Category Archives: The Spine

Ergonomics, Lower Back Pain, Musculoskeletal Injuries, The Spine, Work Place Injuries

Kidney Belts for Lower Back Pain: Yay or Nay?

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One of the most common questions I get is whether kidney belts are useful to reduce back pain particularly in forklift or truck drivers and people handling goods.

It’s a good question.  I often think of the image of the weight lifter with his kidney belt.  They must know something?

To simplify the science, a lot of lower back pain can be contributed to spinal tissue failure from prolonged or recurrent high compression or shear forces through the spine that occur when:

  1. Lifting heavy weights
  2. Lifting lighter weights using poor posture e.g. with arms stretched out in front  (functionally increasing spinal compression and shear forces) or with high repetition.
  3. Sustaining postures that reduce the lumbar curve (such as bending or slouch sitting)
  4. Being exposed to whole body vibration through sitting in a vehicle for more than 3 hours per day.

(1-4).

Is there anyway that we can reduce this spinal loading without changing our handling techniques?

Yes: if you hold your breathe for a few seconds, this raises the pressures in your abdominal cavity which  reduces spinal loading by relaxing the spinal muscles (the back muscles increase spinal loading when they work) (5-7).  However, you can’t hold your breathe forever and this advantage is lost.  So not really a workable solution.

What about kidney belts? Research found that kidney belts can slightly lower spinal muscle contractions (8-11%) and limit the amount of forward bending during lifting and encourage squat lifting, therefore reducing spinal loading in this scenario (6), however,  kidney belts tended to increase spinal muscle contractions in forklift drivers and make them more likely to experience back pain than forklift drivers who didn’t wear them (6,8).

References:

  1. Chaffin DB, Park KS (1973). A longitudinal study of low-back pain as associated with occupational weight lifting factors. Am Ind Hyg Assoc J. 34(12):513-25
  2. Freivalds A, Chaffin DB, Garg A, Lee KS (1984). A dynamic biomechanical evaluation of lifting maximum acceptable loads. J Biomech. 17(4):251-62.

  3. Adams MA, McNally SD, Chinn H, Dolan P (1994). Posture and the compressive strength of the lumbar spine. J Biom. 27(6):791-791.

  4. Nachemson AL (1981). Disc pressure measurements. Spine. 6(1):93-7.

  5. Arjmand, N.; Shirazi-Adl, A. (2006). Role of intra-abdominal pressure in the unloading and stabilization of the human spine during static lifting tasks. European Spine Journal. 15:1265–1275.
  6. McGill, S. M.; Norman, R. W.; Sharratt, M. T. (1990). The effect of an abdominal belt on trunk muscle activity and intraabdominal pressure during squat lifts. Ergonomics. 33:147-160.
  7. Daggfeldt K, Thorstensson A (1997). The role of intra-abdominal pressure in spinal unloading. J Biomech. 30:1149–1155.
  8. McGill SM, Norman RW, Sharratt MT (1990). The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 33:147–60.
Ergonomics, Lower Back Pain, Musculoskeletal Injuries, The Spine, Work Place Injuries

Lower Back Pain and Spinal Loading

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Lower back pain is a very complex problem and may have many causes.  One cause is when spinal tissue failure occurs as a result of high compression forces applied through the spine leading to spinal injuries.  High spinal compression forces may lead to micro fractures in the vertebral endplates, compression fractures of the vertebral bodies and damage to the spinal discs (1-3).

Activities which cause high spinal compression forces include:

  • Lifting heavy weights.
  • Lifting lighter weights in weak postures which increase the functional weight of the object and thus the load on spinal tissues (e.g. lifting from the floor or above shoulder height).
  • Sustained spinal bending postures (with or without a load in the hand).
  • High repetition spinal bending postures (with or without a load in the hand).
  • Exposure to whole body vibration in vehicles that experience vibrational acceleration including shocks between 2-6g (11).

(1-4,11).

Certain body postures also create higher compression forces through the spine than others.  For example, bending the spine while lifting, increases the pressures on the spinal discs by more than 100%.   Spinal bending combined with twisting increases spinal disc pressures by more than 400%.  On the other hand, when people recline backwards in a chair, even while adopting a slouching posture, spinal disc pressures reduce by 50-80% – a posture most of us adopt when we’re getting tired during extended bouts of sitting.  Sitting up straight in a chair actually creates twice the spinal compression compared with reclining backwards in a chair – something to tell your granny or your teacher when they criticize your reclined slouching posture!

