How To Set Up Your Desk To Stop Back Pain, Neck Pain And Shoulder Pain

Over the years we’ve helped countless people with office related problems. With a combination of hands on work, exercises, postural and wellbeing advice. We see office set up and posture contribute to all kinds of RSI, knee and back issues. There’s lots you can be doing to help yourself if you are struggling with such conditions. And just as much to stop yourself from getting any issues in the first place.

Most desk ‘injuries’ are fairly easy for us to fix but it’s the advice that follows that will help you stay in a good state. Here we give away our secrets that have been helping people recover from office related injuries. Individually helpful but combined a powerful antidote to general office malaise.

This article is even more relevant than ever as post COVID with the increase in working from home. It’s important to make sure that your home office set up is just as good as your work office setup.

1. The Hips Don’t Lie – Desk Setup For Your Pelvis

As Shakira rightly told us. It all starts from the hips. Well pelvis technically but I wanted to shoehorn in the Shakira reference! If we have a stable base from where we sit it’s harder for other things to go wrong. The key is to understand where we should be. We have a little trick to show you where you should be in this video here originally recorded with reference to inguinal hernias but the information within is just as relevant to desk setup:

In case you’re not able to access the video we’ll describe this process. Start sitting completely slumped. Most people find this very easy. Now move to the opposite position where you are bolt upright. Move between these two positions a couple of times. You should notice that you are just moving your pelvis. Keep moving the pelvis between these two positions and make it a smaller movement each time. You will eventually settle in what we call pelvic neutral. From here go back to your normal posture. This will give you an idea of how far away from ideal you usually are.

Be sure to have a ‘feeling’ that you are using your core muscles to hold yourself in this position. Try not to form a rigid brace. We normally say an awareness – about a 30% contraction. It is important that you are not aware of the muscles in your back when holding this position. If it is uncomfortable try going back more towards your normal posture a bit. Not all the way back to where you were but a happy half way house. If you can’t find a position that is comfortable you probably need to come and see us!

This movement is very much front to back. We also need to consider side to side. Many people sit with more weight on one side of their bottom than the other. Or even with legs crossed or sitting on one of their feet. This creates or maintains imbalance. Sit with your feet flat on the ground. Wiggle your weight from one bottom cheek to the other until you can feel your weight evenly between your two cheeks. Again, go to where you normally sit to get an idea of how far away from ideal you are.

You may find it useful to imagine a piece of string pulling up from the top of your head to help maintain this neutral pelvis with that slight core awareness.

2. Optimal Use Of Standing Desks

I’m not normally one for gimmicks but many of our clients have found benefit from standing desks. I wouldn’t say it’s the panacea that the manufacturers make out them to be but it can help. Be aware we can all have just as bad posture in standing as we can in sitting!

If nothing else it gets you to vary your position and also gives you a focus to break your day up into more manageable chunks to aid focus levels and the  quality of your posture. We talk about the importance of breaks in our previous article Peak Performance.

If you are getting a stand up desk I would recommend getting a sliding adjustable one that you can use standing up and also sitting down. If you have the option try one out before you invest in one to make sure it will work for you.

If you do use one it is also important to understand how to stand with as good alignment as possible. Watch the following video to find out how to find your neutral standing position:

For those unable to access the video right now here’s a written description. We find neutral pelvis in standing in a very similar way to how we found it for sitting. Moving between extremes of tucking your bottom under your pelvis and curving your low back and sticking your bottom out. Make this movement smaller each time and eventually you will find your neutral.

Now you have your pelvis neutral in that plane rock or sway gently from side to side moving your weight from outside of one foot to the inside of the other and back the other way. Repeat this swaying motion making smaller and smaller adjustments until you can ‘feel’ your weight evenly distributed between both feet. Repeat this process moving your weight from the front of your feet to the back.

Once you have found neutral go to where you would naturally stand. You might be quite surprised as to how far you moved. Granted this is all a bit of a faff! But after a few attempts you quickly get a better sense of where neutral is and it becomes more instinctive to go straight to it.

3. Don’t Reach For The Mouse

This next tip is absolute gold. I actually helped ‘cure’ my accountants RSI with this tip alone. I’m still waiting for him to actually book a session and recoup some of his annual fees!

Many people, especially when stressed or tired, reach forwards for the mouse. This puts the shoulder in an internally rotated position. A physio concept called adaptive shortening means if you put muscles in a position for a length of time they think they should stay there i.e. they adapt to be short.

