Preventing wrist, neck and shoulder pain at a desk job

Desk pain comes from repetition

Office aches rarely come from an injury. Tiny movements such as pressing keys and gripping a mouse are repeated thousands of times a day, and the same posture holds for hours, so strain gradually accumulates in the muscles and tendons. At first it is just stiffness by the end of the day, but left alone it lingers into the morning and stops easing with rest. That is why it is far easier to fix your desk and habits before the pain starts than to treat it afterwards.

Wrists: no bending, no pressing

Wrist pain usually has one of two causes. One is typing with the keyboard's back feet raised so the wrist bends back toward the hand; the other is resting the inside of the wrist on a desk edge or hard surface for long periods. The wrist is most comfortable roughly in line with the forearm, and a wrist rest is better used to support the palm during pauses than while you are actually typing.

• Folding the keyboard's back feet away usually bends the wrist less
• Cup the mouse lightly with the whole hand rather than pinching it with the fingers
• Press the keys gently instead of hammering them
• Do not leave your wrists resting on the desk edge for long

Arms and shoulders: no reaching

Look at the desk of someone with tight shoulders and the keyboard and mouse are often far from the body. Working with the arms stretched out keeps the shoulders lifted and the muscles at the side of the neck never rest. The right distance is one where your hands reach the keys with elbows lightly at your sides and bent close to a right angle. A wide keyboard with a number pad pushes the mouse far to the right, so if you rarely type numbers a narrower keyboard may be kinder to your shoulder. Chair armrests should just support the elbows; set too high, they lift the shoulders instead.

Neck: where the screen and papers sit

Most neck pain comes from a screen that is too low or off to one side. With the top of the screen around eye level and about an arm's length away, you do not need to bow your head. With two monitors, put the one you use most directly in front and the second to the side. When typing from paper documents, stand them up beside the screen rather than laying them flat, so you nod up and down less. Wedging a phone between shoulder and ear is especially bad for the neck; use earphones or a speaker instead.

Check the lower back and legs too

Fix the upper body but let the lower back slump, and the strain ends up back in the neck and shoulders. Sit well back in the chair against the backrest and set the height so your feet rest comfortably on the floor. Crossing your legs or leaning to one side feels fine briefly, but over time it throws your balance off. If boxes or clutter under the desk leave no room to stretch your legs, clear them out first.

Breaks are the biggest prevention

Even a perfect desk does little if you do not move for hours. Getting up to walk or change position for a moment every 30 to 60 minutes beats any piece of equipment. It is easy to lose track of time when focused, so a timer helps. Drinking water often is a small trick that gives you natural reasons to stand up.

• Spread your fingers wide, then make a fist, a few times
• Stretch an arm forward and gently pull the fingers back with the other hand
• Tuck your chin back and roll your shoulders backward in big circles
• Stand up, straighten your back and walk a few steps

Common mistakes

When pain starts, many people buy an expensive chair or special keyboard first, but without changing the basics such as screen height and keyboard distance the effect is small. Working all day on a laptop alone is another common mistake. Because the screen and keyboard are joined, fixing one throws the other off, so for long hours a stand plus a separate keyboard and mouse is worth having. Also avoid trying to stretch the pain away forcefully. When something hurts, move gently only as far as a mild pulling sensation.

Symptoms not to ignore

If tingling or dullness in the fingers gets worse at night and wakes you, if your hand weakens so that you often drop things, or if neck pain shoots down your arm, it may be more than muscle fatigue. Swelling or warmth are similar warning signs. If a few days of rest and a better setup do not help, or it keeps getting worse, see a doctor such as an orthopaedic or rehabilitation specialist. This article is general prevention information and does not replace diagnosis or treatment.