therapists recommend the 20–20 principle: every 20 minutes, a movement break of at least 20 seconds should be performed. Finger-spreading exercises, wrist mobilization drills, and targeted strengthening exercises can further improve tissue resilience and functional capacity over time.
Splints still have a place, but their use is now viewed more selectively than in the past. Wrist orthoses may be beneficial during acute overuse episodes or nighttime carpal tunnel symptoms but should not be worn continuously. Modern hand therapy increasingly recognizes that immobilization alone rarely solves the problem.
The Digital Workplace Is Changing Hand Therapy
Hand pain associated with working from home is no longer a niche issue. Current evidence clearly shows that prolonged digital work has real physical consequences—particularly for the hands and wrists.
For hand therapists, this creates an important responsibility: identifying problems early, promoting prevention, and helping patients better understand both ergonomic and functional stressors.
The good news is that most risk factors are modifiable.
This is where modern hand therapy demonstrates its greatest strength—not through passive treatment alone, but through a combination of evidence-based education, targeted exercise programs, ergonomic prevention strategies, and individualized treatment planning.
No ergonomic guidebook or smartphone app can replace what effective hand therapy provides: the ability to recognize functional problems early and intervene before temporary overload becomes chronic pain.
References
- Behrens T., Casjens S., Hosbach I., Ellegast R., Griemsmann S., Weber B., Wechsler K. (2024). Muskel- und Skelett-Beschwerden bei mobiler Bildschirmarbeit. IPA Aktuell 20. DGUV, Institut für Prävention und Arbeitsmedizin (IPA) / Institut für Arbeitsschutz (IFA). URL: de/ipa/publik/ipa-aktuell/ipa-aktuell-20 (abgerufen am 19.06.2026).
- Casjens S., Griemsmann S., Hosbach I., Wechsler K., Weber B., Clarenbach C., Petersen J., Neubauer B., Ellegast R., Behrens T. (2025). Changes in Musculoskeletal Pain Among Computer Workers When Working From Home. In: Journal of Occupational and Environmental Medicine 67(5) , S.363-370. doi: 10.1097/JOM.0000000000003337. Epub 2025 Feb 7. PMID: 39965904; PMCID: PMC12039904.
- Challoumas D., Ramasubbu R., Rooney E., Seymour-Jackson E., Putti A., Millar NL. (2023). Management of de Quervain Tenosynovitis: A Systematic Review and Network Meta-Analysis. JAMA Network Open. 6(10):e2337001. doi: 10.1001/jamanetworkopen.2023.37001. PMID: 37889490; PMCID: PMC10611995.
- DGUV Forschungsprojekt (2025). Muskel-Skelett-Beschwerden bei mobiler Bildschirmarbeit. Institut für Arbeitsschutz der DGUV (IFA), Stand 2025. URL: dguv.de/ifa/forschung/projektverzeichnis/ifa0508.jsp (abgerufen am 18.06.2026).
- DocMedicus Gesundheitslexikon: Mausarm (Repetitive-Strain-Injury-Syndrom) – Einleitung. Stand: 27. August 2024. URL: gesundheits-lexikon.com/Knochen-Gelenke-Sehnen-Muskeln-Bindegewebe/Mausarm-Repetitive-Strain-Injury-Syndrom (abgerufen am 19.06.2026).
- Santos W., Rojas C., Isidoro R., Lorente A., Dias A., Mariscal G., Benlloch M., Lorente R. (2025). Efficacy of Ergonomic Interventions on Work-Related Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2025 Apr 28; 14(9):3034. doi: 10.3390/jcm14093034. PMID: 40364066; PMCID: PMC12073017.
- Sheerin M., O’Riordan C., Conneely M., Carey L., Ryan D., Galvin R., Morrissey AM. (2023). Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta-analysis. Australian Occupational Therapy Journal 71(1), 2024, S. 175-189. DOI: 10.1111/1440-1630.12905
- Statistisches Bundesamt (Destatis) (2026). 25 % der Erwerbstätigen arbeiteten 2025 im Homeoffice. Pressemitteilung Nr. N024, 22. April 2026. URL: destatis.de/DE/Presse/Pressemitteilungen/2026/04/PD26_N024_13.html (abgerufen am 19.06.2026).
This article is intended for the professional development of hand therapists and rehabilitation professionals. It does not replace individualized clinical assessment or medical advice. All references were reviewed to the best of our knowledge (June 2026).
The IHHC Editorial Team is responsible for creating, reviewing, and continuously updating the content published by the International Hand Health Community (IHHC). Its mission is to present current knowledge from hand therapy, occupational therapy, physiotherapy, rehabilitation, and medicine in a way that is evidence-based, practical, and easy to understand.