May 17, 2006 4:00 AM PDT

Your computer may be a pain in the neck

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Sit up straight.

If you're reading this article with hunched shoulders and a craned neck, your "computer slump" could one day give way to what some physical therapists call "postural syndrome."

Postural syndrome is essentially repetitive stress to the neck and thoracic spine, or the 12 vertebrae of the mid-back and chest area, from the so-called flex-forward position. Doctors and physical therapists say that the injury commonly targets the fourth, fifth and sixth discs in the thoracic spine, leading to muscle tenderness, stiffness or, in some cases, nerve irritation.

A prolonged slouch over many years causes the disc space to narrow, which in turn can cause nerve irritation that spreads underneath the shoulder blades, down the arms and down the back.

Sure, most office workers and their ergonomic specialists are familiar with the dangers of repetitive motions with a mouse and keyboard at the PC all day, resulting in weakened wrists, tennis elbow or, worse, carpal tunnel syndrome. But some physical therapists say that such injuries lately are taking a backseat to patient complaints of pains in the mid- to upper back and neck.

"We call it the flex-forward posture, where your head's jetting forward, the abdominals shut down and the majority of the pressure comes to the mid-back," said Caroline Palmer, a physical therapist at the Stone Clinic, based in San Francisco. "Your spine is going to have to give somehow."

Frozen at the keyboard
Its concentration in the fourth thoracic spine leads some to refer to it as "T4 syndrome" because it can cause numbness to nerves in the back and arms, and radiate pain to the upper and lower back. Despite the differences in terms, all doctors and physical therapists agree: The human body was not meant for sitting or working in one position all day, and prolonged work at the computer can eventually cause the body to short-circuit.

"It's not a life-or-death situation," Palmer said. "It just sucks to have to live with it."

Postural syndrome, experts say, often goes hand-in-hand with other repetitive stress injuries (RSI) like sore neck, wrists and hands, but it's far less well known. In many cases, people still don't think about their posture, physical therapists say.

"People are aware of easy wrist stretches they can do at the desk. But they don't pay so much attention to their head's jetting forward and their rounded shoulders," said Doreen Frank, a physical therapist near Albany, N.Y., who has many patients who are office workers.

As a result, she said, "I see lots of people with cervical thoracic strain and it's very much related to sustained poor posture at the computer."

Frank has practiced for 25 years and over the last five years she has seen more people with postural problems than with carpal tunnel. Even her patients who are in good shape and exercise regularly suffer when they sit in a prolonged state of incorrect alignment. Parents, especially, might slouch at work, then drive home with their neck forward, then sit and watch their kids play soccer--again with the neck forward.

Breaking the spell
It's difficult to say how many people are affected, but anecdotally, more doctors and physical therapists say they are treating patients for postural syndrome, particularly in high-tech areas like the San Francisco Bay Area and New York.

"It's definitely on the rise," said Diane Mickle, a physical therapist in New York. "We're finally putting together the cause and effect."

Still, other physical therapists say it's not everywhere. Robert Fleming, another physical therapist based near Albany, said computer-related RSI is typically concentrated in the neck, lower back and arms.

But physical therapists say the answer to the problem lies in education and injury prevention. People need to remember the tenets of good posture from their school days, and take regular breaks every 20 minutes, if possible, from sustained sitting at the computer.

Break-reminder software such as RSIGuard is also helpful for people who tend to sustain focus for hours upon hours without stretching or leaving the computer. Sites like My Daily Yoga can be helpful for learning regular stretches to combat strain.

"Even momentary breaks--the most important is to break postural habit," Frank said.

See more CNET content tagged:
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4 comments

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These are Very "Simple" Solution!
Design computer systems that would allow people to use the computer in the most natural ways common to man - "TALK" and "LISTEN" to the "COMPUTER" while in the best ergonomic postures and audible positions!
Posted by Captain_Spock (894 comments )
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National Institutes of Health Guidelines
The National Institutes of Health has helpful guidelines on both computer ergonomics and exercises for computer users available at: <a class="jive-link-external" href="http://www.nih.gov/od/ors/ds/ergonomics/exerciseeyes.html" target="_newWindow">http://www.nih.gov/od/ors/ds/ergonomics/exerciseeyes.html</a>
Posted by jonmca (1 comment )
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Denied by Doctors
For years Doctors have written off complaints of upper back pain as ficticious, because prior to lengthy computer use, the areas involved had the least amount of wear and tear - which means it is almost impossible to get the kind of disc erosion that causes the suffering of people with lower back problems.

Computer users, however, aren't suffering from bulging discs or similar ailments, they are suffering from arthritis, tendonitis and muscle strain from forcing your body to hold bad posture for hours at a time, and generally using muscles in ways they just aren't normally used for.

Sufferers generally start out with minimal symptoms, maybe getting a mild pain behind their shoulder blades if they sit up straight or lay on their backs. This progresses over the years to sever pain, if say you took a deep breath (thus moving your rear rib cage which is now arthritis ridden, or moving sore tendons and strained muscles).

The answer is there isn't one, even if you abide by acceptable ergonomics rules - because this is new, and no one can honestly say whether say it's continually over-reaching for your mouse, or sitting with a hunched over back or slouching or just the fact your over-using parts of the back that just weren't designed for excessive use.

The best ergonomic procedures will help prevent or progress injuries. There are recommended stretching exercises and upper back strengthening exercises that will reduce the number of pinched neck nerves, frozen shoulders, you know that excrutiating pain that starts in your neck, making it almost impossible to turn your head, then moves on to include your shoulder, shoulder blade and maybe in the worst cases your middle back. That's because the same tendons that are hurt in your neck, extend down to your lower back.

But as for a cure. Nope, and now that Viox and Celebrex have been removed from the market, even the mild relief they give is no longer available.
Posted by ajbright (447 comments )
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A Logical Solution
All of the problems described are inherent with thr poor posture brought about by sitting for prolonged periods. As long as one sits at his computer screen, no amount of fancy mechanicals will be of avail. It is surprising to see so many "learned" physicians missing this point entirely. As human beings we were never designed to sit - remember, our species is called **** erectus. What's the first effort a baby attempts? It tries to stand! And we applaud him for it! So, as adults, why have we forgotten this most human of physical traits? Even the Romans recognized this - they didn't sit for dinner. They reclined! I have been working at a computer for seventeen years, and have never suffered any of the problems described in this piece. Yes... you get it. I stand! By the way... I'm 70.
Posted by filmamerica (1 comment )
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