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Neck and Upper Back Pain

Why is it Important and Who is Affected?

Neck and upper back pain is a common problem with people who work in stressful jobs especially requiring awkward and static postures. The condition usually involves strain to the muscles that run along either side of the spine. Excluding some source of external trauma the problem is increasing among nonstrenuous type jobs including computer users and office workers, dentists and dental hygienists. There are now 25 million people in the U.S working over 10 hours a day in white-collar jobs. These workers spend much the day working with their shoulders rounded and heads in a forward position over a desk. 

How Does Cervical and Upper Back Strain Affect the Worker?

These workers may experience these muscular aches and stiffness along the spine in the upper back and into the two scapulas, into the trapezius muscles on either side of the neckline with pain as far up as the sub-occipital region. This area, located at the back of the head, includes two small muscle groups that connect the skull to the top of the spine and help to stabilize the head. These muscles may be acutely tender to the touch and bring about muscle tension headaches. Mobility may be impaired if there is trauma involved. 

How is the Condition Prevented or Treated?

The worker may be predisposed to muscular strains in this area because of postural distortions that are unique to certain jobs. For this reason it is vital to modify the work routine and environment in order to minimize strain to the neck and upper back. Workers need to be able to adjust the level of the work surface in order to maintain the spine in a neutral position. This is accomplished by using ergonomic desks and chairs, which can be adjusted according to individual needs. When working by hand it is usually desirable to have the forearms bent to roughly 90 degrees with the arms hanging freely and the shoulders relaxed. This posture minimizes static tension of the shoulders and upper back. Taking frequent stretching and exercise breaks to restore circulation and prevent muscle fatigue can offset the negative effects of static postures. Sleeping on the stomach should be avoided. Poor sleeping postures are frequent contributors to neck strains and conditions like torticolis. Cervical pillows are useful because they support the natural cervical curve as opposed to the conventional pillow, which forces the head into flexion.

1) Brier, Steven R. Primary Care Orthopedics. St. Louis: Mosby, Inc., 1999