The Ergonomics of Neck Pain

You can reduce risk factors for the development of neck and shoulder pain. Some of the things to avoid are prolonged sitting with the neck bent forward; holding a phone between the shoulder and ear; bending the head back (looking up) for long periods.

Neck and shoulder pain are common among younger and younger people and can be caused by musculoskeletal disorders of the upper extremities. Preventative measures should be taken to minimize risk factors for neck and shoulder pain before you are in pain.

The risk factors for and causes of neck and shoulder pain as well as preventative measures for the development of neck and shoulder pain found in the medical research are listed here.

Neck pain from computer use

Neck pain is a very common condition that affects nearly 50 percent of people over the age of 50 years at some point in their lives.  With the increased use of computers and other stationary-designed workplaces, more and more younger persons are faced with this problem.

There are many structures in the neck that can cause pain. There are also multiple sites, when problematic, that can cause referred pain to the neck. It is important to note the following:

  • Whether pain is felt outside the neck;
  • Whether pain is felt in the shoulders;
  • Whether pain is felt down the arms;
  • Whether pain is felt in the hands.

Signs to seek medical attention for neck pain

Signs to seek medical attention as soon as possible include the following:

  • Numbness,
  • Weakness,
  • Tingling of the upper extremities,
  • Severe headaches,
  • Visual changes,
  • New neck pain lasting more than three weeks,
  • Persistent neck pain.  
Businesswoman stretching neck and shoulders
Stretching can minimize risk factors for neck and shoulder pain

The anatomy of the neck 

The anatomy of the neck is made up of the cervical spine which, in turn, is composed of seven vertebrae (bones) which are joined by intervertebral discs. These discs are made up of a gel-like material that absorbs increased pressure. During the fourth decade of life (40’s), progressive degeneration of these discs occurs. The end result is a decreased ability of the discs to absorb shock and pressure.

Two common causes of neck pain 

Two common causes of new or persistent neck pain are bulging discs and bone spurs.

Bulging discs

As the disc loses some of its shock absorbing ability, it grows; and at times will bulge on the structures surrounding it.

Bone spurs

It is also common for the vertebrae themselves, which are made of bone, to grow additions called bone spurs. The spurs may grow in such a way as to compress nerves in the neck.

Bulging discs and bone spurs may cause neck pain to be referred

People with either condition — bulging discs and bone spurs — may experience pain that can be referred to any level of the back of the neck. 

Muscle spasms may cause neck pain

Also, spasms of any of the many muscles of the neck are common causes of neck pain.

Try to date when your neck pain began to determine the cause

It is helpful to date when the neck pain began. Once a specific activity can be linked to neck pain, treatment is easier.  Most people with neck pain have no objective findings on physical exam.    The history of the neck pain is an important tool for you and your health care provider to use to diagnose the cause of each pain.

Prolonged sitting with your neck bent forward can cause neck pain / spasm

Prolonged sitting with the neck flexed (bent forward) in one position, such as work on computers, is a common occupational cause of neck pain. A sustained position (without moving regularly) can cause spasm of the neck muscles and resulting pain.

Prolonged sitting with the neck bent forward (for example, on social medial, looking down at your phone) increases your risk for twisting injuries which may not hurt for 24 – 48 hours after the incident.

Bending your head back (looking up) can cause neck pain

Prolonged neck extension (bent backward, looking up) is another common occupational situation that can give rise to neck pain in people doing overhead work.

The physical exam of the neck demonstrates that most people can easily place their chin on their chest, touch both shoulders with the chin and bend sideways to touch ear to shoulder on both sides.

Normally, the neck can be extended so a person is looking up at the sky.  Sometimes, slight neck extension causes pain and this could be caused by disc degeneration, which is common.

Studies show that degenerative changes in the spine of the neck (cervical spine) in people without complaints are evident in over 90 percent of people over 50 years old.

Treatment for neck pain 

Treatment of the neck differs if the neck needs to be immobilized with a collar. If this is you, you most likely will know who you are.

