Posture at the PC: Part 2

Neck:

              The neck is a major anatomical region, within it are large blood vessels, important glands, the respiratory tract, spinal column, lymph nodes, and a multitude of muscles.  Because it serves us as the connection between our head and the rest of the body, the health of the neck has implications for every region of the body.  The neck presents some unique health challenges as it relates to time on the computer.  Overwhelmingly, neck pain and dysfunction are incredibly prevalent in our culture, and increasing with our current changes in lifestyle.  A scientific review published in 2008 demonstrated that the prevalence in neck pain in various studies ranged from 60-80% of Americans during their lifetime, and as high as 63% in a given year.  The most alarming finding was the progression that the study cited over time.  It demonstrated how neck related pains and injuries had almost doubled from the late 80’s to late 90’s suggesting it was due to occupational change. The daunting implication here is what the occupational change of 2020 could mean for the general population’s necks.

https://www.ncbi.nlm.nih.gov/books/NBK542313/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528269/

Aside from housing and protecting the structures that supply the head, our neck also is responsible for supporting its weight.  On average our heads weigh about 10-12lbs each, and it is a very active process to keep it upright.  So small postural changes can have a large impact on how that weight is carried by our necks.  For instance, as our heads start to bend forward the effective weight of the head starts to increase dramatically, with even just 30 degrees of bending the neck has to exert around 40lbs of force.  This is tolerable for short durations, but longer term postural changes can be associated with unpleasant health conditions.  An Australian study published in the Public Health Records demonstrated a significant relationship in adolescent males in a forward flexed posture from computer usage. The next time your see someone at the computer watch their posture, and see if their head is bent forward. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1936962/

The example I like to give patients is that your neck carrying your head, is similar to how you would carry bowling ball.  If you keep that bowling ball close to your body it is manageable, but the farther you extend your arms it becomes more tiresome to hold.  This constant exertion from the muscles of the neck as a result of postural change can lead to deep agonizing exhaustion in the muscles of the neck.  Once the muscles of the neck have depleted their energy stores or become over stretched patients tend to experience a range of symptoms, from deep achy discomfort to agonizing burning sensation.  Beyond just being painful these postural changes have real implications the functions of our body.  One documented change is that as our ability to breathe is directly impacted by our forward head posture.  Give a try! Seriously, stick your head way out in front of your body and try and take a deep breath, and then just imagine the daily impact from that small postural change.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348172/

Picture taken from: https://bostonbodyworker.com/uncategorized/life-hack-forward-head-posture-covid/

             

Neck pain and dysfunction is very closely related to extended time on the computer and its position for long durations, so what can be done for this? The first step should be primary prevention.  Carefully evaluating your computer setup, and creating an environment that is accommodating for your neck is very important.  Ideally, you want the center of the monitor to be at eye level.  Avoiding constantly looking downward is the best combatant for avoiding the forward head postural changes.  I’ve found that this is more difficult than it may seem, and many times I’ve encouraged patients to place their monitor on a stack of books, or significantly lower their chair.  Next, make sure that the head isn’t slightly turned to one side or the other.  Finally, is allowing the shoulders to be relaxed.  Being in a position where the shoulders have to shrug constantly during time on the computer would also contribute significantly to postural changes.

Shrugging our shoulders constantly is a large culprit for longer term neck discomfort.  Naturally, shrugging our shoulders happens with the trapezius and levator scapulae muscles.  These muscles anchor at different points related to the shoulder, and on the neck.  When they tighten it leads to our shoulder girdle being lifted.  This process gets altered when stationary at the computer though. Imagine yourself sitting at the computer with your arms raised to the keyboard so your shoulders are shrugged.  The upper trapezius and levator scapulae muscles become shortened.  After staying this way for over an hour the muscles start to make postural changes and tighten.  Following being on the computer the increased tension in these muscles can irritate the attachments on the neck. Below is an excellent stretch to perform if you experience neck pain following long sessions at the computer.  I encourage patients to perform this stretch intermittently every hour they work at the computer. Also, if this is the case I would highly encourage you to examine how shrugged your shoulders have to be at your current computer station. 

https://www.ncbi.nlm.nih.gov/books/NBK518994/

image taken from: http://qoo.ly/xa45n#https://backintelligence.com/upper-back-stretches/

 