(3,4).

In 1979, it was noted that when heavy lifting was performed while holding one’s breath (for a few seconds), the intra-abdominal pressure was raised, the spinal extensor muscles activity reduced and both led to reduced compression loading on the lumbar spine, reducing the risk for spinal injury.  However, if the heavy lifts extended for longer than a few moments, the breathe was released and the intra-abdominal pressure fell to much lower levels, reducing this spinal support mechanism substantially (5).  This reduction in spinal compression due to raised intra-abdominal pressure was supported by research published in 2003, 2006 and 2010 and showed that the greatest benefit occurred when the body was in flexed (bent) postures (6-8).

The question arises as to how raised intra-abdominal pressure reduces spinal compression and helps to protect the spine from spinal compression failure leading to spinal injury and lower back pain.

Both abdominal and spinal extensor muscle contraction cause an increase in the spinal compression forces.  However, the abdominal muscle contractions (0- 40% MVC) also assist in raising the intra-abdominal pressure, and when doing so, the net forces on the spine result in reduced spinal compression.  In these circumstances it was also found that there was a reduction in the activity of the erector spinae muscles, with a greater reduction in these muscles’ activity corresponding to a greater increase in intra-abdominal pressure (8).

Furthermore, a 2013 published study revealed that chronic lower back pain sufferers who were experiencing a remission from their pain still exhibited lower levels of agonistic abdominal muscle activity and higher levels of antagonistic paraspinal muscle activity when compared to healthy individuals when performing spinal flexion (stooping/bending) with or without handling a load.  This alteration in their abdominal and spinal muscle recruitment activity/ patterns could result in increased spinal loads (not measured in their study) and possibly contribute to the recurrence of lower back pain in individuals where these altered recruitment patterns have become the norm (9).  On the other hand, research published in 2011 showed that activation of the core muscles showed no improvement in spinal stability, casting doubt on the mechanism in which core muscle rehabilitation is used to assist in the treatment of chronic lower back pain (10).

 

References:

  1. Chaffin D.B.; Park K.S (1973). A longitudinal study of low-back pain as associated with occupational weight lifting factors. Am Ind Hyg Assoc J. 34(12):513-25.
  2. Freivalds A.; Chaffin D.B.; Garg A.; Lee K.S. (1984). A dynamic biomechanical evaluation of lifting maximum acceptable loads.  J Biomech. 17(4):251-62.

  3. Adams M.A.; McNally S.D.; Chinn H.; Dolan P. (1994). Posture and the compressive strength of the lumbar spine. J Biomech. 27(6):791-791.

  4. Nachemson A.L. (1981). Disc pressure measurements. Spine. 6(1):93-7.

  5. Hutton, W. C.; Cyron, B. M.; Stott, J. R.R. (1979). The compressive strength of lumbar vertebrae. J Anatomy. 129(4): 753-758.
  6. Daggfeldt, K.; Thorstensson, A. (2003).  The mechanics of back-extensor torque production about the lumbar spine. J Biomech. 36(6): 815-823.
  7. Arjmand, N.; Shirazi-Adl, A. (2006). Role of intra-abdominal pressure in the unloading and stabilization of the human spine during static lifting tasks. European Spine Journal. 15:1265–1275.
  8. Stokes I.A.; Gardner-Morse M.G.; Henry S.M. (2010). Intra-abdominal pressure and abdominal wall muscular function: Spinal unloading mechanism. Clinical Biomechanics. Nov;25(9):859-66.
  9. D’hooge, R.; Hodges, P.; Tsao H.; Hall L.; MacDonald D.; Danneels L. (2013). Altered trunk muscle coordination during rapid trunk flexion in people in remission of recurrent low back pain. J of Electromyograhy and Kinesiology. Feb;23(1):173-81.
  10. Stokes I.A.; Gardner-Morse M.G.; Henry S.M. (2011). Abdominal muscle activation increases lumbar spinal stability: analysis of contributions of different muscle groups. Clinical Biomechanics. Oct;26(8):797-803.
  11. Bazrgari, B.; Shirazi-Adl, A.; Kasra, M. (2008). Seated whole body vibrations with high-magnitude accelerations—relative roles of inertia and muscle forces. Journal of Biomechanics. 41:2639-2646.
Lower Back Pain, The Spine

Obesity and Lower Back Pain

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Lower back pain is a very common ailment affecting a large portion of the population at any given time.  It’s also generally accepted that we are suffering from an obesity epidemic in South Africa and in many other countries across the world.

