16 October is World Spine Day, and October is also National Safe Work Month. So it's a good time to look at where many of us spend most of the working week: at a desk.
Neck and lower-back stiffness from desk work is one of the most common things people mention when they come into the clinic. They often ask me what the "correct" posture is. The honest answer surprises most of them: there isn't one. What matters more is a set-up that suits your body, and changing position often through the day.
This article covers what the research says about posture, a few simple changes to your workstation, how to build movement into your day, and when it's worth having your neck or back assessed.
What the research says about posture
For years we've been told to "sit up straight" to protect our backs and necks, but the research hasn't backed that up. A 2019 paper in the Journal of Orthopaedic & Sports Physical Therapy pointed out that there's no strong evidence that sitting, standing or bending "incorrectly" causes spinal pain.
Equipment on its own hasn't shown much effect either. A Cochrane review of 15 trials involving 2,165 office workers found that adjusting the workstation, and sit-stand desks, didn't reduce arm and shoulder pain or discomfort. Each of those was tested in only one trial. Extra breaks showed a small benefit for neck discomfort, but the quality of that evidence was very low.
Strengthening has better support. A 2024 review found low-certainty evidence that exercises for the neck, shoulder and shoulder-blade muscles reduce neck pain and disability in office workers.
So the goal isn't to hold one perfect position all day. It's a set-up that's comfortable for you, regular changes of position, and keeping the muscles that support your neck and upper back strong.
Small changes to your desk set-up
There's no single right set-up, but Safe Work Australia's workstation guide and Comcare's office guidance are a good starting point:
- Screen: place it directly in front of you, about an arm's length away. Your eyes should be slightly below the top of the screen, so you're not tilting your head. Use a stand if you need one.
- Two screens: put the one you use most directly in front of you. Set them side by side and angle them in slightly, so you're not twisting your neck all day.
- Chair: let the backrest support your lower back, with your thighs angled slightly down and your feet on the floor or a footrest. If armrests stop you pulling in close to the desk, lower or remove them.
- Keyboard and mouse: keep them close and directly in front, so you're not reaching. Your forearms should angle slightly down to the keyboard, with your wrists in a neutral position.
- Laptops: the screen sits too low for long sessions. A laptop riser plus a separate keyboard and mouse lets you follow the screen advice above.
- Glasses: if you wear multifocals, move your head to look through the right part of the lens rather than tipping it back. Have your eyes checked regularly.
Build movement into your day
Comcare's advice is simple: stand up, sit less, move more. Safe Work Australia also recommends regular breaks and changing position often.
- Set a reminder to get up. Stand for phone calls, or walk over to talk to a colleague instead of emailing them.
- Rest your eyes. Comcare suggests the 20-20-20 rule: every 20 minutes, look at something 20 feet (about 6 metres) away for 20 seconds.
- Move your neck and shoulders gently through the day. Slowly turn your head from side to side, and roll your shoulders back and down a few times.
- Build strength over time. Of the approaches covered here, strengthening the neck and shoulder muscles has the most research support, though the evidence is still limited. Clinical Pilates is one way we do this at Momentum, with exercises chosen based on your assessment.
When to get it checked
healthdirect recommends seeing a doctor if your neck pain is severe, getting worse, doesn't ease in a few weeks, is causing you distress or is affecting your daily life. For back pain, it suggests seeing your doctor if it isn't improving after about 6 weeks, or if it's affecting your sleep or daily activities.
Call triple zero (000) or go to your nearest emergency department if your back pain:
- came on very quickly and is severe
- follows a significant injury or accident
- comes with a fever or feeling unwell
- stops you from walking or moving
- comes with weakness or numbness in your legs, or changes to your bladder or bowel function
- comes with unexplained weight loss
If desk-related stiffness keeps coming back, or you'd like your set-up and movement looked at, you can book an assessment at Momentum. Every new patient consultation includes a postural assessment, and you don't need a referral. Request an appointment or call 0400 611 001.
Sources
- Slater D, Korakakis V, O'Sullivan P, Nolan D, O'Sullivan K. "Sit Up Straight": Time to Re-evaluate. J Orthop Sports Phys Ther. 2019;49(8):562–564.
- Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018;10:CD008570.
- Jones LB, Jadhakhan F, Falla D. The influence of exercise on pain, disability and quality of life in office workers with chronic neck pain: a systematic review and meta-analysis. Appl Ergon. 2024;117:104216.
- Safe Work Australia. Setting up your workstation.
- Comcare. Computers and workstations.
- healthdirect. Neck pain and Back pain.
