Neck Pain at Work

Neck Pain at Work

Extended periods of sitting at work can lead to many different painful symptoms in
the body. A common area of complaint is the neck. Neck pain can be due to several
different mechanisms, the most common being postural related. In this blog post we
will discuss general neck anatomy, what structures may be contributing to pain, and
some simple strategies to help combat these symptoms.

Some Basic Anatomy Explained..
Our spine is made up of 3 sections: the cervical spine (neck), the thoracic spine (mid
back) and lumbar spine (low back). Each section has various structures (muscles,
ligaments, etc.) attached to it and various nerves/vessels exiting the spinal cord at
each level. The natural curve of the cervical and lumbar spine is called lordosis and
the curve of the thoracic spine is called kyphosis. When sitting with poor posture for
extended periods, the thoracic spine can become stiff and rounded forward. This
results in a greater resting cervical lordosis, forward head posture and forward
rounding of the shoulders, known as “Upper-Crossed Syndrome”.

Upper-Crossed Syndrome is defined as alternating groups of tight/weak muscles in
a crossing pattern (see image). This posture can also lead to other injuries with
certain activities (such as weight training). Certain muscles become weak, including
the deep neck flexors, rhomboids, and lower trapezius. The muscles that are tight
tend to be the pain generating structures. These include the levator scapulae, upper
trapezius, and pectoralis major/minor. Stretching these specific muscle groups can
help alleviate some symptoms at work, but they may not be the only aspect that
needs to be addressed in the system. Seeking care from a health professional may be
warranted to create a treatment plan specific to your individual needs (e.g. doing an
ergonomic assessment of your work station).

How to Fight Back!
Frequent breaks from sitting should be taken throughout the day to give your body
a break from static sitting posture. This can be implemented several ways to make
sure your posture breaks are met, but productivity does not suffer. One simple way
is to drink more water (preferably out of a small to medium sized water bottle). This
way you will have to get up to fill up the water bottle more frequently, creating
posture breaks. Some people prefer to just stand up and move around every 30-50
minutes. There are always new ideas and strategies to help with this.
The ergonomics of your workspace should also be looked at to determine if there is
anything that can be improved upon. The image below is taken from the Ontario
Chiropractic Association website and shows some general guidelines to follow with
regards to ergonomics in the workplace (in regards to sitting).

Standing desks have become popular because they allow you to go from sitting to
standing while still continuing to work. However, this option is not for everyone and
is not always feasible.

Don’t Forget to Stretch!
As mentioned above, stretching can be beneficial to help alleviate symptoms while
at work. Below are stretches for the 3 major tight muscles involved in neck pain
related to upper-crossed syndrome. I have also included one drill for thoracic spine
mobility. All of these can easily be done at the office. The stretches should all be held
for 20-30 seconds and can be performed as needed throughout the day.

Upper Trapezius
The upper portion of the trapezius can become dominant over the lower portion
with upper-crossed syndrome. The main functions of the upper portion of the
trapezius muscle are to elevate the scapulae (shoulder blades), bend the head to the
side (when only one side activates) and extend the neck (when both sides activate).

1. Bend the head to the opposite side of trap you wish to stretch (stretching left
trap, bend head to the right).
2. Use the hand on the same side to pull the head further into the stretch
3. The above may be enough, but to increase the stretch, put the arm on same
side as the stretch behind your back

Levator Scapulae
This muscle is often very tight with upper-crossed syndrome and can feel like a
painful knot deep in the middle of the upper trapezius. The muscle actually begins at
the transverse processes of the first 4 cervical vertebrae (directly related to cervical
spine function) and inserts on the scapula (shoulder blade) on the inside top corner.

The major function is to not only extend (working together) and bend the neck (only
one side activating), but also to elevate the scapula.

1. Bend head to the side and rotate towards opposite armpit of the side you
wish to stretch (bend and rotate to the right if you wish to stretch the left)
2. Use hand on the same side to pull further into the stretch
3. This may be enough, but to increase the stretch, lift up the arm on the side of
the stretch and place hand behind neck

Pectoralis Minor
This muscle is underneath the larger pectoralis major. This muscle stabilizes the
scapula as well as contributes to its movement. With upper-crossed syndrome, this
muscle will shorten and pull the shoulders forward.

1. Set up in a classic pectoral stretch, with the side you wish to stretch by the
2. Move in closer to the wall so that your armpit is 3-4 inches from the wall
3. Slowly slide the hand up the wall and hold (stretch should be felt deep under
the pectoralis major).

Thoracic Spine Mobility
How well the thoracic spine moves needs to be addressed when your occupation
involves sitting for extended periods of time. There are many different drills that
can be done to work on this, but the below drill can be performed sitting at your
desk at work. You are going to fully round the shoulders and mid back into full
flexion, bending the head forward. Then slowly extend through the spine (pull the
chest forward), extend the head back and bring the arms back with your hands
turned out. This can be repeated for 5-6 slow repetitions. This is similar to the pose
in yoga cat-cow.

I hope you find these strategies useful to help with neck pain you may be
experiencing at work! For more information or to learn more about the treatment
options offered at Catalyst Health, feel free to contact any of the practitioners or
myself for more information. Thanks for reading!

Dr. Jonathon Perry DC
Functional Integrated Acupuncture 
Athletic Movement Assessment 
Fascial Abrasion Technique 
Dynamic Neuromuscular Stabilization - Exercise 1/Weightlifting 

1. Muscolino, J. (2015). Upper crossed syndrome. Journal of the Australian Traditional-
Medicine Society, 21(2), 80.
2. Silva, A. G., Punt, T. D., Sharples, P., Vilas-Boas, J. P., & Johnson, M. I. (2009). Head posture
and neck pain of chronic nontraumatic origin: a comparison between patients and pain-free
persons. Archives of physical medicine and rehabilitation,90(4), 669-674.
3. Cunha, A. C. V., Burke, T. N., França, F. J. R., & Marques, A. P. (2008). Effect of global
posture reeducation and of static stretching on pain, range of motion, and quality of life in
women with chronic neck pain: a randomized clinical trial.Clinics, 63(6), 763-770.


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