Work-related upper back, shoulder and neck discomfort are generally observed more in workers with sedentary, desk based roles. Since March 2020 and the shift to home working, I have noticed an increase in the prevalence of upper back, shoulder and neck discomfort among employees I have carried out DSE assessments with.
In this blog post, I am going to identify the potential physical causes of upper back, shoulder and neck discomfort associated with desk-based jobs and the steps you can take to reduce the risk of developing these issues.
Factors That Increase The Risk of Upper Back, Shoulder and Neck Discomfort at the DSE Workstation
There are a number of factors present in desk-based roles that can increase the risk of developing discomfort in the upper back, shoulders and neck.
Prolonged Desk Based Postures
Static desk based postures require continuous contraction of the muscles of the upper back, shoulders and neck. This continuous contraction, or loading, in a fixed position results in reduced blood flow in the muscles, meaning that waste products cannot be removed effectively and oxygen and nutrients cannot be distributed efficiently. This causes fatigue and discomfort in the musculoskeletal system, which can contribute to those aches and pains you feel at the workstation.
This static loading of the upper back, shoulder and neck happens whether you are in the seated or the standing position, especially if you are using the keyboard and mouse.
Prolonged sitting causes imbalances in our core stabiliser muscles due to the overuse of some muscles, but low activation of others. The abdominals can weaken while the lower back muscles tighten. The glutes can weaken and the hamstrings and hip flexors tighten. These imbalances and deconditioning of the spinal muscles can impact the alignment and strain on the upper back muscles.
Prolonged hunched and forward leaning postures can also contribute to what is known as Upper Cross Syndrome. This occurs when the upper back, shoulders and neck become overworked and strained, while the chest muscles become short and tight. This in turn causes the muscles in the front of the neck and the lower shoulder to become weakened.
Prolonged mouse use, especially if you use the mouse with the right hand and use a standard size external keyboard, can increase workload and fatigue in the right shoulder.
Inadequate Lumbar Support
Poor lumbar support when seated at the workstation can increase loading on the spine and back muscles and tissues. This strain and fatigue contributes to increased strain and discomfort in the upper back, shoulders and neck.
A lack of lumbar support can arise due to inappropriate seating at the workstation, such as a dining chair or swivel chair with a fixed backrest, or by the incorrect placement of the lumbar support of the DSE office chair.
Adverse postures refer to postures that put excessive strain on the musculoskeletal system. They occur at the workstation due to incorrect positioning, inappropriate equipment, fatigue and bad habits!
Common desk related adverse postures that can increase strain on the upper back, shoulders and neck include being seated at the incorrect height for the work surface, the work surface being either too low ro too high for your standing position, hunching forward and looking down at the laptop, and sliding forward in the seat.
Mouse position can also be a cause of adverse postures if you use the mouse with the right hand and use a standard size external keyboard. The position of the mouse relative to your midline causes adverse postures of the right shoulder.
Also, having the keyboard and mouse too far from your seated position can cause you to lean forward or reach forward when using these devices.
These postures put excessive stress on the spine, discs and tissues and increased strain on the upper back, shoulders and neck.
The main source of contact stress at the workstation that can impact upper back, shoulder and neck discomfort is the contact between the edge of the table and the forearms when seated too low for the workstation, or when the standing height of the desk is too high for your stature.
While this contact stress does not directly cause discomfort in the upper back, neck and shoulders, it encourages increased stress and tension in the shoulders as we compensate for this imbalance between working position and surface height.
Reducing The Factors That Increase The Risk of Upper Back, Shoulder and Neck Discomfort at the DSE Workstation
Reduce Prolonged Static Postures
I recommend taking regular microbreaks from the workstation every 45 minutes to decompress the discs in the lower back, activate the glutes and core, relieve tension in the back and shoulder muscles and increase circulation. These microbreaks should be taken away from the workstation, to allow the upper body to relax and recover.
If using a sit stand workstation, ensure to change posture regularly. Avoid prolonged static standing and take regular microbreaks to boost circulation.
Take calls on the move when you can and a wireless headset can be a great tool to allow frequent movement from the desk during virtual meetings when working from home.
Remember, using a sit stand desk in the standing position is not a substitute for mobile microbreaks!
Ensure the Lower Back is Supported When Seated
If using a chair with a backrest that cannot be adjusted, add additional cushioning or a lumbar support that can be positioned in the lumbar spine.
If using a DSE appropriate office chair, ensure that the backrest or lumbar support height is adjusted to position the lumbar pump in the lower back. Ensure the recline is adjusted so that your back rests against the backrest when in the typing position.
Reduce Adverse Postures
To reduce adverse postures at the desk, ensure you are seated at the right height for the surface, with shoulders relaxed and elbows level with the surface and support underfoot if required. Use a footrest if required.
Ensure the monitors are at the right height to allow you to rest your eyes on the top third of the screen when your ears are over your shoulder. If using a laptop or tablet, use an external keyboard and mouse to allow you to raise it up to an appropriate height.
Keep the keyboard, mouse and any frequent use equipment close to you to reduce reaching and forward leaning postures. If you operate the mouse with the right hand and are using a standard keyboard, consider changing to a compact keyboard to improve mouse alignment. If you use the numeric pad on the standard keyboard, a separate numeric pad can be used on the left hand side of the keyboard.
Sit back in the chair, with your back in contact with the backrest.
Reduce Contact Stress
To reduce contact stress that can contribute to upper back, shoulder and neck discomfort, ensure the relationship between your seated or standing height and your work surface allow you to operate your devices with relaxed shoulders. You should not feel pressure between your wrists or forearms and the edge of the desk.
While upper back, shoulder and neck discomfort may not always be caused by the desk, desk-based DSE roles can aggravate any underlying conditions or injuries.
It is important that any discomfort is reported and addressed as early as possible and an ergonomic risk assessment is completed to reduce levels of discomfort and long term impact.