Neck and back pain from desk work: what actually helps

The posture myth

Many people believe that slouching causes back and neck pain and that sitting up straight prevents it. Research has not found a strong link between any one posture and future pain.¹ People who sit upright are not protected from pain, and people who slouch are not doomed to it. What seems to matter more is how long you stay in one position, and how strong, active and rested you are overall.

Your best posture is your next posture

Muscles and joints like variety. Sitting still for hours, even in a good posture, can leave you stiff and sore. Shifting position often, standing for some tasks and taking short movement breaks keep tissues comfortable.

• Set a reminder to change position or stand every 30 to 45 minutes
• Take phone calls standing or walking
• If you have a sit-stand desk, switch between sitting and standing through the day
• Walk over to a colleague instead of messaging when you can

Desk setup: what is worth changing

• Screen: top of the screen near eye level and about an arm's length away, so you are not craning forward
• Laptop: for long sessions, use a stand with a separate keyboard and mouse
• Chair: feet flat on the floor, and your back supported in a position you find comfortable
• Keyboard and mouse: close enough that your elbows stay near your sides
• Lighting: reduce glare so you are not leaning in to read

These changes improve comfort, but on their own they do little to prevent pain. They work best combined with movement and exercise.

Exercise has the best evidence

Clinical practice guidelines for neck pain and low back pain recommend exercise.²³ For office workers with neck pain, specific strength training for the neck and shoulder muscles reduced pain in a randomized trial.⁴

A simple daily movement plan

1. Chin tucks

   10 slow repetitions, gently drawing your chin straight back.

2. Shoulder blade squeezes

   10 repetitions, drawing your shoulder blades gently down and back.

3. Upper back extension

   5 to 10 slow repetitions, leaning back over the top of your chair.

4. Standing back bends

   A few gentle repetitions after a long stretch of sitting.

5. A 10-minute walk

   At lunch or between meetings, every day.

Stop any exercise that causes sharp pain, numbness or tingling, and get checked if pain lasts more than a few weeks or spreads into an arm or leg.

Working from home: the couch and laptop trap

Working from a couch, bed or kitchen stool usually means looking down at a laptop for hours. If you work from home, a simple setup helps: a laptop stand or a stack of books, a separate keyboard and mouse, and a chair at a table. Phones are worse still for neck posture, so take longer calls on a headset and hold your phone higher when reading.

Eye strain and headaches

Long screen sessions can cause eye strain and headaches that feel like they come from the neck. Take short visual breaks: every 20 minutes, look at something about 20 feet away for about 20 seconds. Make sure your glasses prescription is current for screen distance. Headaches that start at the base of the skull and come with neck stiffness may be cervicogenic headaches, which respond well to treatment.

When to get help

• Pain that has lasted more than four to six weeks
• Pain, tingling or weakness spreading into an arm or leg
• Headaches that start at the base of the skull
• Pain that wakes you at night or comes with fever or weight loss (see a doctor first)

Myth or fact?

Tap each statement to see what the evidence says.

Keep reading

• Herniated disc on your MRI? What the findings really meanWhat disc bulges and degeneration mean, and how often herniations shrink on their own.4 min read · Patients
• Vertigo, dizziness or lightheadedness? How to tell the differenceWhat spinning, rocking, woozy and faint usually mean, and when dizziness is an emergency.4 min read · Patients
• All guidesBrowse the full learning center.

Related conditions we treat

References

1. Slater D, et al. "Sit Up Straight": Time to Re-evaluate. Journal of Orthopaedic & Sports Physical Therapy. 2019.
2. Blanpied PR, et al. Neck Pain: Revision 2017. Journal of Orthopaedic & Sports Physical Therapy. 2017.
3. George SZ, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy. 2021.
4. Andersen LL, et al. Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthritis & Rheumatism. 2008.

Clinically reviewed by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This guide is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor.