By Evie Ullman, DPT
The majority of patients I see with neck pain have jobs that require them to sit in front of computers all day. Holding a static position in poor postural alignment for hours on end at your workstation can wreak havoc on the structures in your cervical spine. Your head, which weighs 8-12 pounds, sits atop your spinal column with the forces of gravity pulling down on it all day. Think of what this can do to the support structures underneath it.
The position of your low back is directly connected to neck alignment. Try this: sit up straight right now. If you did it correctly, the first thing that happened was that your hips rolled forward and you created a small arch in your low back known as lumbar lordosis. Then your chest came up and your shoulders rolled back, and lastly your head followed, creating another small but important backward arch in your neck known as cervical lordosis (loss of this lordosis causes extra tension on the spinal cord). Your chin should not protrude forward or be tucked down. You should be looking straight ahead. Seated posture starts from the bottom up, literally. Therefore, a good desk chair with rigid lumbar support is essential. If you don’t have one, get one. Even if your company can’t pay for it, you should spring for a new chair. How much money did you spend on your dining room furniture? On your living room furniture? How many hours per day do you spend sitting in that furniture? And how many hours per day do you spend sitting in your desk chair at work? Now do you think it’s worth spending money on your desk chair? If you still can’t afford a new chair, add-on lumbar support cushions, whether makeshift or prefab, are a decent short term solution, but they might shorten seat depth by too much and throw alignment off, so choose wisely.
Arm position at your desk is of utmost importance if you have neck pain. The weight of your arm can cause traction on the brachial plexus, a network of nerves that sprouts from the cervical spine and branches off in different directions down the shoulder, elbow, forearm, and eventually into the hand. When your shoulders are slightly shrugged up, they begin to cause upward compression on the cervical spine. When they hang down, they apply traction on the nerves. Ideally, your elbows should be bent at 90 degrees and your wrists should be straight on your keyboard, not cocked upward or bent downward. Your mouse should be even with the keyboard—don’t let it get away from you! You do not want to reach forward for the mouse. Laptop computers are horrible for people with neck pain. They force you to look like a praying mantis—this is not good posture for the human body! If you work on a laptop for more than 20 minutes at a time, you should get a peripheral mouse and a peripheral keyboard and only use the laptop monitor, set up higher on a desk so that the monitor is at eye level, essentially mimicking a desktop computer.
If you spend 15% or more of your time at work on the phone, you need to have a headset. Shoulder rests do not cut it. Whether they are short phone calls or long ones, each time you squeeze the phone between your ear and shoulder, you side bend your neck, compressing one side of the cervical spine. If your company can’t pay for a headset, buy one. You must have the right tool for the job. If you were a carpenter and you needed to bang nails into the wall and you didn’t have a hammer, would you use a rock? No. You would go get a hammer. So get a headset!
For those of you who work on two computer monitors simultaneously, I recommend placing those monitors as close together as possible, and when switching back and forth between the two, swivel your chair slightly instead of turning your head.
Click the link for a diagram of correct seated posture for computer work.
If you are still unsure about your workstation, use your cell phone camera and have a coworker snap a side view photo of you seated at your desk, and bring it to your Physical Therapist.
Dr. Ullman is a Physical Therapist at Boston Sports Medicine
