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Ascent Integrative Health

Fix Your Neck! Mark’s Guide to Feeling Good at Your Desk Again

Posted 4 months ago on

Tight, achy neck? Neck pain is a common problem for office workers that leads to absenteeism and decreased productivity. Worse yet, it interferes with what’s important outside of work once it sets in as well. This guide is intended for the kind of neck pain that comes on with prolonged sitting, involving tight, aching muscles and stiff and sore joints. The following information is guided by current science in pain and biomechanics and can help you in getting back to feeling like yourself. Read, take control, and feel good again!

Before We Begin

Although this guide covers a lot of the basics, there is no one-size-fits all approach to neck pain. If you have been having neck pain from your desk for more than 1-2 weeks, and it is not getting better with the advice followed in the book, physiotherapy can help. A physiotherapist can assess and provide a treatment plan specific to your body and situation. Physiotherapists are also highly trained to look for signs and symptoms that suggest your pain is more than just aggravation from your desk job and know when to refer you to a doctor for help. Your safety and long-term well-being are the most important things of all to us.

Physiotherapy, when done right, aims to get you better for the long-term rather than just provide temporary relief. When you attend a physiotherapy session, we will perform a thorough assessment and tailor a program specific to you. We will perform various hands-on interventions such as soft tissue release, joint manipulation and mobilisation, dry needling or acupuncture, and/or other techniques to help you feel better in the short term. Most importantly, we will get down to the root of the problem, educate you and empower you, and provide you with the routine and tools to get you back to feeling better again for good!

Signs of Postural Neck Pain

·       Pain is worse when sitting for long periods or when first moving after a long time of sitting

·       You feel worse when you are inactive compared to when you are more active

·       You get headaches with your neck pain from time to time

·       When pain radiates across the shoulders into the shoulder blades

·       When during painful episodes there still are periods in the day with no pain (even if only for a few minutes).

·       If you sometimes experience fluctuating pain, numbness or pins and needles radiating down your arm and into your hand.

·       You have had multiple episodes of neck pain over the years (i.e. neck pain for a few days or weeks followed by feeling pain free for a few weeks and months, only to have the pain later return, and so on).

·       During times when your neck is pain free you have good range of motion

 

Neck Mechanics 101: ‘Upper-crossed’ Posture

Muscles adapt in response to the positions that they spend the most time in and to the movements that they most often perform. Most office-related neck pain follows a similar pattern. Of course, everyone is going to be somewhat different, but there are some common and predictable muscular imbalances that are frequently seen in people with neck pain.


Muscular Imbalances

Your upper trapezius and levator scapula run from the top of your shoulder blade to the base of your neck work to elevate your shoulders. Your pectorals run from the front of your shoulders to the center of your chest and pull your shoulders forward. With head-forward posture these muscle groups often sit in a shortened position and become tense. Imagine rounded, elevated shoulders. These muscles benefit from gentle stretching and massage.

Your deep neck flexors sit in the front of your neck and help to hold your head upright. The lower and trapezius and serratus anterior muscles stabilize your shoulder blades. With computer work these muscle groups often rest in a stretched position and become under-active. Imagine the front of your neck being stretched as your chin pokes forward and the muscles stretching across your back as it rounds. These are muscles that we need to activate and strengthen!

Stiff Joints

Joints get stiff over time too if they spend most of their time in the same position and not enough time moving through their full range of motion. This is most commonly seen at the base of the neck where your cervical spine (the top seven vertebrae of your spine) meets with your thoracic spine (the middle 12 vertebrae of your spine where your ribs attach). Other issues may occasionally occur higher up in your neck, but these are best addressed in person by a professional.

Taking a little time to gently move your joints in all their ranges of motion can improve your mobility and prevent stiffness from developing. While sitting as tall as possible, bend forwards, backwards, side to side and twist! Of course, avoid moving beyond the point of mild discomfort.

 

Ergonomics Set You Up for Success

Good ergonomics can help you feel better and prevent future pain. Simple modifications to your workspace can help promote good posture and alignment. Here are some tips to check for with your workstation:

Set your chair height so that your feet rest flat on the floor and your thighs are horizontal, parallel with the floor.

·       Your chair height should be set so that your feet rest flat on the floor or a stool and your thighs are parallel with the floor.

·       There should be a 2-3 finger-wide gap between your knees and the front edge of your chair.

·       Your back support should rest in the small of your back. A pillow or lumbar support roll can help here.

·       Your computer screen shoulder be 18-30 inches from your eyes, and the centre of your screen at or just below eye level.

·       Your wrist should be straight and in a neutral position; avoid tilting the back of the keyboard upwards.

