Ergonomics can ease pain in the neck

Q: I don't have a physically strenuous job. I work in an office. But by the end of the day, my neck and shoulders ache. What's causing it?

A: Without knowing it, you may be bringing on neck and shoulder pain by the way you perform everyday activities. If so, you have plenty of company. Doctors estimate that 70 percent of us will be troubled by neck pain at some point in our lives. Improper posture while using a computer deserves much of the blame. Workers often sit for hours with their shoulders slumped and their heads thrust forward toward the monitor, which puts stress on neck muscles.

You should get relief by following simple ergonomic principles. (Ergonomics is the field that offers advice for arranging your home and workplace so that you can do tasks safely and efficiently.) Broadly speaking, that means keeping your neck in a neutral position, with your head balanced directly over your shoulders, not thrust forward or tilted to one side.

Sounds obvious, but how does that affect the way you work and move? Here are some tips for achieving a healthy neck posture during common activities at work and home:

-- Sitting at a computer. Keep your head balanced directly over your spine as much as possible. Adjust your chair's height so your feet rest comfortably on the floor. Sit with your buttocks far back in your chair, and use a small pillow to support your lower back if needed. Desktop computers can be tilted or raised so that the monitor is directly in front of you. If you work on a laptop, however, properly adjusting the keyboard and monitor may be difficult or impossible. Try plugging a separate, full-size keyboard into a laptop to achieve better positioning.

Even if you have perfect posture, get up, stretch and move around every half-hour. If you tend to get lost in your work, set a timer or program your computer to flash a reminder.

-- Talking on the phone. If you spend a lot of time on the phone, don't lean your head to one side to hold the phone on your shoulder. Instead, use a headset or speakerphone, which will help keep your head in a neutral position, and your hands free for other tasks. Headsets are available for both your desk phone and cell phone.

-- Reading or writing at your desk. When you're reading, sit up straight and hold the document, book or report up so that you don't need to bend over. Or use a document holder to prop up the material. You can put papers on a slanted board raised slightly off the desk to keep them at a comfortable reading angle. For writing, adjust your chair so you don't need to bend over.

-- Reading at home. Try to maintain an upright posture when you sit in a chair. Hold your book so that you don't have to lean down or forward to see it. Putting the book on a pillow in your lap may help. If you read in bed, sit up straight or use a wedge-shaped pillow to support your back.

-- Wearing bifocals. The bottom portion of bifocals or progressive lenses corrects close-up vision, but that means you must bend your head to see the ground while walking or climbing stairs. Consider purchasing a pair of "walking glasses" that have your distance prescription without bifocal lenses.

When you need to focus on medium distances, such as at a computer screen, you're likely to need an intermediate correction, which bifocals don't have. Investing in a pair of single-vision glasses with the appropriate prescription for computer work can help prevent eye and neck strain. Alternatively, you may be able to move your monitor and adjust the font size of text on the screen, so you can read it while looking through the upper half of your bifocals.

-- Walking. Avoid high heels. These shoes can change the alignment of your body from the ground up, ending in a head-thrust-forward position that stresses neck muscles. This is one reason that women are more likely to develop neck pain than men.

-- Carrying a bag. Choose a lightweight purse or backpack, and don't overload it. Don't sling a backpack over one shoulder. Try a backpack designed to put weight on the hips rather than just the upper back. With heavier loads, use a wheeled pack or briefcase. If you must tote a bag on a shoulder, switch shoulders from time to time.

-- This is a great time to take a look at your office and make some changes for the year ahead. Simple ergonomic adjustments should help, but if you're still in pain, consult a physical therapist or personal trainer for advice about stretching and strengthening exercises.

The Harvard Medical School Adviser is researched and written by the faculty and staff of Harvard Medical School. Visit www.health. harvard.edu/adviser.