"A Matched Set" by Tony Alter under licence CC BY 2.0
“A Matched Set” by Tony Alter under licence CC BY 2.0

I have had many patients who have come for treatment report that their doctor has blamed their lower back pain on their weight.  Being overweight is often a touchy subject for people carrying the extra pounds, so I’ve never been very comfortable making those types of associations or discussing weight issues with these patients.  Moreover, I’ve also had so many skinny patients with severe cases of lower back pain that I preferred to focus on the structural causes of the presenting lower back pain in these individuals rather than any weight issues.

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Read my post on lower back pain and driving posture

However, is this the correct approach?  Does one’s weight impact on one’s experience of lower back pain and should it really be swept aside like I tend to do out of deference to people’s feelings?  I thought it might be useful to look at the research to see what studies have found, but first of all, we need to define the parameters of our discussion.

What does it mean to be overweight, and what does it mean to be obese?  According to the Obesity Organisation, a body mass index (BMI) of 24.5-29.9 will place you in the overweight category, a BMI of 30-39 will mean that you are obese, and a BMI of 40+ will mean that you are morbidly obese.

How do you go about calculating your BMI?  

To calculate your BMI, divide your body weight (in kilograms) by your height squared (in centimeters).

Bear in mind, however, that if you’re very muscular, pregnant or breast feeding, your BMI will not be a proper indication of your health.

Use this BMI Calculator to easily workout your BMI.

Right, now that you know your BMI and in which bracket you fall, let us return to my original question: Does being overweight or obese have an influence on your lower back pain?

Some researchers did a literature review of all studies performed in relation to body weight and lower back pain up to 2009 (click here to access the article) and found that there was an association between carrying extra weight and a higher incidence of lower back pain.  They also found that obese people (BMI of 30+) had more lower back pain than overweight people (BMI of 25-29).  This shows an increasing correlation between your weight and your experience of lower back pain.  In other words, the more weight that you carry, the greater your risk of experiencing lower back pain.  

A more recent study published in 2015 (click here to access this article) also probed the associations between body weight and the experience of lower back pain.  Unfortunately this study only focused on men, however, they did look at the associations of weight gain and lower back pain over time (decades).  They found that an increasing BMI of overweight and obesity was linked an increased risk of experiencing radiating lower back pain (in other words lower back pain that has pain going into one or more legs).  What was interesting though, was that they found that generalised lower back pain (known in the medical community as non-specific lower back pain) was not linked to weight gain at all.

This implies that not all lower back pain is affected by your weight, which from experience as a clinician, I know to be true.

So, after all of that, what is the ‘take home’?  Basically, if you are carrying extra weight and are either overweight or obese, you are more likely to experience lower back pain.  However, (and logically), not all lower back pain is influenced by weight gain.

What types of lower back pain are influenced by being overweight?  I will explore this in a future post.

Ergonomics, Lower Back Pain, The Spine

reducing back pain associated with picking Up Your Kids

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Children.  They’re little bundles of joy and we love to pick them up and cuddle or play with them, but who of you find that since you have kids, you’ve been experiencing an ache in your lower back?

Why is this?  They’re small, we’re big and surely we’re strong enough to move them around anyway we like?

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Well, part of the problem lies in the fact that they’re small and we’re big, or, rather tall.  When we go to pick these little people up, it means that we have to bend down quite low, close to the ground to reach them.

Now if you find yourself picking up your little one as in the picture below, you will definitely end up with lower back pain.

poor child lifting technique, lower back pain, lack of lumbar lordosis

“Bending the back when lifting a child from the floor” by CS Body Health cc. All Rights Reserved. 2016

Most of us don’t like bending our knees when we go down quickly to pick something up off from the ground.  Why is this?  Well, it takes more energy to bend your knees than to bend your back, and naturally we avoid using unnecessary energy.

“Bending your knees while keeping the legs together strains the quadriceps muscles” by CS Body Health cc. All Rights Reserved. 2016

However, what people don’t realise, is that if you use your legs differently, you can reduce the effective weight of your child a lot when you lift them for various biomechanical reasons.   In other words, your child will feel lighter and you will get a lot less back pain if you do this:

  1. Open your legs WIDE.  Wide enough so that when you bend your knees slightly, your knees don’t feel strained and you can reach your child.
  2. Pull them as close to your belly button as you can before you pick them up. (MUCH CLOSER THAN IN THE PHOTO)
  3. Pick them up in this posture, and THEN stand up straight.
  4. Compare the feeling in your back to this new way to your old slouching way.  You will feel a considerable difference in the loading on your back.