·       Keep items that you use most often within easy reaching distance

Perfect Posture Does Not Exist

Stiff joints and muscular imbalances aside, it is important to know that there is really no such thing as ‘good’ or ‘bad’ posture. People come in all shapes and sizes and there a million variants of ‘normal’ in humans, and every body has its own version of ‘ideal.’ Some people are short and stocky, others tall and slender; some are flexible but shaky, others are stiff but strong.

In fact, occasionally people can have what looks like terrible posture yet have zero pain, and someone with picture-perfect alignment may develop significant pain from just a minor shift. Pain is produced by processing centres in your brain, and all of us have brains and nerve systems that react in different ways to changes in our bodies. Typically, more sudden changes to your body are more likely to set off your nervous system’s alarm system and fire off pain signals in your brain.

This does not mean that posture doesn’t matter. Pain and posture often depend on the context of the situation. For some people, time will catch to them, and for others (for a variety of reasons), it won’t. You may have no pain at all if you only spend six hours a day sitting with head-forward posture, but things may start to feel sore and tense when you have a big deadline to meet and suddenly change from four hours of sitting per day to ten. Someone who gets into a car accident and suffers from whiplash may suddenly find the sitting posture they’ve had for years suddenly causes a lot of discomfort. Another person who has been sitting at a desk for ten years with poor posture and stiff joints may have feel fine on most days but might find themselves at a higher risk for injury when they decide to jump into bootcamp fitness classes that require excellent mobility and muscular control. In other cases, the trigger may be a small shift in lifestyle that requires some detective work to figure out.

Stress Can Leave You Feeling Stuck

Neck pain is commonly associated with stress. Contrary to popular belief, research shows that stress alone doesn’t typically actually cause neck pain; however, if other aggravating factors, like poor ergonomics, are also at play, stress can feed into the problem. It can also make it more difficult to recover once the pain is there. Being stressed can make it easy to focus on every ache, twinge, and restriction we feel, and its easy to get caught up in it.

Remember that most neck pain is benign and will get better, and that you are going to be okay. Take some time out of your day to relax and practice some self-care. Take a warm bath or shower, get outside, and spend quality time with friends and family. Do things you enjoy that help to take your mind away from the pain.

A simple strategy is to find a quiet place without interruption and focus on deep diaphragmatic breathing – focus on taking long breaths in as your belly expands and long breaths out and you belly grows smaller. This can relieve stress and relax the muscles of your neck all at once.

 

Take Breaks! Move More! The Most Important Advice We All Know but Never Follow.


Movement is medicine!
If you take anything away from this guide, this is it! It’s very easy to get caught up in your work when you are busy or very passionate about what you do. However, this shouldn’t come at the expense of your neck or overall health! Neck pain can really hamper productivity, and worse yet, interfere with you doing the things you love outside of the office.

Set alarms on your phone or computer to remind you to get up and move around from time to time. Change positions frequently. Although standing desks have become popular, standing can be just as hard on your neck as sitting if you do not take the time to move and change positions frequently throughout the day.

You also do not need to sit up or stand straight 24/7 to keep your neck and back healthy. Relax– slouching in of itself for short periods isn’t going to ruin you. The bigger problem, whether you sit or stand at your desk, is staying in the that same one position for too long—over weeks, months, and years, your body will eventually stiffen the position it spends most of its time in without regular movement in all ranges of motion. If you’re looking down at your phone throughout the day and rarely look upwards, eventually its going to get tougher to look upwards as you age. Mix it up from time to time and move around lots!

Stretch! Look up, down, over each shoulder and bend from side to side. Stretch out your shoulders and move your arms around. If you are in pain, keep movement slow and gentle and avoid moving beyond the point of mild discomfort. Take every opportunity you can to get up from your desk and walk around. When you have enough time, try some light exercise, like going for a brisk walk. Many patients worry that exercise will make their neck pain worse, but in most cases getting your heart rate up and breathing in some fresh air is all you need to start feeling better.

When to See Your Family Doctor

Most cases of neck pain don’t need to be seen by a doctor and will eventually get better with conservative management. However, there are specific warning signs to look out for that may indicate your problem is more serious. Contact your family doctor if you experience neck pain with any of the following:

– When pain intensity is severe and/or worsening over time despite conservative management

– Immediately following trauma such as falling, a motor vehicle accident, or a blow to the head

– Severe pain radiating down into both arms at the same time

– Severe headache

– When light tapping on the spine is painful

– When there are signs of infection (fever, fatigue, night sweats, redness, discoloration, swelling or any visible tissue deformity), or when you cannot bend your head forward.

– When there is significant weakness, heaviness, or loss of feeling in the extremities

– When pain is constant and unchanging no matter what position you are in or activity you are doing, and/or accompanied with unexplained weight loss (i.e. not a single minute during the day without pain)

– Associated with dizziness, vertigo, light-headedness, clumsiness, or loss of balance

– When accompanied by other unwell symptoms in your body

If you are ever unsure about your situation, it is always best to seek help. If you are still unsure whether your neck pain requires your doctor’s attention, feel free to get in touch which the clinic where we will be happy to provide some advice and direction.

