Neck and shoulder pain related to computer use

doi:10.1016/j.pathophys.2004.03.001

Pathophysiology

Volume 11, Issue 1, July 2004, Pages 51-56

https://doi.org/10.1016/j.pathophys.2004.03.001 Get rights and content

Abstract

The neck and shoulder pain (NSP) symptoms are very common among intensive computer users. This paper reviews recent 20 years’ research publications, which have focused on pathophysiology and other aspects of the neck and shoulder pain related to computer use (NSPRCU). The disorder is usually multidimensional, occupational, personal and social factors are among these evolved. Suggestions concerning the diagnostics, procedures of prevention, and treatment options have been discussed. As the details of pathophysiology of these disorders are not yet clear, further studies on NSPRCU are necessary.

Introduction

Neck and shoulder pain (NSP) is a common complaint in the general population. Swedish insurance data show that 18% of disability payments made for musculoskeletal disorders was spent on neck and shoulder problems already 10 years ago [1]. The amount and extent of the computer use has increased very fast, and also the disorders, such as NSP and low back pain (LBP), which are related to computer use, have become more and more common [2], [3], [4], [5]. An 8-year study of workers’ compensation claims associated with upper extremity disorders in the State of Washington (US) found that the most frequent injuries were those of the hand, wrist, shoulder and elbow [6]. Even though the recorded prevalence of NSP is not yet as high as that of the low back pain, it causes remarkable personal suffering due to pain, disability, and impaired quality of work and life in general. Surprisingly, there is a considerable lack of information regarding the NSP in contrast to that of LBP. This review will reveal the present understanding on the pathophysiology of the NSP as well as the principles of the diagnosis, prevention and treatments, with a special focus on their relationship to the computer use.

Section snippets

Definition and classification

The term ‘neck and shoulder pain related to computer use’ is defined as the neck and shoulder disorders caused by repetitive and/or continuous computer work. The classification of NSP has been incoherent due to a lack of well-established clinical tests and diagnostic methods to get a specific diagnosis. Most frequently, NSP arises from functional disorders. Pain symptoms in the neck and shoulder may coexist, overlap and quite frequently no tissue damage can be revealed. Diverse classifications

Pathophysiology

Several structures have been shown to cause pain in the neck and shoulder area. When irritated or inflamed, e.g. nerves, muscles, bones, discs, facet joints and ligaments are capable of evoking pain [7], [9]. The risk factors for NSPRCU have been documented by many studies [9], [10], [11], [12], [13], [14], [15], [16]. Very commonly, they encompass: (1) work related factors (such as repetitive motion, forceful exertions or strain, awkward postures and/or unnatural positions and uncomfortable

Clinical manifestation

The initial symptoms of NSPRCU are neck and shoulder stiffness, fatigue and dull pain. The pain may be aggravated by moving of neck and shoulder, and it may be stronger at night. If a cervical disc herniation with a nerve and/or nerve root compression exists, the pain may be stronger and accompanied by other sensory abnormalities in the affected nerve distribution. Also in the carpal tunnel syndrome related to computer use, shoulder, wrist and hand pain as well as numbness and paresthesiae in

Diagnosis and treatment

NSP is a common symptom with a number of possible causes as already described. Proper therapy, therefore, is based on a correct diagnosis. Accordingly, the medical history and the current symptoms of the patient have to be carefully screened. If the NSP exists without any other specific causes or systemic disorders, but the subject has a history of repetitive computer use, the diagnosis of NSPRCU can be made [8], [52]. Because the NSPRCU can result from local but also non-local neck and

Prevention

Usually, NSPRCU can be prevented by: (1) promoting the ergonomic adjustments of working environment; (2) changing the poor working habits; (3) increasing exercise during the work. Following suggestions may be helpful to prevent the NSPRCU [9], [24], [34], [69], [70], [71]:

•
Ergonomic posture is important, especially if a person sits at a desk much of the day. The trunk thigh angle should exceed 100° perhaps be rather close to 135° as then the pressure in disks is about the same as when standing.

Conclusion

NSP is a common problem among those who use computer intensively. It seems likely that NSP results from many factors, including the physical load and psychosocial work environment. The available evidence regarding the etiological factors is not consistent across studies, and the associations are not generally strong. Future longitudinal research should evaluate the relative importance of each individual risk factor and the role of potential confounding variables, such as screen exposure also

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View full text

Neck and shoulder pain related to computer use

Abstract

Introduction

Section snippets

Definition and classification

Pathophysiology

Clinical manifestation

Diagnosis and treatment

Prevention

Conclusion

Pain

Pathophysiology

Clin. Biomech. (Bristol, Avon)

Surg. Neurol.

Maturitas

Int. J. Ind. Ergon.

Personal. Ind. Diff.

Pain

Med. Clin. North Am.

J. Shoulder Elbow Surg.

Spine J.

Complement Ther. Med.

Neck-and-shoulder pain, an increasing problem. Strategies for using insurance material to follow trends

Scand. J. Rehabil. Med. Suppl.

Work related and individual predictors for incident neck pain among office employees working with video display units

Occup. Environ. Med.

Prevalence of shoulder pain in the community: the influence of case definition

Ann. Rheum. Dis.

Prevalence, determinants, and consequences of chronic neck pain in Finland

Am. J. Epidemiol.

Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995

Am. J. Public Health

Recent trends in work-related cumulative trauma disorders of the upper extremities in the United States: an evaluation of possible reasons

J. Occup. Environ. Med.

Occupational risk factors for shoulder pain: a systematic review

Occup. Environ. Med.

A prospective study of work related factors and physical exercise as predictors of shoulder pain

Occup. Environ. Med.

Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work

Spine

Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France

Occup. Environ. Med.

Risk factors for the development of neck and upper limb pain in adolescents

Spine

The association between psychological distress and musculoskeletal symptoms experienced by Chinese high school students

J. Orthop. Sports Phys. Ther.

Work-related musculoskeletal disorders

Curr. Opin. Rheumatol.

Soft-tissue injuries related to use of the computer keyboard. A clinical study of 53 severely injured persons

J. Occup. Med.

Work posture, workstation design, and musculoskeletal discomfort in a VDT data entry task

Hum. Factors.

Preliminary findings on the effect of load-carrying to the structural integrity of the cervical spine

Surg. Radiol. Anat.

Pattern of muscle activity during stereotyped work and its relation to muscle pain

Int. Arch. Occup. Environ. Health

ABC of work related disorders: neck and arm disorders

BMJ

Age related changes in normal isometric shoulder strength

Am. J. Sports Med.

Muscle sarcopenia: an overview

Acta. Myol.