Work injuries used to be from highly mobile tasks of hunting and gathering, for which the body was actually well designed. So the injuries tended to be from pure accident, rather than from enforced ergonomics. This changed with the industrial age, when we started to see work injuries to the hands from machines, or to the low back from lifting. But now that we have entered the digital age, our workplace has once again radically changed. Robots and machines do the assembly and lifting, while we sit.
We don't get injuries from "hunting and gathering" in the field, we get them from "hunting and pecking" at a keyboard.
To see what hours of unremitting bad posture does to the neck, take a look at this image:
In order to see the flickering images on the screen, the head is projected drastically forward, leaving the neck almost parallel to the horizon. While this is fine for a few moments, it becomes an unremitting strain for the neck muscles after a few hours. Much the same as trying to hold two buckets of water at arms length for hours. Human muscles are built for movement, and need to be supplied with fuel and oxygen between beats. Permanent contraction becomes painful, as the muscles are literally starved of oxygen and fuel, much like we can visualize in our hands if we are having a "white knuckle" anxiety attack. We have small mucles that span the gap between each vertebra, and larger muscles along the entire spine and in layers protecting the neck. If these muscles do not relax between movements, then bad things happen.
First the muscles start to scream with pain, developing knots, and restricting simple movements.
Secondly, over time, the disc spaces between the vertebrae become compressed, and the joint surfaces between the vertebra start to dry out. This explains most of the disc disease and osteoarthritis that we see causing neck pains as we age.
However, neck pains are rare among people who move during their work. We see inspiring examples of octagenarians with perfect posture who spend their lives as ski instructors, yogis, or dancers, or in people who seek out athletic endeavours when they are able to get away from their desk jobs.
But the age of the keyboard does not need to bring new pains to our neck, or to our lives. It simply means we need to develop a strategy to the new workplace. Take a look at the two images below:
In this one, we can see trouble already starting. The laptop is either at the right level for your hands (ie on your lap), or it is at the right level for your neck (ie on a tall table). In the former case, it is terrible for your neck, and in the latter case it is terrible for your hands (see our post on carpal tunnel). The same could be said of even smaller devices like the tablet or the phone. Never a problem for a short task, but this is a prescription for trouble when it extends for hours, days, and years without remission.
By contrast, take a look at this person's posture. In particular, the neck is now in its normal position, as part of the spine, not a right-angle side road. The weight of the head can now be carried by the structure of the vertebrae, instead of relying on the constant pull of the mucles. Oxygen and food supplies can now be restored to the neck muscles, and knots and pains go a way (or, better yet, never get started!).
If your work posture is giving you a literal pain in the neck, try these tips:
- Use a head-set or speaker feature on your phone.
- Have someone take a picture of you at your desk, near the end of day. How's your posture? If it is like the bad example above, then its time to do an ergonomic assessment. Many employers will have professionals who can do this, sometimes requiring a doctor's note. Or, you could follow some of the above advice to help prevent your own neck pains. In my own case, I have found a stand-up screen/keyboard works well when I am in front of my patients.
- Set a timer. Every fifteen minutes MOVE YOUR NECK! You can still keep your eyes on the screen if you must, but pull back your shoulder blades, roll your shoulder tips, and swivel your neck in all directions. Use something to pop up on your screen, or try a kitchen timer. Frankly, even a cuckoo clock would work (the original ones all chimed at the quarter hour, not just on the hour). The movement will restore circulation to tense muscles, and it will bring fluid back into the joint spaces. Pain and stiffness don't last long, as long as you move!
- When you walk, look ahead of you. Swing your arms normally, and hold your head as if you were balancing books on it. Don't hunch your neck over your cell phone or tablet while you are walking or on public transit. As a reminder, back into a wall and have a friend measure the distance between the back of your skull and the wall; your head should almost touch the wall behind you, and not be leaning towards the wall in front of you! For a video about this, see: http://www.youtube.com/watch?v=FV3ZflQjmxk
- If you have a stiff neck, see your doctor for assessment. Sometimes images are needed, like ultrasounds or X-rays. If the problem is musclular, massage can work wonders. If the problem is caused by a rigid alignment of the vertebrae, then chiropractic or physical therapy can be of great value. I have also found great results from doing medical acupuncture, with needles placed into strategic trigger points with almost instant relief. Also, consider a change of pillow, depending on whether you sleep on your back or side; some do well with the "reverse curve" pillow, others prefer a horse-shoe shaped pillow filled with air or bean husks. Be prepared to try a few variations to see what works best for you.
- Consider yoga or pilates, or other athletic endeavours that break away from the desk posture. Also consider the foam roll, (as seen in our blog on back posture); my patients find this an excellent daily antidote to desk posture. Lying flat on the floor with a rolled towel across the line of your neck can also restore the normal curve of your neck, and ease the muscles that create the stiff and rigid conditions of modern neck pain