Set alarms on your phone or computer to remind you to get up and move around from time to time. Change positions frequently. Although standing desks have become popular, standing can be just as hard on your neck as sitting if you do not take the time to move and change positions frequently throughout the day.

Wear and Tear is Normal!

It is common for people with the most benign cases of neck pain to end up in their doctor’s office and, in an over-achieving effort to be as safe and thorough as possible, many are misguidedly sent for numerous unnecessary scans and investigations. Most x-rays and MRIs of the neck will show normal age-related wear and tear, which can be very frightening if you are not well-informed on how the human body changes as we age. Dwelling on these scans can really set you down the wrong path and make you fearful of movement and exercise, which is often what is needed to get better.

Do you tell your mother that she has ‘degenerative face disease’ because she has wrinkles? Of course not. The same principle applies to your spine—many cases of ‘degenerative disc disease’ are like wrinkles on the inside—they are not necessarily the cause of your pain.  Wear and tear happens in all of us, even before we hit middle age, and does not always correlate with or cause pain. Some people have severe wear and tear and feel fine; others have minor wear and tear and feel awful. Studies have shown that most people in their twenties with no neck pain will still have disc bulges on an MRI. Many cases of chronic neck pain actually get better as people enter their 60s and 70s, which wouldn’t be the case if it all came down to wear and tear.

There are always exceptions, and sometimes scans can provide helpful insight in more complicated situations, but for most people there is little to worry about when you get scans showing degenerative change.

 

Take Control: Do-It-Yourself Exercises

This guide provides a general overview of neck pain. Everybody is going to be a little different in their presentation and individualized plans are of the more likely to get you better faster. That said, there are some simple exercises that often help many cases. These exercises begin to address the common imbalances and areas of stiffness described in the Neck Mechanics 101 section of this post.

Try to work in a comfortable range of motion with minimal pain. Do not try to force a movement; slow and gentle is the way to go. It is okay to feel some discomfort but stop if it exceeds a mild level (i.e. if pain is greater than 2/10, with 10 being the worst). Stop if your neck feels worse afterwards or if you get pain radiating down your shoulder blades or into your arms. Stop if you experience any dizziness or lightheadedness. Good form matters! Get in touch with us if you are unsure whether you are doing these exercises right.

Do not do these exercises if you fit any of the criteria in the ‘when to see a professional’ section– seek help first!

1. Chin tucks

So many patients get better with just this simple exercise. Chin tucks activate the deep neck flexors at the front of your neck which help to stabilize your neck and hold your head up straight. Chin tucks also stretch out the tense muscles in the back of your neck and decompress and mobilize the stiff joints at the base of our neck.

·       Stand or sit tall with good posture

·       Keeping your head level and your gaze forward, exhale and draw your chin towards the back of your throat, like you are trying to make a double chin.

·       Hold for a second, relax, inhale and return to neutral. Repeat 10 times a few times throughout the day

Tip: Imagine you are balancing a glass of water on top of your head—try not to let it spill as you pull your head back.

 

2. Upper back extension

When sitting with your head forward, the upper thoracic spine rounds forward, and because we spend so much time in this position it gets stuck there. Work the joints in the opposite direction with this stretch to keep them from getting ‘stuck’.

·       Sit tall with good posture. Interlock your fingers behind your neck.

·       Gently engage your core, drawing your stomach and front ribs in; this will keep you from moving through your lower back as opposed to your upper back.

·       Using your hands to keep your neck straight, inhale and lean back, extending through the upper back.

·       Exhale and return to the start position.

·       Repeat 10-15 times a few times throughout the day

Tip: Avoid arching through your low back as this may cause irritation for a few people!

3. Wall slides

Wall slides target a lot of areas all at once. They open your chest, the back of your neck, and stretch your lats, activate the muscles in your mid back, and help to bring extension back to the upper thoracic spine.

·    Lean against a wall with your knees bent.

·    Try to keep the back of your head and back against the wall. Gently draw your front ribs and abdominals inward. If you have significant head forward posture, you may need to place a roll behind your head against the wall.

·    As if you are making a snow angel, inhale and slide your arms up the wall without letting your elbows or wrists lose contact.

·    Exhale and return to the start. Repeat 10-15 times once or twice a day

Tip: You may not be able to get your arms very far at first with this exercise; try to only move as far as you can without losing arm contact. Do not push into pain or try to force your arms up the wall.

 

That’s It for Now! Looking for More Resources?

Feel free to get in touch with our clinic at any time! Mark is available at mark@ascenthealth.ca and is always happy to offer direction and advice.