How to avoid back and neck pain at work
Back and neck pain affect a large proportion of the population and 80% of people will experience back pain in their lifetime. Furthermore, 1 in 2 visits to the GP are associated with musculoskeletal issues and 57% of these visits are attributed to neck and back pain.
A major cause of this increasingly common issue is the link between back and neck pain and increased number of hours we spend sitting.
Many office workers now spend majority of their working week sitting at a desk using a computer. This makes them susceptible to back and neck issues especially if their environment is set up in a way that puts them at further risk of injury, with long periods of sitting shown to be associated with detrimental musculoskeletal and cardiovascular symptoms.
In fact, research has shown low level repetitive forces are much more hazardous than those less frequent higher exertion forces. This means you may be more susceptible to back and neck injury sitting in your office chair than someone in a much more physically demanding job due to the long and repetitive nature and static posture of the tasks carried out in these roles.
Patients may develop poor head, neck and shoulder posture due to poor sitting habits and environment set up as well as carrying out repetitive tasks and movements such rotation to one side. This can result in aggravation of joints and discs in the spine as well as the supporting soft tissues and can be further exacerbated by pre-existing issues such as already tight or weak structures.
This increased stiffness caused by long periods of sitting also places you at higher risk of further musculoskeletal injury when you do move such as at the gym after work.
The types of injuries that can occur include:
Pain and functional impairments of muscles
Inflammation and functional impairment of bones, joints or tendons
Compromised nerve function due to compression, impingement or stretch on nerves – this can further affect limb function and sensation
Degenerative disorders such as arthritis and degenerative disc disease
Symptoms as a result of these injuries include:
Local or generalised pain and discomfort
Loss or hypersensitivity in particular areas
Loss of muscle motor control, strength, endurance
Loss of flexibility of muscle and joint range of motion
Change in posture, balance and control of movements
Change to muscle tone or bulk
Abnormal joint alignment and loss of joint stability
These symptoms will make the performance of tasks more difficult and affect daily activities and quality of life. They change the way we move and result in awkward postures than may cause further pain and damage. Not only will these issues have a physical effect, research has also shown them to have an effect on concentration, cognitive capacity, stress levels and mood.
People in high stress jobs with high cognitive demands and decision making tend to be more susceptible to musculoskeletal injuries with there being a correlation between stress and tissue damage. As are those with high workloads and long hours due to the affect increased fatigue has on tissues as well as inadequate recovery time and being less likely to be physically active due to being time poor.
The risk of these neck and back issues only increase with age due to tissue degeneration, making them more susceptible to the risks associated with repetitive movement and poor posture as well as the cumulative exposure to these risks over a period of many years. However research has also shown that those older individuals who maintained a healthy active lifestyle had the physiological functioning of sedentary adults 15 years younger. Therefore not only is a good environment set up important, but so is continuing to lead a healthy and active lifestyle, particularly as one gets older but also at any age, as this will reduce the stress on all tissues of the body particularly in the back.
Research from the American College of Sports Medicine recommends the average individual accumulates 150min per week of moderate or 75min of vigorous aerobic activity as well as strength training 2 times per week.
As discussed, poor posture is a large contributor to neck and back pain, particularly forward head and shoulder posture and common in those spending long periods looking down or forward such as when using a computer. This posture puts increased stress on lower neck vertebrae increasing degeneration of discs, facet joints and other structures. This causes the muscles of the neck and upper back to overwork and act in a way they are not designed to in order to counteract the effect of gravity, pulling the head down causing not only pain and trigger points but also reduced range of motion. The resultant forward shoulder and rounded back will also make these individuals more susceptible to shoulder and back pain.
To deal with this it is often important to look at the workplace ergonomics as part of not only treatment but also in prevention of neck and back pain.
Desk and chair set up, as well as computer and keyboard lay out, will play a significant role in promoting good neck and trunk posture and limiting risk of injury and pain.
Environment set up to prevent back and neck pain:
Surface height of desk – needs to suit task to be done and the height of the individual. Sitting at desk you should be looking straight ahead
Seat height – allows elbows to be 90 degrees, by side, forearms parallel to floor when typing. Feet are flat on floor, thighs parallel to floor. If unable to get feet/thighs and elbow/forearms to match up may need a footstool to raise knees level with hips. The backrest should maintain natural curves of the spine.
Screen height - Eyes pointed at top 1/3rd of screen – close eyes when you open them where eyes fall is where middle of screen should be
Set up work station so not rotating constantly to 1 side more than other – e.g. if have 2 screens 1 screen off to right will result in repetitive and asymmetrical rotation in 1 direction
Ensure adequate lighting to prevent detrimental postures in an attempt to see better.
Change positions frequently – stand , sit, stretch, walk Research has shown that improvements to workstation set up, particularly monitor, key board and chair adjustments resulted in significant reductions in neck and back complaints as well as reducing stress levels among workers.
Safe work Australia, an Australian government initiative launched to help promote a safe work environment for Australians in all industries has found that majority of work place injuries occur due to exposure to repetitive low load movements such as sitting. They suggest prevention is the only way to reduce back injuries. By eliminating the exposure to the mechanism of injury this will reduce the injury rates and therefore reduce time lost and cost to both the individual and the business.
5.4 weeks is the average time lost due to injury and even those whom didn’t lose time had reduced functional capacity, work performance and productivity. By identifying risk factors within your environment and applying the principles of ergonomics it is possible to reduce the risk of an individual having neck or back pain as well as other work place injuries
5 Quick Tips to Avoiding Neck and Back Pain at Work
Our ergonomic guru Jane Parry has six years' experience working as a rehabilitation consultant conducting work place ergonomic reviews and is particularly passionate about this issue and assisting people prevent injuries and pain at work. These are her tips to help keep you healthy at work:
1. Use a pedometer - Something like a Fitbit or phone app is useful to track your movements throughout the day and make sure you are getting your 10 000 steps in. You may be surprised at the number of steps you actually do on a day to day basis. Generally the total is much lower than expected. Even if you monitor this for a week or so to get a gauge and know how much more you need to be doing to achieve the total.
2. Change position. REGULARLY – set an alarm every 30mins/1 hour on your phone as a reminder to get up move, even if it is simply walk to the water cooler and get a drink. Sitting for just 2 hours results in 50% loss of fluid in intervertebral discs, once this occurs you are no longer cushioned by these discs but rather sitting on your facet joints. To prevent this move sooner rather than later.
3. Use a document holder – By placing a document holder between computer screen and keyboard it allows you use both books and computers and write as well as type without having the need for repetitive rotation side to side. This is a cheap and easy investment that could save you plenty of pain in the future. Have a look at the Sit Back And Relax website for some affordable and effective document holders
4. Email on the computer – using a computer rather than your phone to respond to majority of your emails allows you to create a controlled set up that promotes good posture rather than that promoted when using your small screen and keys. Although sometimes this is not always possible, try to limit yourself to 5 emails a day on your phone and only those that are urgent.
5. Take objects such as wallets out of your back pocket. The slight change in pelvic and spine alignment caused by this over a long period of sitting can cause significant back pain. Simply take the object out and place it in your drawer or on your desk for instant improvement in posture and alignment. I you have any further questions or want to learn more feel free to give the practice a call or drop by and chat to Jane or any of our physios.
About the author
Bay Active physiotherapist Emily Leys is also a team physio for the NSW Waratahs and a professional cricket player for the Sydney Sixers. She graduated from the University of Sydney in 2015 and has a particular interest in sports and soft tissue injuries.