When they get a bit bigger – get them to stand up on a chair or box and pick them up close to you from a height where you don’t need to bend your knees or your back.

"Bending the knees with the legs wide apart" by CS Body Health cc. All Rights Reserved. 2016
“Bending the knees with the legs wide apart” by CS Body Health cc. All Rights Reserved. 2016
"Good child lifting technique" by CS Body Health cc. All Rights Reserved. 2016
“Good child lifting technique” by CS Body Health cc. All Rights Reserved. 2016
Ergonomics, Lower Back Pain, The Spine, Work Place Injuries

Correcting Your Driving Posture to Reduce Lower Back Pain

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People who suffer from lower back pain often find it aggravated by driving, or some people who drive a lot find themselves experiencing lower back pain.

Either way, there are a few things to be aware of regarding your posture in the car that will help both scenarios reduce their lower back pain and improve their driving experience.

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  1.  You need to maintain your lumbar curve in your car seat.
poor driving posture, lower back pain, loss of lumbar lordosis
“Poor slouching driving posture. Loss of lumbar curve”by CS Body Health cc. All Rights Reserved. 2016
Good driving posture, driving ergonomics, lower back pain
“Good driving posture. Lumbar lordosis maintained and supported by backrest” by CS Body Health cc. All Rights Reserved. 2016
Vertebral Column by Unknown and is licenced in the Public Domain
Vertebral Column by Unknown and is licenced in the Public Domain

Your lumbar curve is there to help reduce the loading on your spine.  When you slouch, you increase the pressure on your spinal discs and increase your risk of developing a spinal disc problem that may result in lower back pain.  The backrest of your chair is specially shaped to help maintain your curve.  To gain the benefit of your backrest, ensure that your buttocks are positioned right back against the backrest and that you are leaning backwards into it.

2.  In order to sit properly while you drive and maintain your lumbar curve, you need to position your legs at the correct distance from the pedals to prevent tight hamstrings on stretch from flattening your lumbar curve (read my post on tight hamstrings and lower back pain).

Your hamstrings attach to the bottom of your pelvis and go on stretch when you straighten your knee.  If you have tight hamstrings, when you straighten your knees to reach/press down on your car pedals, the stretch in your hamstrings will result in your pelvis being rotated backwards and your lumbar curve flattening, increasing the pressure on your spinal discs and increasing your risk of developing lower back pain.

In order to determine the correct distance of your car seat to the pedals, place one hand in your lower back and feel the curve of your lower spine, then move your seat forwards and back until you can comfortably reach the pedals while still maintaining your lower/lumbar spinal curve.

Driving Ergonomics
“Optimum chair pedal distance” by CS Body Health cc. All Rights Reserved. 2016

3.  Incline your car seat’s backrest to -8 degrees to reduce the loading on your lumbar spine and reduce spinal fatigue.

There is more loading on your spine when your backrest is upright than when it is reclined backwards.  You instinctively know this, and when you are tired from sitting upright for too long, you will intuitively move your buttocks forwards on the chair seat and lean backwards to take the strain off your spine.  Thus, positioning your car seat too upright will cause fatigue of your back and increase your risk of developing lower back pain if you are driving for long periods of time.

Too upright driving posture
“Driving posture too upright” by CS Body Health cc. All Rights Reserved. 2016

4.  Elevate/lower your chair so that your hips are 90 degrees or less. If your hip angle is too sharp, this will also increase your risk of slouching in your chair, which in turn will lead to increase pressure on your spinal discs and increase your risk of developing lower back pain.  If your seat does not allow you to sit high enough, help yourself by sitting on a small cushion.

5.  Move the steering wheel up/down/forwards and back until you find a comfortable distance from yourself to the steering wheel.  Your elbows should be slightly bent.  This will prevent your shoulders from fatiguing, which when it occurs, will also increase your spinal loading and spinal fatigue when driving and increase your risk of developing lower back pain or aggravating your current pain.

Driving ergonomics
“Steering wheel positioned too far from driver” by CS Body Health cc. All Rights Reserved. 2016

6.  Stretch your hamstrings (read my post on how to stretch your hamstrings if you have lower back pain) if they are tight to help yourself maintain good spinal posture when you drive.

