Why does my neck hurt after work?

Neck pain is a common complaint I hear as a therapist. Many patients with symptoms of neck and upper back pain say it worsens throughout the work day. For these patients, positioning of their workstation can have dramatic impacts on how their body feels after working a full day at a desk. Some people may have underlying conditions that cause pain, and some may have sustained injuries, but most are suffering from the impact of poor ergonomics. How we sit at a desk impacts the whole body, but especially the upper back, neck, and shoulders. In a time where many people are working from home, an ideal desk setup may not be practical, but there are things we can do to set ourselves up for success.

The study of ergonomics focuses on “designing and arranging things people use so that the people and things interact most efficiently and safely”. https://www.merriam-webster.com/dictionary/ergonomics As physical therapists, we are trained to observe the setup of work conditions in various occupations and help patients arrange their work stations to create efficiency and safety. I had a patient recently who had two computer monitors at her desk. She had one main monitor and one to the side, but she was constantly turning her head to look at the side monitor. Along with other therapies, changing the setup so that the monitors were centered on her desk helped relieve her symptoms. She received manual therapy to her neck and upper back, neuromuscular re-education to the stabilizers of her neck, postural exercises, stretches and strengthening exercises for home, education about her condition, and education about work station setup. Together, these therapies alleviated her symptoms and allowed her to engage in physical activities, such as weight lifting, that she was previously avoiding due to neck pain.

Looking at a screen with improper workstation setup can lead to increased strain on the neck and increased muscle recruitment from muscles that should not be firing continuously. In perfect biomechanics, the external auditory meatus (or the hole in your ear) should line up with the tip of your acromion, or the pointy bone at the edge of your shoulder. When the external auditory meatus is in front of the tip of your shoulder, it is known as anterior head carriage, or forward head position. Forward head position creates much stress and strain on the neck and often causes pain and/or headaches. For every inch of forward head posture, it can increase the weight of the head on the spine by 10 additional pounds. Kapandji, Physiology of Joints, Vol 3.

Another issue comes when the shoulders start rolling forward. This means that the scapulae, or shoulder blades, are not in a “correct” position in relation to the spine and rib cage. The shoulder blades are meant to sit on the ribcage, tipped slightly forward and inward toward the spine. If the shoulders roll forward, the shoulder blades tip excessively forward and inward, creating stress on the muscles that attach to them. You can also have what is called downward rotation of the shoulder blades, which often occurs when the levator scapula muscle gets tight and overworked, which causes stress on the upper trapezius muscle. The levator scapula and upper trapezius are two of the large muscles of the neck and often contribute to neck pain and/or headaches. When these two muscles are in discord, the levator scapula gets tight and the upper trapezius gets lengthened and taut. This dysfunction often occurs due to improper posture.

The issues described above can be observed by the shoulders sloping excessively downward from the neck and top of the sternum or the shoulders rounding forward excessively. If you have a desk job and the keyboard is too far away from your body, you may be reaching forward all day, which can cause these dysfunctions to occur. This may also happen if you do not have proper back support and you are slouching most of the day.

If you think improper ergonomics may be contributing to your neck pain, upper back pain, or headaches, contact Moms in Motion PT today so we can come observe your setup, explore contributing factors to your pain, and treat your neck pain appropriately! Visit our website, www.momsinmotionpt.com, for more information and to become a patient.

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