What really causes neck pain in the office?

Introduction

The neck is one of the most commonly targeted areas for office ergonomic interventions across the globe as it is susceptible to pain and soreness from a variety of sources.  In a study of over 600 European office workers, it was found that 56.1% of all the participants had some level of neck pain.¹

     However, not all of the factors related to the neck actually lead to neck pain!  According to a research study lead by Venerina Johnson, a premier researcher at Queensland University in Australia, there are specific key causes of most neck pain, and many of these causes only lead to significant pain in combination with other factors.²  

Individual Risk Factors

     First, a variety of factors associated with the individual can lead to neck pain.  Individual factors are characteristics of a specific person which might impact neck pain in either a positive or negative way.  These factors are extremely important as they are often based on habits or personal choices and are often the easiest risk factors to change.  Individual risk factors associated with neck pain include:

• Rarely performing physical activity
• A history of neck trauma and pain
• Using bifocals or graduated lenses
• Negative affect, or a negative outlook on work related stress and health
• Touch typing with extra force³

Work Demands and Workstation Factors

     Next, the demands placed on a worker at a specific workstation can impact neck pain.  While it may not be possible to change work responsibilities, changing the workstation and the environment where work duties are completed can significantly improve neck health.  This might include taking stretch or movement breaks or even making a workstation more comfortable and ergonomic.  The key work demands and workstation factors that lead to neck pain include:

• Using a keyboard or mouse of over 6 hours a day
• Sitting at a workstation for over 2 hours without taking a break
• Perceiving the workstation as very uncomfortable
• Working without the arms parallel to the floor²

Workplace Psychosocial Factors

     Finally, and perhaps most surprisingly, neck pain can be modulated by psychosocial factors.  These factors include the social environment of the workplace and how supported a worker feels by others.  These factors are often the most difficult to change from an individual perspective and often require significant cooperation from many people, including upper management.  The main psychosocial factor that was correlated to increased neck pain was:

• Perceptions of low supervisor support²

Combinational Factors

     While these factors can cause neck pain on their own, many of them, particularly low supervisor support, are significantly more dangerous when they are present together in certain combinations.  For example, neck pain was considerably more prevalent in workers with low supervisor support, high decision authority, and many job demands.  In this situation, there was significant job strain placed on the employee, which likely caused the increased neck pain.  Additionally, low supervisor support exacerbates the effect of prolonged mouse use, leading to more self reported disability.  These are only a few of the interaction effects that can modulate neck pain, and many other combinations of risk factors are also likely dangerous.³

Predicting Neck Pain

     While all of these factors can contribute to neck pain, assessing all of these aspects to try and predict if a scenario will lead to neck pain isn’t overly practical.  In a follow-up study assessing the most important factors to predict neck pain, it was found that neck pain can be significantly predicted from 3 key factors.  This makes prediction significantly easier and also makes it accessible to most people if they are willing to be honest and openly assess their habits and feelings.  These three key factors which predict neck pain include:

• longer sitting time
• higher job strain
• higher psychological distress 

Some factors can also predict if an employee is unlikely to experience neck pain.  These positive predictive factors include:

• More Physical Activity
• More Neutral Postures
• Greater neck extensor muscle endurance⁴

Working From Home

     It is often thought that working from home might increase MSD’s and neck pain as home computer workstations are often less ergonomic.  However, a study conducted at the start of the Covid-19 lockdown on office workers who moved to a home environment revealed an interesting finding.  This study found that although home computer workstations were significantly less ergonomic, this was offset by improved work life-balance and more frequent break taking.  Working from home appears to influence a variety of factors which have both positive and negative influences on neck pain, as there was significant individual variability in this study.  It was proposed that a mixture of proper ergonomics and improved work life balance would likely reduce neck pain regardless of the workplace location.⁵ Thus, for office workers, it appears there are a variety of individual, workplace/workstation, and psychosocial factors that can all be improved to reduce neck pain.

For more info on injury prevention, watch our MSD Prevention webinar.

References

¹Nunes, A., Espanha, M., Teles, J., Petersen, K., Arendt-Nielsen, L., & Carnide, F. (2021). Neck pain prevalence and associated occupational factors in Portuguese office workers. International Journal of Industrial Ergonomics, 85, 103172. https://doi.org/10.1016/j.ergon.2021.103172

²Johnston, V., Jimmieson, N. L., Souvlis, T., & Jull, G. (2007). Interaction of psychosocial risk factors explain increased neck problems among female office workers. Pain, 129(3), 311–320. https://doi.org/10.1016/j.pain.2006.10.017

³Johnston, V. (2021) New Way Forward for the Prevention and Management of Discomfort in Office Personnel: Learnings From Across the Globe [Webinar]. The Centre of Research Expertise for the Prevention of Musculoskeletal Disorders.

⁴Jun, D., Johnston, V., McPhail, S. M., & O'Leary, S. (2021). A Longitudinal Evaluation of Risk Factors and Interactions for the Development of Nonspecific Neck Pain in Office Workers in Two Cultures. Human factors, 63(4), 663–683. https://doi.org/10.1177/0018720820904231

⁵Aegerter, A. M., Deforth, M., Johnston, V., Sjøgaard, G., Volken, T., Luomajoki, H., Dratva, J., Dressel, H., Distler, O., Elfering, A., Melloh, M., & NEXpro collaboration group (2021). No evidence for an effect of working from home on neck pain and neck disability among Swiss office workers: Short-term impact of COVID-19. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 30(6), 1699–1707. https://doi.org/10.1007/s00586-021-06829-w