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Risk and Protective Factors in Computer-Work-Related Neck Pain

Among office workers who use computers extensively, the one-year prevalence of significant neck pain has been reported at 46%. The lifetime prevalence may be as high as 70%.1 The ability to offer evidence-based advice and to identify which workers need more than advice can help clinicians be of greater use to this group of patients.

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Multiple studies have examined the risk factors involved with computer-work-related neck pain. The recent work of Cagnie and colleagues published in the European Spine Journal stands out for the useful and pragmatic set of outcomes.1 Their study, covering 512 office workers over multiple companies and professions, found strong protective effects against neck pain from these factors: being physically active outside of work, upright posture, frequent rest breaks, and variation of work tasks. Based on the objective data, the authors go on to recommend consideration of dynamic sit/stand chairs, sit/stand desks, document holders, correct screen placement, and adjustable chairs. However, the authors also assert that the preventive effectiveness of neck schools based largely on ergonomics has not been convincing. A separate study finds similar protective effects plus the interesting factor that workers who individually determine how and when they perform their work have decreased likelihood of computer-work-related neck pain.2

Cagnie et al. find the following risk factors for computer-work neck pain:

  • Female (OR = 1.95)
  • Age 30 to 50 (OR = 2.61)
  • Forward head or bent neck (OR = 2.01)
  • Prolonged sitting (OR = 2.06)
  • Same movements per minute (OR = 2.05)
  • Mental tiredness (OR = 2.05)

The presence of the risk factors may suggest decreased likelihood of sufficient response to advice and an increased need to offer treatment.

The greatest odds ratio for any single risk factor was revealed by the work of Eltayeb and colleagues who showed that having a previous history of complaints increases the likelihood of future neck pain by more than seven times (OR = 7.2).2 The patients who present neck pain complaints to clinicians are already a self-selecting group showing more concern than the remainder of the many office workers who experience neck pain. The presence of any of the proven risk factors plus the likelihood of continued problems provides encouragement to offer treatment.

Often, patients cannot implement postural advice. The common forward-head posture for instance usually results from a muscle imbalance that requires specific rehabilitation to correct. In a relaxed standing or sitting posture, the external auditory meatus should align vertically with the acromion process. Habitual forward-head posture increases stresses on the neck, shoulders, and even respiratory system.

Physiotherapy treatment for these patients can provide more in-depth consultation and individualized rehabilitation plans specifically designed to improve the individual’s capacity to manage workplace challenges. When you have patients at risk of recurring, work-related pain, please offer them Advanced Physiotherapy & Injury Prevention.


  1. Cagnie B, Danneels L, Van Tiggelen D, et al. Individual and work related risk factors for neck pain among office workers: a cross sectional study. Eur Spine J. 2007; 16: 679-686.
  2. Eltayeb S, Staal J, Hassan A, de Bie R. Work related risk factors for neck, shoulder, and arms complaints: a cohort study among Dutch computer office workers. J Occup Rehabil. 2009; 19: 315-322.

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