Ergonomics, Lower Back Pain, Monitor Ergonomics, Neck Pain, The Spine, Work Place Injuries

Is Your Computer Monitor Positioned Too Far Away from You?

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Neck and lower back pain are such common complaints that we all know someone (if it’s not ourselves) who has experienced at least one of these complaints.  There are many causes for neck or lower back pain.  These can include different types of injuries, disease processes, genetic predispositions, and most importantly and commonly of all, our posture.  Our posture at work and our posture at home and at play.

Our work posture is getting more and more attention, especially since the advances in technology have relegated most of us to work behind a computer for long hours each day.  There are a host of things to consider in our work environment that can negatively affect our posture and cause our neck or lower back pain.

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Part of my job is going around performing office ergonomics for people.  One of the most common things I hear is people blaming their chair for their neck or lower back pain.  Most often, however, this is not correct and the real culprit is the monitor and where it has been positioned on the desk.  Luckily, this is a much cheaper and easier solution to the problem.

Your poor monitor position (read my post on 4 poor monitor positions that cause neck pain) is definitely one of the first places to look if you suffer from neck or lower back pain and you think your work posture is to blame.  There are a number of factors to consider in relation to your monitor position, but one very important and neglected element is the correct monitor distance that your monitor is positioned away from you while you work.

If your monitor is positioned too far away from you, you will find yourself leaning forwards in order to see your screen better, creating all sorts of problems in your spine (especially in your neck and lower back) and over activating your shoulder muscles, all leading you down the path of aches and pains.

Monitor Positioned too far
Image by US Navy under Public Domain

So what is the correct distance that you should place your monitor?

Generally, your monitor should be positioned a lot closer to yourself than you think it should.  And if you don’t believe me, ask yourself why you keep leaning forwards when you work.

How do you determine the correct distance that you should position your monitor at?  I call it the “Frankenstein” test.

  • Firstly, position your chair as close to your desk as possible while your arms and wrists are still able to comfortably work on your keyboard and be supported with an elbow angle of 90-120 degrees.  (In order to get close enough to your desk, you might need to adjust your armrests.  Generally I find that most armrests get in the way of the desk when you want to come closer, so one solution is to raise your armrest so that it just slides onto the surface of your desk, allowing you to bring your chair closer.  If you are unlucky enough not to have adjustable armrests and your armrests are really stopping you from bringing your chair sufficiently forwards, I recommend getting your building maintenance to remove them.  Use your desk for your arm support instead).
  • Then, lean backwards against your backrest and replicate Frankenstein’s outstretched arms – where your fingertips end, that is where your screen should be.

Closer than you think?  Give it a try and remember to keep leaning back against your chair’s backrest.  Your backrest is there to help keep you in good posture while you work.  A combination of those two factors (leaning back in your chair and having your monitor at the correct distance away from you) will go a long way to reduce your neck or lower back pain associated with poor working posture.

Ergonomics, Neck Pain, The Spine, Work Place Injuries

Touch Typing and Neck Pain

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Which one are you?  The painstaking 2 finger typer or the smug finger flying touch typer?

Who would’ve thought that typing at school would come in so handy?  Or are you kicking yourself because as it turns out you never had the foresight to take typing as a subject when you had the chance? 

finger typing
“An alphanumeric computer keyboard” by R. Jason Brunson, U.S. Navy under Public Domain
Touch Typing
“Computer keyboard” by Gflores under Public Domain

Does it really matter if you can touch type or not?  What are the implications for your health in the workplace?  How does something so seemingly insignificant make such a difference?

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I’ve written a number of posts on computer posture (click here to read about how your monitor position can cause neck pain) and neck pain (Click here to read about correcting a monitor positioned too far or too low on your desk causing neck pain).   One thing I haven’t discussed is how touch typing (or not) can influence your neck pain.

As I mentioned previously, 30-50 % of people will suffer from neck pain and office workers are at a greater risk than others for developing neck pain.  One of the reasons that neck pain is so common in the office environment is that people bend their neck too much in an office job.  Research has shown that individuals who bend their neck for 70% or more during the day dramatically increase their risk of developing neck pain compared to their colleagues who don’t.

What are some of the reasons that cause people to bend their neck for too in an office environment?