These shortened muscles then have an impact of the main nerve (brachial plexus) which gives sensation in the whole arm. This can in turn exacerbate or even cause issues in the arm, especially in the wrist and elbow. A secondary compensation to this posture causes tight muscles in top of the shoulder and / or a round the shoulder blade (scapula).

The solution? Your mobile phone. Simply start the day paying attention and ensure the mouse is in line with the natural position of your hand with your elbow at 90 degrees and your body square on to the monitor i.e. not rotated forward. Then place your ‘blocker’ – your mobile phone – in the way so you have a reminder when you start encroaching forwards.

For a few days this is hugely annoying! But you soon get the hang of it. With the ‘blocker’ in place you will soon learn a new better habit.

For those of you reading this on a laptop using a tracker pad or equivalent we recommend attaching an old fashioned mouse via your USB. For those with exceptionally heavy mouse usage in their working day like for example a graphic designer we recommend a vertical mouse. The mouse is fixed in position and you use your fingers to move the cursor. Of course make sure you place the vertical mouse in a position where you are not reaching for it in the first place!

4. Make Sure The Monitor Is In-line With Your Eyes

Head position is hugely important. If we keep our head tipped downwards all the time the muscles that do this adapt and shorten. Limiting our ability to extend the neck in the opposite direction. It also impacts the nerves which go down the arm and increases the likelihood of RSI type conditions.

The optimal position for the monitor is in line with your eyes so you can look straight ahead. Most modern monitors are adjustable so you can choose the height. Not all monitors are adjustable so you may need to buy a new monitor stand that is the right height for you. As a cheap quick fix you can raid the stationary cupboard for a couple of reams of A4 to prop the monitor up. Those of you working from home I’ve heard a myriad of creative solutions to achieve this!

For the same reasons as above try to keep your laptop usage to a minimum. If you have to use them a lot try to use a docking station that hooks into a monitor at the correct height. We see lots of people whose conditions get worse after too much laptop work.

If you do use one try to always be sat at a desk. Not on the sofa. Not in bed. Not cramped on a train. It’s your choice but all of these things promote terrible posture. If you’re commuting just read something instead. Ideally not work related. You’ll be in the office for plenty of hours anyway. You’ll be fresher when you arrive and more efficient.

5. Support Your Arms

This may sound a bit odd but your arms are quite heavy. About 5% of your body weight for each arm. If you’re ‘holding’ 10% of your body weight in total in a non-optimal way for 8 plus hours a day then this will take its toll.

Solution? Simply make sure you the majority of your arms are rested on your desk to take the weight. This means that your keyboard and mouse should be far enough forwards on your desk for your forearms to rest on the desk. All of this is summarised nicely in the previous picture in section 4.

6. Reach Down To The Keyboard And Mouse

You know these keyboard pads and mouse pads you always wondered what they were for? The idea is so that you reach down to the keyboard and mouse.

Why would this be important? Gravity. If the muscles of your forearms are constantly holding your wrists in a ‘cocked’ position they’ve got more work to do. If they can just chill and rest they don’t have to do anything. RSI is after all an overuse issue. Anything we can do to make muscles work less can only be a good thing.

If you don’t have keyboard or mouse rests simply ensure your keyboard is on a nice low profile and pay attention to how you hold your wrists. Try to avoid that extended position for prolonged periods. In the picture above there is not a keyboard rest but the keyboard is nice and slim and the wrists are in a reasonably neutral position.

7. Relax The Shoulders

I’ve heard so many people say ‘I hold my tension on my shoulders.’ Choose not to. Be more aware of what they are doing. If you can’t control them no one else can!

The difficulty is that we don’t tend to notice when we do tense our shoulders. A simple exercise is to shrug your shoulders up and down a few times at regular intervals. It will get blood pumping to the muscles and also make you aware that shoulders, like share prices, can go down as well as up!

If you would like some specific exercises to align the shoulders better then you can do a lot worse than pretending you’re a swimmer. The posture that many office workers adopt is very similar to that of people who swim a lot. For that reason check out our page on injury avoidance for swimmers and give those exercises and stretches a try. See which ones feel the best for you and do those ones regularly.

Interestingly there are muscles in the neck which help with breathing which can give a sensation of tension in the shoulders when over worked. If you’re interested they’re called scalene muscles. We often find that these are at fault for a lot of neck pain and shoulder tension. In which case read the next section about breathing…

8. Breathe

Try to pay more attention to your breath whilst you’re working. It’s well documented that as we get more stressed we go into our fight and flight response. In nervous system terms this is called sympathetic nervous system dominant. In plain English it means we’re getting wound up! Many of us don’t notice this process so we need to pay more attention to interrupt this.

