Office Factors Related to Chronic Neck Pain

Keyboard too close, too long in one job position, and muscle tension are 3 factors found in one study

Int Arch Occup Environ Health. 2017 Jul;90(5):373-410. doi:
10.1007/s00420-017-1205-3. Epub 2017 Feb 21.

Physical risk factors for developing non-specific neck pain in office workers: a
systematic review and meta-analysis.

Jun D
https://www.ncbi.nlm.nih.gov/pubmed/28224291

  • 23 people afflicted with non-specific neck pain some time in life
  • “Office workers have a higher annual prevalence (ranged 17.7–63%) and
    incidence (ranged 34–49%) of neck pain than other occupations.”
  • associated with periods of time off work -Netherlands study found 17% workers off work sometime over this condition in 2 year period
  • 60% off for such will have recurrence within 1 year

Close keyboard position to the body <15 cm – get greater ulnar deviation, wrist flexion, shoulder elevation, internal shoulder rotation and greater elbow flexion  – also “limited area of support for the upper arms on the desk, enabling the user to generate less torque for shoulder abduction and flexion during typing task  – moderate evidence

  • a wide arm board to support the forearms during computer work – helps
    smaller than 137° inner elbow angle when mouse use more likely develop new onset of neck pain

I have found forearm supports help:

Example of it is use (two supports):

  • I used ergocanada.com

Low work task variation is associated with issues. However,  “workplace
physical factors (duration of computer use, mouse use, keyboard use, and work break time) showing no effect on the development of neck pain”.

Most important factor seems more related to “self-perceived muscular tension during
computer use” –  had a large adverse effect on the development of neck pain.

So what causes shoulder tip pains? I have had periods where shoulder tip muscles are tight and any degree of relaxation has no effect –  I believe is it more related to various structures rather than merely myofascial (Plea to authors – please stop doing studies on myofascial pain and using the trapezius as a target subject)

Causes:

  • C4-5 facet
    Can’t Get Rid of Shoulder Tip Pain? – Think C4/5 Neck Facet
    http://painmuse.org/?p=208
  • First rib:
    described here:
    Shoulder Pain at Night – What Can You Do?
    http://painmuse.org/?p=331
  • microentrapment of nerves in trapezius muscle including accessory nerve. One nerve in particular can get pulled on by first rib ligament:

I find better results with injecting tip with a semineurolytic agent like 5% lidocaine in which I now add 0.5% methylene blue with doubles the time it knocks the nerves in area out to maybe several weeks. Another option would be to inject with botulinum:

New Hope For Refractory Neck Pain – Botulinum “Botox” – But Not Cheap
http://painmuse.org/?p=185

Comment – People with tense shoulder tips need lots of work and could use 5% lidocaine or botulinum injection. Hypnosis or biofeedback helps. I use an activator on neck then lift the head while patient lying – for 30 seconds give good relief. I have found brabbing the shoulder tip, pulling up and shaking 140 times can get a release. To soften it up first I will push tight muscles with fingers the thump fingers that are pulling with an activator –

that causes microstretch that can cause significant release – do that until softened up some then do the pull up and shake the 140 times.

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