If your neck hurts, the first treatment is:

  • aspirin (as long as you are not pregnant) or Tylenol-related products;
  • and — believe it or not — performing as much of your daily activities as possible.

Muscle relaxants may be prescribed

If neck pain lasts for more than three to four days, a course of muscle relaxants prescribed by your physician may be helpful.

People may seek manipulation therapy for neck pain. Be aware that the value of this type of treatment is uncertain.

Workplace design is critical to minimize risk factors for neck pain

One of the most important treatments is one of the least recognized. It is observation of your surroundings to determine what may be causing the pain. 

Workplace design and body motion are critical elements that can worsen pre-existing conditions or create / prevent new ones.

Workplace design can minimize ergonomic risk factors for neck pain 

The study titled “Physicial Risk Factors for Neck Pain,” which is referenced below, concluded that there is a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk.

It was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors:

  • Neck flexion,
  • arm force,
  • arm posture,
  • duration of sitting,
  • twisting or bending of the trunk,
  • hand-arm vibration,
  • workplace design.

If you feel you may need to see a doctor, check out these links:

The American Academy of Orthopaedic Surgeons:–conditions/neck-pain/



The Mayo Clinic: 

References with Quotes:

1. Risk factors for neck pain can be minimized

“Ergonomic risk factors for different types neck and shoulder disorders, such as:

Cervical spondylosis;

– Cervical syndrome a/k/a cervical disc disease;

– Thoracic outlet syndrome;

– Shoulder joint osteoarthorosis;

– Rotator cuff tendinitis;

– Tension neck syndrome a/k/a ‘tendomyotic pressure pains in shoulders and neck’can be minimized.”  

Scandinavian Journal of Work and Environmental Health, 2000; 26(1):7-19, “Physical Risk Factors for Neck Pain,” by Geertje A.M. Ariens, Msc; Willem van Mechelen, PhD.; Paulien M. Bongers, PhD; Lex M. Bouter, PhD; and Gerrit van der wal, PhD.

2. Risk factors for musculoskeletal disorders among newspaper employees

“A total of 973 workers completed the survey.  The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 percent.  Neck symptoms (26 percent) were the most frequently reported, followed by hand or wrist (22 percent), shoulder (17 percent), and elbow (10 percent) symptoms.”  

Scandinavian Journal of Work and Environmental Health, 1994; 20:417-26, “Job Task and Psychosocial Risk Factors for Work-Related Musculoskeletal Disorders Among Newspaper Employees,” written by Bruce Bernard, M.D.; Steven Sauter, PhD; Lawrence Fine, M.D.; Martin Petersen, PhD, and Thomas Hales, M.D.

3. Ergonomics method for prevention of musculoskeletal discomforts in industrial workers

“Five main factors were associated with musculoskeletal discomforts: 

1) Lack of worker selection and lack of appropriate training to prevent occupational hazards or work-related diseases;

2) Poor ergonomic design of the workplace and tasks, including organization;

3) Poor working posture;

4) Lack of task variation;

5). Insufficient rest breaks.”

Journal of Human Ergo., 1993: 22:95-113, “Ergonomics Method for Prevention of the Musculoskeletal Discomforts Among Female Industrial Workers: Physical Characteristics and Work Facts,” written by P. Chavalitsakulchas and H. Shahnavaz, Center for Ergonomics of Developing Countries, Luled University, Sweden.

4. Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs

“The rise in frequency of these (musculoskeletal) disorders is believed to be associated with the advance of automation and specialization in work (National Occupational Health and Safety Commission, 1988). 

“Much faster work rates and the redesign of jobs often require that a production worker or data entry clerk do a single task or a very limited number of tasks repeatedly, commonly tens of thousands of times per day. 

“Although new technologies have generally reduced the workload and fewer jobs entail heavy lifting, the repetitiveness of today’s ‘light work’ concentrates the work load on fewer, smaller muscle groups.”  

American Journal of Industrial Medicine. 1991; 19:87-107, “Workplace Ergonomic Factors and the Development of Musculoskeletal Disorders of the Neck and Upper Limbs: A Meta-analysis,” written by Susan Stock, M.D.

