Article response:
Do we all have computer neck?

London Evening Standard, July 6 2011

I was interested to read an article in The London Evening Standard this week highlighting the growing problem of neck pain caused by using computers, mobile phones and other devices. Although this is not a new phenomenon as suggested by the author it certainly seems to be a growing one as more and more people spend more and more time tied to their desk or working from mobile devices even if they are not.

Neck pain is a massive problem in our society and accounts for a staggering number of sick days off work and comes at a huge cost to the NHS and the economy as a whole. Because of this it has attracted a large amount of scientific research over the last few decades to try and find the cause of and solution to the problem in order to help relieve millions of people's suffering, or more likely, to keep them at work. In the vast majority of cases, problems can be prevented or at least very well managed just by understanding the problem and managing your lifestyle and activities better.

Neck pain in relation to using computers is probably in part due to lack of movement and the repetitive use of the hands typing. Our necks are very mobile and with our eyes on the front of our head limiting any real peripheral vision, we are reliant on this mobility to inform us pf what is going on in our surrounding environment. Our neck muscles and our joints are designed for movement and both have important neurological links with our eyes and our balance (vestibular) apparatus to keep us balanced. Our neck is not supposed to be kept still looking straight forward (or down) for long periods. Even in the optimal posture, nothing is better for pain than regular movement.It has also been demonstrated by measuring the electrical activity in neck muscles that the big strong superficial muscles actually work more in people who use computers than in people who don't. These muscles are designed to contract and relax, shorten and stretch continuously which happens when we move. They are not designed to hold the head in a static position or support the weight our arms constantly while we tap away on a keyboard. This constant static use of muscles and the lack of movement of our neck causes fatigue and reduces the blood flow to these tissues which causes discomfort or pain. It has also been shown that deeper muscles often work less in certain postures which can lead to increased stress and strain on joints and encourages the stronger superficial muscles to work more to compensate. Other research has shown that, typically, people who use computers in static postures have stiffer necks than those who don't.

Most people assume pain means damage but it doesn't always. In this situation it means something's not right, you're not moving enough.

Other factors like your genetic make up, your posture and body awareness, your desk environment, your work habits and schedule and (especially) stress can all contribute to this sub-optimal situation which eventually ends up with neck pain.

The article mentions the use manipulation to help manage the problem. Passive (manual) therapies like manipulation, mobilisation and massage can have temporary but relatively short lasting pain relieving effects but relying on this approach is missing the point. It is well proven that people who understand and effectively manage their problem themselves have much better outcomes (less pain and less functional restriction) than people who rely on passive therapies. And it has been shown that people who vary activities and positions and those who exercise have fewer problems too.

Physiotherapy can help with the short term relief provided by manual therapy but can also help to retrain optimal muscle function. Physiotherapy can also help improve postural awareness and control with simple exercises and help guide changes in work behaviour to prevent the gradual build up of pain. Doing a work station assessment will ensure you know the best position to be in and that your desk is optimally set up for you. But most of all your physiotherapist can help you to understand and how to manage the problem yourself.

Physiotherapists at Central Health Physiotherapy are experienced in dealing with these problems and can help you to help yourself to manage neck pain whether its caused by long hours at the computer or not. They can also carry out a work station assessment.

Chris Pinches, Lead Physiotherapist, Central Health Physiotherapy