  1. The computer/laptop/tablet monitor that you’re using is positioned too low on your desk while you work, forcing you to bend your neck.
  2. You are working with documents a lot and don’t have a document holder to hold them up at eye level, thus causing you to bend your neck while you work.
  3. You don’t know how to touch type and you are forced to keep looking at your hands when you use the keyboard, forcing you to bend your neck throughout the day while you work.

When I go around to companies and perform office ergonomics, helping people to sit correctly at their computer workstations, sometimes correcting someone’s computer ergonomics is not enough to resolve the problem.   If an employee constantly still develops neck pain despite having their computer workstation  setup correctly (click here to view software to help you correct your computer ergonomics) ,  and neck injuries such as whiplash, or arthritis, or any systemic diseases which may cause neck pain are not clouding the picture, the reason why they may still be developing neck pain is possibly due to the fact that they are 2 finger typers, constantly looking down at their keyboard.

What is the solution when an inability to touch type is the problem?  Simple, but it does require some effort.  Learn how to type properly.  There are a number of FREE online typing courses:

  1. Typing Study.com
  2. Typing Club
  3. Type Online

I’m sure there are more, just google it if you don’t like any of the one’s I’ve mentioned above.  If you do use any of the above, I would appreciate feedback to help with the recommendation to others.  Please post comments to this article.

Learning how to touch type will help you to keep working in a healthy body posture, reducing your need to bend your neck so often through the day and therefore reduce your risk of developing neck pain.  Another bonus to learning to touch type is that the increased fluidity and speed of your new found typing skills will also help you to work faster which may also help reduce some of the deadline stress associated with your job.  Stress in and of itself can also be a factor in your neck pain (read my post about stress and neck pain).  A double bonus.  Good luck and please let me know how it goes.

Reference:

Ariens G.A.M., B. P. (2001). Are neck flexionk, neck rotation, and sitting at work a risk for neck pain? Results of a prospective cohort study. Occupational and Environmental Medicine, 200-207.

Cagnie B., D. L. (2007, May). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine, 16(5), 679-686.

Guzman J., H. E.-J. (2008). A new conceptual model of neck pain linking onset, course and care: The bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine, 33(4S), S14-S23.

Guzman J., H. S.-J. (2009, February). Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics, 32(2S), S227-S243.

Ergonomics, Monitor Ergonomics, Neck Pain, The Spine, Work Place Injuries

How to Correct a Low Computer Monitor Position Causing Neck Pain

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So,  you’ve discovered that your monitor (laptop, tablet or desktop computer screen) is positioned too low on your desk (read my post about 4 monitor positions that cause neck pain) causing you to bend your neck for too long, straining your neck.  How can you go about correcting this and ease up the strain on your neck causing your neck pain?

“Catching Up On Email…” by Ed Yourdon under Licence CC BY 2.0

Well, firstly, the changes to your monitor are entirely dependent on the type of technical device that you use.  There are, however, certain principles that apply to all types of devices with a monitor that you might use that you need to be aware of in order to adjust your monitor correctly and reduce your neck pain.

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  1. Using the same device’s keyboard, mouse (or touch pad) and monitor and sit in the correct position for your body can be a bit tricky.  Often this scenario will place you in a really poor posture when using your device, and if this posture is prolonged, it will likely result in you developing neck pain. The way out of this it to lower your chair until your head is looking straight ahead at your screen and place the keyboard of your laptop far enough away so that your elbows are >90 degrees (open elbow angle) but not so far that when you lean back in your chair, your monitor is further than arms’ length away (which will result in forward leaning posture creating high risk of back and neck pain).  Phew!!
  2. Again, whether you are using a laptop or desktop (or tablet), your monitor needs to be at eye level, allowing the curve in your neck to remain neutral (chin level, not tucked in or poking out).  Your cervical lordosis (neck curve inwards as in the xray below) is pivotal for good posture behind your device.
cervical curvature
“Medical X-Rays” by Nevit Dilmen under Licence CC BY 3.0

3.  You will need some assistive device to help raise your monitor to the correct height.  Some desktop monitors have a built-in system that allows you to move the monitor up or down as desired, but most do not.

Let’s consider each scenario separately:

If You Use a Desktop Monitor

If you are using a normal, old fashioned desktop monitor, this will be one of the easier scenarios to raise your screen to the correct height.  Just use books (it’s cheaper), a monitor raise or an adjustable monitor arm (check our our monitor raise and adjustable monitor arm in our shop).

