Office work – a pain in the neck?

If you work in a clinic in a big city, then neck pain is probably one of the most common condition you manage. In office workers, neck problems are quite likely due to a poor workplace and postural habits, stress and long hours, combined with physical deconditioning due to inactivity. Addressing these issues is key to getting these patients better and below we highlight some key points in successfully managing neck pain.

1. Workplace assessment – Most large corporates will have this service available to their workers to ensure their desk set-up is ideal. After all, it is in their best interests to keep their workers healthy, happy and productive. For example adjustable desks to allow workers to regularly change their work position from sitting to standing are becoming more common and one study revealed it can reduce upper back and neck pain by 54% (Pronk et al 2012).

2. Reduce stress – Stress can be a big driver of pain, so it is certainly worth discussing this with your patients. How can they reduce stress? Much of this relies on addressing the causes. Unrealistic expectations from employers is a key one and a study by Kaaria et al (2012) showed that workplace bullying and work related emotional exhaustion were predictors of chronic neck pain in employees. We can’t always control this but we can at least encourage our patients to dig deeply into the causes of their stress. This gives them a starting point to address it.

3. Get more active – this ties in with the above point. Long hours at the desk means less activity. Considering that physical exercise helps to reduce anxiety symptoms (Jayakody et al 2014), then it is something we should to highlight to our patients. Being physically active reduces the likelihood of having neck pain (Cagnie et al 2007). This is most likely the result of reduced stress and an overall better physical condition.

4. Change postural habits – A study by Szeto et al (2005) showed that those with ‘high discomfort’ neck pain had an average 8 degree increase in head flexion angle compared to a low discomfort group during the performance of a typing task. Furthermore, they had significantly higher activity in the upper trapezius and lower activity of cervical extensors. It is proposed that this increased extensor demand results in the higher activity of upper trapezius, which anatomically is designed for shoulder elevation, as opposed to controlling the neck extensor moment. A concerted effort to change postural habits is a must and exercises done regularly at the desk such as chin retractions and scapular positioning exercises may assist. Additionally, very simple movement exercises such as shoulder rolling, neck flexion/extension, neck rotations, back extensions and lateral flexion performed twice a day over 4 weeks has been shown to reduce pain and improve function in those workers with moderate to severe neck and shoulder pain (Tunwattanapong et al 2015).

Workplace assessments and a concerted effort to change postural habits may be key to reducing neck pain.

While the above approach sounds simple, the biggest issue is actually having your patients change their habits to address these issues. Support and an emphasis on long term self management is critical in this process. Only then can we help bring about a sustainable change and improved quality of life for these patients.

REFERENCES

Cagnie, B., Danneels, L., Van Tiggelen, D., De Loose, V., & Cambier, D. (2007). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine Journal, 16(5), 679-686.

Jayakody, K., Gunadasa, S., & Hosker, C. (2013). Exercise for anxiety disorders: systematic review. British journal of sports medicine, bjsports-2012.

Kääriä, S., Laaksonen, M., Rahkonen, O., Lahelma, E., & Leino‐Arjas, P. (2012). Risk factors of chronic neck pain: A prospective study among middle‐aged employees. European Journal of Pain, 16(6), 911-920.

Pronk, N. P., Katz, A. S., Lowry, M., & Payfer, J. R. (2012). Peer Reviewed: Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Preventing chronic disease, 9.

Szeto, G. P., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—1: neck and shoulder muscle recruitment patterns. Manual therapy, 10(4), 270-280.

Szeto, G. P., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—2: neck and shoulder kinematics. Manual Therapy, 10(4), 281-291.

Tunwattanapong, P., Kongkasuwan, R., & Kuptniratsaikul, V. (2015). The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: A randomized controlled trial. Clinical rehabilitation, 0269215515575747.