(Business 2.0) – Offices can be dangerous places. Certainly not as dangerous as meatpacking plants, where one out of four workers falls sick or is injured each year. Still, a sedentary and stressful lifestyle can leave the deskbound with wrenching back pain, elevated blood pressure, even muddled brains. Here's how to ward off the perils of the workplace. --MARY DESMOND PINKOWISH

PROBLEM: FATIGUE

MAY LEAD TO: Muddled thinking, cravings for starchy or sugary foods, and a greater chance of heart disease.

[PROBLEM:] STRESS

[MAY LEAD TO:] GERD, an impaired immune system, and abdominal fat, which increases the risk of heart disease.

[PROBLEM:] REPETITIVE STRAIN

[MAY LEAD TO:] Tingling, numbness, muscle weakness, or shooting pains in the arms, legs, and lower back.

FATIGUE

Are your love handles growing? A lack of sleep could be making them grow faster. If you're taking a lot of work home and going to bed too late to get enough sleep, scientists say you're headed for trouble. First, the sleep-deprived often have trouble thinking clearly and remembering details. But it gets worse. Lack of sleep may cause a hormonal change that can trigger cravings for sugary and starchy foods, enough that diabetes--rather than that important sales call--could become your biggest problem. Finally, scientists are also seeing further evidence that fatigue raises the risk of heart disease.

SOLUTIONS: The simple answer is to sleep longer. A 20-minute afternoon nap works great, but that's not an option in most offices. Instead, try exercise: Working out stimulates neurotransmitters in the brain, keeping you alert.

ALTERNATIVE: Provigil is used to treat narcolepsy, but a few doctors are prescribing the drug for people who work long hours without sleep. It is, of course, risky, since the long-term effects aren't known. Still, users say it keeps them alert without the jangling feeling caused by amphetamines or caffeine.

SHOULD YOU WORK WHEN YOU'RE SICK?

Feed a cold, starve a fever ... and either way, stay the heck out of the office. After all, if there's one thing that the spread of SARS is reminding health officials, it's that quarantines work. Don't be a hero; instead, ask your IT folks to set you up with remote e-mail access.

For those stuck in the office with hacking martyrs who think they're so valuable that they can't miss work, do what your mom told you: Keep your fingers out of your eyes, nose, and mouth. And wash your hands throughout the day, not just after you use the bathroom. A recent study found 428 times more bacteria on the average desk than on the office's toilet seats.

STRESS

Churning gut, hammering heart. Sometimes it seems you can actually feel the poison--adrenaline--flowing through your body. Your blood pressure goes up. You take shorter, panting breaths. Muscles tighten, and hormones are released into your bloodstream, muddling your thinking, increasing your risk of heart disease, and hindering your immune system. Excess cortisol, a hormone that has been linked to the development of abdominal fat, gets released. Meanwhile, stress produces heartburn, which is the unpleasant sensation of stomach acid eating away at your esophagus. When it occurs regularly, it's a serious condition known as gastroesophageal reflux disease (GERD).

SOLUTIONS: Hundreds of books have been written about stress, but the best advice boils down to keeping yourself at a simmer. Projecting a calm demeanor induces a less reactive cardiovascular system. Breathe deeply; drop your shoulders and lift your head and neck until you feel a good stretch in your torso.

Beyond relaxation, the most effective weapon may be exercise, which helps to relieve tension and also appears to reduce cortisol. If you can't always get to the gym, drop and give us a dozen push-ups, soldier.

As for GERD, drugs called proton pump inhibitors--such as Nexium, Prevacid, and Prilosec--reduce stomach acid and help the esophageal lining to heal.

ALTERNATIVE: Stress experts recommend "progressive muscle relaxation," a method that has been shown to reduce outbursts in the mentally disturbed. You begin by tensing the muscles in the face, for as long as 10 seconds, then relaxing them. You repeat the process down through other muscle groups, all the way to your feet.

CAN I TELL IF IT'S A HEART ATTACK?

In a word: No. If you feel a tightening or crushing pain near the sternum, you could be having a heart attack. Then again, it could merely be heartburn, a muscle spasm, or an anxiety-driven panic attack. The symptoms can be similar--which is yet another good reason to deal with your stress issues--but it doesn't pay to guess. An attack isn't always sudden; it can start slowly with mild discomfort. Symptoms--and remember, you won't necessarily feel all of them--include chest pressure; pain in one or both arms or the back, neck, jaw, or abdomen; sweating or nausea; and shortness of breath. Call 911 if symptoms persist for more than five minutes. Even if you aren't sure it's the real thing, get it checked out.

REPETITIVE STRAIN

Carpal tunnel syndrome is very real and very painful. The tingling, numbness, and--in the worst cases--shooting pains are caused by prolonged bending of the wrist, which pinches a nerve. But it's hardly the only such affliction. Cradling the phone's handset between your neck and shoulder can compress nerves in the neck and cause similar symptoms in your arms and upper back. Sitting hunched over with your legs dangling or tucked under the chair will do it to your lower back and legs.

SOLUTIONS: It's all in how you sit. Keep your ears, shoulders, and hips in a vertical line. Position your monitor at arm's length (you should be looking down at a 15-to 20-degree angle). Set the keyboard so your elbow forms a 90-degree angle. Make sure your chair has lumbar support and the front edge slopes slightly forward. Put your feet flat on the floor or invest in a footrest. As for the phone, buy yourself a headset.

Also, do stretches like the ones illustrated at right periodically throughout the day.

ALTERNATIVE: A growing number of psychiatrists think some forms of neuromuscular pain are really a symptom of depression. In one study, chronic pain was about four times more common among people with severe depression than in those without major mood disorders. Antidepressants seem to treat the pain, some recent research shows.

Separate and straighten your fingers until tension stretch is felt. Hold for 10 seconds. Relax, then bend your fingers at the knuckles and hold for 10 seconds.

Open your eyes as wide as possible. Open your mouth and stretch the muscles around your nose and chin and stick your tongue out. Hold for 10 seconds.

Raise your shoulders to your ears until you feel slight tension in your neck and shoulders. Hold for three to five seconds, then relax. Do this two or three times.

Turn your chin toward your left shoulder to create a stretch on the right side of your neck. Hold for 10 to 20 seconds. Do the left side. Repeat.

SOURCE: University of Maryland Department of Environmental Safety

ARE PRICEY ERGONOMIC CHAIRS THE ANSWER?

Though some people buy them for status, the sales pitches for those $600-and-up desk chairs like Herman Miller's Aeron, Humanscale's Freedom, and Steelcase's Leap usually focus on ergonomics. And indeed, they are extremely comfortable: You can sit for hours without noticing that you're sitting. Alas, that's often part of the problem: The inactivity can cause muscles to cramp and puts pressure on nerves in the arms, legs, and back. If you have the option to grab one of these chairs, take it--but make sure to stand up and stretch at least once an hour, or prepare to suffer the consequences.