With the data on the prevalence of neck pain and dysfunction seen above, it’s likely that you are beyond just the primary prevention.  From a scientific standpoint it seems that some form of physical intervention is best. At Concho Valley Chiropractic neck pain is one of the common things that we see.  The best steps in this case are to identify the cause of the pain, then figure out the daily activities contributing to it.  We here thoroughly enjoy formulating a personalized approach to working with many different types of neck conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528269/

 

Back

              The lower back is a part of the body that has given trouble to many Americans.  It is so troublesome that it is ranked in the top two reasons for missed work among Americans by the Official Disability Guidelines.  Statistically, you or someone you know has suffered with lower back pain at some point recently.  Additional time at the computer presents many challenges towards the lower back.  The lower back is comprised of 5 different bones, the discs between them, and an array of larger muscles and ligaments.  It serves us by supporting the body above and houses the nerves that control our legs.  In reality our lower back is always working.  It keeps us upright when we are sitting, standing, driving, running, jumping, and working.  So it is incredibly important to maintain it when we work at the computer.

https://www.ncbi.nlm.nih.gov/books/NBK557616/

 

Computer time relates very directly to health of the lower back.  A study conducted in 2012 in the journal of Craniovertebral Junction and Spine indicated that 8 out of 10 people, who use the computer for more than 4 hours in a day suffer from lower back pain.  If we think about this in 2021 between home office-work, streaming services for leisure, virtual schooling programs, and popularity of video games most people are going beyond that 4 hour mark.  This has to do with postural changes, increased pressure on the lower back when sitting, and tightening of the muscles that attach from the lower back to the hips. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3669474/

              The next anatomical structure that his highly impacted by prolonged time at the computer is the intervertebral disc.  These are the squishy and flexible structures made of fibrocartilage between each of the bones of the spine.  They exist to spread out compressive forces on our spines and allow us to move in many different directions.  Because the intervertebral discs are located on the front aspect of the spine there is an increase in pressure with movements that bend us forward.  Of all of the activities that increase pressure in our discs, sitting raises it the most. This leads to a situation for most people where the activities they repeating every day, are leaving them greatly predisposed to injury.  Making sure you sit upright, with good lumbar support is an excellent measure for reducing the pressure put on the discs of your lower back. This slight change in posture, magnified over the thousands of hours that someone will sit at the computer can make a huge difference in that person’s likelihood of pain and lower back injuries.

https://pubmed.ncbi.nlm.nih.gov/17346987/#:~:text=Abstract,rupture%2C%20and%20low%20back%20pain

There are some good preventative measures that we give most of our patients who spend a frequent amount of time at the computer.  First, is that we need to find time to get that pressure off of our lower backs and get moving during the day.  Taking frequent breaks is very important, so find a way to get up and walk around between tasks or between games.  Standing and walking shifts some of our weight away from the intervertebral discs, and allows other structures to help. This is why standing desks are having such a rise in popularity.  Being able to switch between seated and standing through the day is the best course for keeping our lower back healthy.  Even when people have standing desks I still encourage them to take breaks and move around periodically.  Movement is how our discs gain their nutrients.  The discs do not have a very extensive blood supply.  Intervertebral discs gain nutrients through a process called, imbibition, where they absorb nutrients from the surrounding bones with movement.  A key point that we try to communicate to patients is that too little movement is sometimes just as bad for us as too much movement.

The next preventative measure is to stretch the muscles that become tighter when we use the computer.  This is very similar to changes that happen in neck when our shoulders remain shrugged, but applied to the lower back.  Primarily the muscles that flex the hip, specifically the psoas.  The psoas muscle attaches to our lower backs and the front of our hips, and it’s main job is to raise our legs up in front of us.  When we are sitting the psoas is in a shortened position, and over time our body will accomidates to this this.  Increased tension in the psoas often manifests as diffuse lower back pain.   Stretching the hips in the opposite direction of where the body is being in a prolonged time while sitting is an excellent thing to do after being at the computer for over an hour.  Below is the image of a psoas stretch.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889545/

Picture taken from: https://www.spine-health.com/blog/essential-role-psoas-muscle

Similar to the neck, once primary prevention is passed some form of physical intervention is excellent for the long term health of our backs.  Chiropractic is an amazing portal of entry for working with longer standing back pain issues.  We work with many patients, not only in correcting their lower back pains, but empowering them to keep performing what they need to.  At CVC we want our computer users to not feel for dread longer computer usage, but know what they need to do in order to stay healthy. If you’re experiencing lower back issues, and realize that your lifestyle puts you at the computer for a long time seeking chiropractic care is an excellent treatment option.