Computer ergonomics
“Computer Workstation Variables” by Yamavu under Licence CC 1.0 (Public Domain)

If You Use a Laptop

People who use laptops sit in terrible postures unless they use a laptop raise (check out our laptop raise) or books to elevate the laptop monitor to eye level and use a second keyboard and mouse.  Please ensure that you purchase a proper laptop raise that elevates the monitor sufficiently and doesn’t do a half job and leave you bending forwards over your machine. Alternatively, lower your chair until your monitor is at eye level as described above.

Good laptop raise setup

“Alu MacBook Desk shot” by David under Licence CC BY 2.0If You Use a Tablet

Tablets are an even greater ergonomic risk than laptops.  Their screens are small and their keyboards laughable.  If you’re crazy enough to use it like a working computer, you will have to get a tablet stand (and more than likely need to raise even that up on books to get it to the right height) as well as a second keyboard and mouse (check out our tablet stand).

Tablet Raise
Image by Pixabay under Public Domain.

This tablet raise/stand allows you to use your tablet like a computer, however, it will still need to be raised further on books etc to get the screen to eye level.  In addition, you will also need a keyboard and mouse to allow for proper ergonomics and to avoid unnecessary back and neck pain.

Ergonomics, Monitor Ergonomics, Neck Pain, The Spine, Work Place Injuries

4 Computer Monitor Positions that Give You Neck Pain

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Are you an office worker suffering with neck pain?  If so, you’re not alone.  Office workers are one of the population groups most at risk of developing neck pain, with an incidence of around 55% in some countries.

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If you are an unfortunate office worker suffering from neck pain, is there something that you can do yourself to reduce or prevent your neck pain rather than popping pills or going to see your OMT trained Physiotherapist?

Neck Pain
Image by J. Heuser under Licence CC BY 3.0

The answer is, yes, of course there is!

The first and simplest things that you need to consider is where your monitor is positioned in relation to yourself on your desk (check our our desktop software designed to help you correct your computer ergonomics).  A poor monitor position is one of the most common reasons why office workers suffer from neck pain associated with poor posture.  It’s happily also one of the easiest things for to change to help improve poor posture that could be causing your neck pain.

Consider the following 4 monitor position scenarios.  Do you see yourself in any of them?  All of these poor monitor positions are high risk postures for creating neck pain.

  1.  In this scenario, your monitor (laptop or desktop computer screen) is positioned too low on your desk causing you to bend your neck for too long, straining your neck and resulting in neck pain.  This is quite common, especially for people working on a laptop or tablet.  Mobile computer devices are handy to have, but they all need assistive ergonomic devices to help you work in a safe posture.  Read this post on correcting a low monitor position to help you correct this problem.
"Catching Up On Email..." by Ed Yourdon under Licence CC BY 2.0
“Catching Up On Email…” by Ed Yourdon under Licence CC BY 2.0

2.  In this second scenario, your screen is positioned too high for you, causing you to raise your chin and compress the joints in the back of your neck causing you both neck pain and headaches.  This monitor position will cause neck pain faster than any of the others and is one of the worst postures possible for a computer worker.  This posture is common in people who are aware that a computer monitor often needs to be elevated, but are unaware of their own posture and what the correct position for one’s head and neck needs to be to prevent or reduce neck pain.  Correct your position asap

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Poor monitor position, poor ergonomics, neck pain, monitor positioned too high
“Starcraft II: Triple Monitors” by Kyle James under Licence CC BY 2.0

3.  Here, your screen is positioned too far away from you, causing you to lean forwards away from your backrest and poke your chin out.  This posture will cause both headaches and neck pain.  Read this post on correcting a monitor positioned too far away to help you correct this problem and reduce your neck pain.

Poking chin posture
“Man uses laptop” by Bill Branson under Public Domain

4.  In this last scenario, you are working a lot from notes/papers/files and don’t use a document holder.  This means that you are looking down too often during the day and this constant bending of your neck puts you at a very high risk of developing neck pain.

Alternatively, you’re working a lot from notes and have positioned them on your desk between your keyboard and monitor causing you to push your monitor too far away and take a poking chin posture.

Both of these postures will create neck pain and possibly headaches.

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Monitor Positioned too far
Image by US Navy under Public Domain

I will write about how to correct these postures and position your monitor correctly in the near future, make sure you come back to find out how you can help yourself reduce your neck pain.