To do so whenever you remember just take a nice big belly breath and focus on a really long out breath. As you breath out notice how your whole body relaxes including your shoulders. Repeat as required and as often as possible. If you really struggle to notice set a reminder on your phone.

For a more detailed account of the joys of breathing check our previous article: Does Relaxation Breathing Really Ease Pain And Improve Your Mood?

9. Get up and walk around

The human body was designed to move. It wasn’t designed to sit on its derrière for 8 hours a day. Sadly many jobs require this. But what’s wrong with lots of breaks? I know people say they get in a flow of concentration. But you can’t possibly concentrate for hours on end.

Research suggests that our concentration starts to wane after between 50-90 minutes. How long depends on the individual. Personally I’m very much closer to 50 minutes than 90 minutes before my mind starts to wander. Minimum optimal break is 6 minutes I’m reliably informed from Peak Performance.

What to do with this precious 6 minute break? Ideally a walk in nature, then just a walk outside, then just a walk around the house. Having had your little movement break reset your posture (as in the videos above) and away you go again.

You can set reminders on your phone if you need to. My phone is currently counting down my second 50 minute segment of the day. You may prefer a more natural reminder. Have a small cup of water that needs regularly refilling. Or make lots of cups of herbal tea. Try to avoid caffeine as it stimulates your nervous system. In small doses this is fine but too much will keep you on edge and increase your sensitivity to pain.

10. Move In The Opposite Direction To Sitting

Now I am a realist. I don’t expect perfection. If we strive for perfection we’ll always be disappointed. With the best will in the world your posture and your set up will not always be perfect. That’s ok.

There’s lots we can do to counteract this. Firstly exercise. Do some. Lots in fact. Ideally something nice and high in intensity, get the blood pumping and the ticker going. But if that’s not your bag just a nice walk at lunchtime can be just as good.

Yoga is another great example of something that helps us to unwind the physical and emotional strains of having a desk job.

We can get more specific too. We can work at stretching out the muscles that pull us into bad posture. This should feel good and also make it easier to maintain good posture. Here’s a video demonstrating (with varying degrees of difficulty) how to do this. Make sure these stretches are easy and comfortable. Don’t force them and never to pain. They are best done daily for minutes rather than seconds using your breathing to help you to relax into them.

11. Take Breaks – Lots of Them

We mentioned above the importance of taking breaks to reset our posture. It’s just as important from performance and emotional perspectives. We talk about  this in more detail in our Peak Performance article. Since writing that article I have recently discovered this study which showed that work interruptions such as a trip to get coffee or chatting with a colleague lead to an increase in belonging and, as a result, higher levels of job satisfaction.

The biggest break of all should be our lunch break. So many people I speak to work through their lunch break or just scoff a sandwich at their desk and plough on through. This is a great way to keep winding up your nervous system! Remember if you look after yourself you will be more productive. The net effect is better with breaks. It’s just hard to implement this when we’re all under the cosh.

I’m sure you know in yourself that if you skip lunch you’ll get to sometime in the afternoon and hit the wall. You may as well not be there. Perhaps adrenaline will help you get through but that’s not a good long term solution. Over time it simply runs you down, messes up your immune system and means you feel more pain.

Take a lunch break every day where you are away from your desk. Ideally a whole hour. But at least 30 minutes. Try to get some movement in there and some outdoor space. Grab a sandwich, go to your nearest outdoor space and spend as much time there as you can afford!

12. Take Time To Speak To Your Colleagues

So not technically anything to do with desk set up but increasingly important with so many people working from home now. It’s great for freedom and quality of life but does it leave us feeling isolated. Recent research suggests that the more connected we our to our colleagues the more effective our work can be. This will affect our wellbeing which in turn affect our posture.

In another study it was shown that good workplace dynamics was essential for performance. This can be as much as a 10% increase in productivity.

Closeness to colleagues has also been shown to affect the effectiveness of research. One assumes a similar effect in normal office jobs too. Have you noticed any difference in the effectiveness of your work whilst working from home? There are huge benefits to working from home. But there are some drawbacks. It will be interesting over the next couple of years as a new balance is struck. We’ll update you in a couple of years to see what people are telling us…

Desk Setup Conclusion

There you have it. We hope you find all these points useful. Many of our clients have found many of these tips helpful in helping them get over long standing issues with the added bonus of feeling more relaxed.

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If you’d like more information on how our work may benefit you please click the following link to read about our Brighton Physiotherapy and Sports Therapy clinic.