Repetitive Strain Injuries (RSIs) from computer use or desk work can cause headaches, eyestrain, and pain through the neck, shoulders, arms and back. "The Neck" is the first part of a series taking a closer look at the mechanism of injury and specific injury prevention techniques for particular pain areas.
Anatomy
The neck is made up of seven cervical vertebral bones. The vertebrae, when stacked upon each other, form a bony tunnel that protects the spinal cord as it runs up the back and attaches to the base of the brain. Discs between the bones act as shock-absorbing cushions. Nerve branches come off the spinal cord and pass between gaps in the bony stack to provide power to the muscles and sensation to skin segments of the shoulder, arm and hand. Arteries, responsible for blood supply to the tissues, also pass through gaps along with the nerves.
The cervical spine supports the skull. The muscles of the neck work to turn, rotate or tilt the head. This positions the head in space and allows us to have almost a complete range of vision. Since the head can weigh between 10 and 20 pounds, the head positioned over the cervical spine is the equivalent of balancing a bowling ball on a stack of blocks. When the cervical vertebrae are in proper alignment, the head is centered over the shoulders and gravity works to support and hold the head in place. The farther forward the ball (head) is in front of the blocks (cervical spine), the less stable and efficient is its function.
RSI
Most often, neck pain and tightness is postural in nature. With repetitive desk or computer work, the head can gradually assume a position forward of its proper alignment over the shoulders. The more that the head creeps forward, the harder gravity pushes the head down, and the more rounded the shoulders become. This causes muscular strain, promotes muscular tightness and weakness, pinches the nerves and arteries, and compresses the cervical discs. Neck pain, shoulder pain, and headaches are often the result. In more serious cases, arm fatigue and weakness, impaired circulation, and numbness and tingling can occur. Any extreme or sharp pain should be evaluated by a physician who can check for other medical causes including arthritis, osteoporosis, herniated discs, and meningitis.
RSI Prevention for Neck Pain
Neutral Neck Positioning
- Maintain a neutral spine while working and at rest. The head should be stacked over the cervical spine with the shoulders relaxed.
- Use a lumbar support while seated to help the spine maintain its natural curves.
- Don�t use thick pillows that push the head forward.
- Don�t sleep on your stomach (this position pushes the head back).
- Use a firmer mattress that does not sag.
- When lying down, position a towel roll to support the neck�s natural curves or use a specially designed pillow with a cervical support.
- Avoid falling asleep in a reclining chair or on the couch � you may wake up with a tweaked or stiff neck.
- Position the monitor at a height and distance that allows you to keep a neutral neck position. Your neck should not be tilted up or down. Your head and chin should not push forward. Your shoulders should not be rounded.
- Place the monitor directly in front of you so that you do not strain the neck by looking to one side or the other for long periods of time.
- Use a copy holder to eliminate the need to repetitively look up and down between the copy and the monitor. For large amounts of copy, attach a copy holder to each side of the monitor and alternate use for every page of copy.
- Bifocal use can be an aggravating factor for neck pain as people tend to jut their chins forward and tilt the head back when peering from underneath the glasses for closer work.
- Consider using eyeglasses that are prescribed specifically for computer use.
- Use a headset or hands-free device to avoid cradling the phone between the ear and the shoulder.
- Do not carry heavy bags or purses by hanging the straps over one shoulder consistently. Using a backpack-style purse can distribute the weight more evenly.
- When driving, position the car chair and adjust the rearview and side mirrors so that you maintain a neutral neck posture.
- When lifting objects, keep your back and neck straight; bend from the knees and not the hips; don�t round the back.
Exercise
- Stretch frequently throughout the day.
- Take frequent micro-breaks.
- Try these exercises. Remember, stretches should not increase or cause pain.
- Chin Tuck- Slide your chin back (as if you are trying to give yourself a �double chin�) and hold for five seconds. Relax. Repeat 5 times.
- Head Lengthening � Sit tall and position your head over your shoulders. Imagine that a force is lengthening your neck and pulling your head up towards the ceiling. Hold for five seconds. Relax. Repeat 5 times.
- Head Tilt � Sit tall and position your head over your shoulders. Slowly move your right ear towards your right shoulder. Keep your shoulders relaxed. Hold for 10 seconds. Slightly rotate as if you are trying to look up at the ceiling. Hold for 10 seconds. Slightly rotate down as if you are trying to look towards your right knee. Hold for 10 seconds. Bring your neck back to neutral position. Repeat the sequence 3 times. Then repeat on the left side.
- Head Rotation � Sit tall and position your head over your shoulders. Look as far over your right shoulder as possible. Hold for 10 seconds. Return to the neutral neck position. Repeat 3 times. Then repeat on the left side.
- Chin Tuck- Slide your chin back (as if you are trying to give yourself a �double chin�) and hold for five seconds. Relax. Repeat 5 times.
Relax Your Neck, Liberate Your Shoulders: The Ultimate Exercise Program for Tension Relief
If you prefer following along with a DVD stretching program, Yoga: Relief From Neck and Shoulder Pain
This is a good cervical pillow that supports the neck curve but does not push the head forward.
Obus Forme Contoured Memory Foam Standard Pillow
Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.