5.  Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups 

Cervical Spondylosis and Cervical Syndrome

Cervical Spondylosisdegenerative arthritis (osteoarthritis) of the cervical vertebra and related tissues.  If severe, it may cause pressure on nerve roots with subsequent pain or paraesthesia (numbness and tingling) in the arms.  

Cervical Syndrome (cervical disc disease) . . .for data entry operators the diagnostic criteria was:

a) neck pain radiating to one or both arms; and

b) numbness in the hands in addition to:  

c) limitation of neck movement and radiating pain provoked by test movements.  Pain in the neck radiating to the arm with a segmental distribution was our concept of Cervical Syndrome. 

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Thoracic Outlet Syndrome

“Thoracic outlet syndrome – a symptom complex caused by conditions in which nerves or vessels are compressed in the neck or under the axilla (underarm).  Anatomically, the cause is compression by structures, such as the first rib pressing against the clavicle (collar bone).”   

Tabers Medical Dictionary

Shoulder Joint Osteoarthrosis

Shoulder Joint Osteoarthrosis – our concept of shoulder joint osteoarthosis is that of a reduction in the articular cartilage height (cushions between the bones) and sclerosis (degeneration) in the structures of the glenohumeral joint (shoulder joint).  

Rotator Cuff Tendinitis

Rotator Cuff Tendinitis – Shipyard welders, plate workers, and male office workers  had the following the criteria for this condition:  localized shoulder pain and tenderness of the humeral head (top of the arm bone).  

Tension Neck Syndrome a/k/a Tendomyotic Pressure Pains in Shoulders and Neck is the most common shoulder/neck disease

Tension Neck Syndrome– A constant feeling of one or more subjective symptom.  

“For example neck pain or headache in addition to signs of at least two tender spots or palpable hardening (feeling hard bumps in your neck muscles), or both, plus muscle tightness in neck movements — were the diagnostic criteria of Tension Neck Syndrome for the Finnish studies of slaughterhouse workers, data entry operators, assembly line packers, shop assistants, and female office workers.

– Tension Neck Syndrome a/k/a Tendomyotic Pressure Pains in Shoulders and Neck –

“For the Swiss, data entry operators, ‘conversational terminal operators,’ typists, and office workers, the medical finding listed as ‘tendomyotic pressure pains in shoulders and neck’ was regarded as Tension Neck Syndrome.”  

Tension Neck Syndrome is Most Common Shoulder / Neck Disease

“It should be noted that Tension Neck Syndrome had the highest rates of all shoulder-neck diseases studied and women tended to have higher rates of Tension Neck Syndrome than men.”

British Journal of Industrial Medicine, 1987; 44:602-610, “Prevalence Rates and Odds Ratios of Shoulder-Neck Diseases in Different Occupational Groups,” by M. Hagberg, National Board of Occupational Safety and Health, Medical Division, Sweden; and D. H. Wegman, Division of Environmental and Occupational Health Sciences, University of California, Los Angeles, U.S.A

Author: Melanie Loomos

I was a court reporter for 10 years and spent most of my time in very uncomfortable chairs. As a result, I spent years researching seating and submitted two patent applications: "The Carpal Tunnel Chair,” and "The Pillow with Cantilever Supports.," The Buttpillow® has several configurations so you can find the best cushion for your workstation. For example, Gamers need a rearward tilt if they lean back & coders typically need a forward sloping cushion. The Buttpillow® was improved upon as it was determined different embodiments were needed for proper ergonomic positioning depending on the individual sitter. The Patented "Ergonomic Seating Cushion,” was was granted by the USPTO; and was later amended to include an embodiment specifically to help women maintain the natural curve of their lumbar spine during the second and third trimester of pregnancy. An extreme lumbar curve that restricts blood flow to the fetus is the only external risk factor for low birth weight babies. In 2003, I invented Ergosoft™ break reminder software based on OSHAs Ergonomic Standard so people can identify and minimize ergonomic risk factors for the development of sitting-related pain, eye strain, DVT and carpal tunnel syndrome.

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