Neck and back pain from working at home: what to change and what to try

The laptop sits on the dining table. The chair was made for meals, not for eight hours of work. By evening your neck is stiff and your lower back aches.

Many people who work from home know this feeling. The good news is that neck problems are rarely caused by serious disease, and back pain often gets better on its own. Small changes can help a lot. This guide covers your desk setup, movement breaks and a few gentle exercises.

How common is it?

During the COVID-19 pandemic, many researchers studied people working from home. A 2023 rapid review pulled together six of these studies. Neck pain was reported by between 20% and 77% of home workers, depending on the study. Low back pain ranged from about 20% to 74%.

That is a wide range, and the studies had weaknesses. A larger 2023 review of 25 studies found mixed results, but neck and lower back pain were still the most common complaints. The authors felt that ergonomics and the way work is organised seem to play a part.

Is bad posture to blame?

Not in the simple way many people think. Many people believe that sitting, standing or bending "wrong" causes back and neck pain. Physiotherapy researchers point out that strong evidence does not support this.

What matters more is staying in one position for too long. NHS inform lists "being in the one position too long, like sitting at your desk at work" as a common cause of neck problems. Anxiety, low mood and repeating the same strained movements can also play a part.

So there is no single perfect posture to hold all day. Aim for a comfortable setup, and then change position often.

Set up your desk

The UK Health and Safety Executive (HSE) gives a simple checklist for computer users. It works at home as well as in an office.

• Screen height. The top of the screen should be level with your eyes, about an arm's length away.
• Keyboard. Place it just below elbow height. Keep the mouse in line with your elbow.
• Shoulders. Sit high enough that you do not need to shrug your shoulders to reach the desk.
• Seat. The seat height should support the front and back of your thighs evenly. Leave a gap of 2 to 3 cm between the front of the seat and the back of your knee.
• Lower back. The chair back should support your lower back. A cushion can add support.
• Straight ahead. Keep the screen and keyboard directly in front of you, so you do not twist your back.

If you work on a laptop

With a laptop, if the keyboard is at the right height, the screen is too low. HSE suggests using a separate keyboard and mouse. That way you can raise the laptop screen on a riser. At home, a firm stack of books can do the same job. A cushion on a dining chair can lift you to the right height, and another cushion can support your lower back.

Move every hour

Breaks matter as much as the setup. HSE advises short, frequent breaks rather than long, rare ones. It gives an example. A break of 5 to 10 minutes every hour is better than 20 minutes every 2 hours. The break should let you leave your desk and move around, or at least stretch and change posture.

NHS inform gives similar advice for neck problems. Move your neck for short periods every hour, and avoid staying in one position for too long.

A few easy ways to build this into a work-from-home day:

• Stand up and walk around for every phone call.
• Set a gentle reminder on your phone for once an hour.
• Take a short walk after lunch before going back to the screen.

The World Health Organization recommends that adults limit the time they spend sitting. It also says any amount of physical activity is better than none.

Gentle exercises to try

These exercises come from NHS inform, Scotland's health information service. They suit most people with a new neck or back problem. If you have a diagnosed condition or recent surgery, follow your physiotherapist's advice instead.

Neck exercises (sitting at your desk)

1. Head turn. Face forward. Slowly turn your head to one side as far as is comfortable. You should feel a stretch on the opposite side of your neck. Hold for 2 seconds, then come back to the centre. Repeat on the other side. Both sides count as one repetition.
2. Head tilt. Face forward. Slowly tilt your head towards one shoulder as far as is comfortable. Hold for 2 seconds, then come back. Repeat on the other side.
3. Forward head tilt. Facing forward, bring your chin down towards your chest. Slowly bring it back up.
4. Wide shoulder stretch. Bend your elbows to a right angle in front of you, palms facing up. Keep your upper arms still. Move your forearms out to the sides. Hold for a few seconds, then bring them back.

Back exercises (at home, before or after work)

1. Knee rolls. Lie on your back on your bed, knees bent and pointing at the ceiling. Slowly roll both knees to one side. Hold for a few seconds, bring them back to the middle, then roll to the other side.
2. Cat camel. Start on your hands and knees, hands under your shoulders. Gently round your back upwards and tuck your chin towards your chest. Then slowly let your chest sink towards the floor and lift your head gently. Hold, then release.

How many and how often

• Start with 2 to 3 repetitions of each movement.
• Small amounts through the day work well. You could repeat your exercises every hour.
• If it feels easy, add 1 or 2 repetitions every few days. Build up to about 10 for the neck movements.
• For the back, you can work up to sets of 8 repetitions, 2 to 3 times a day. Once a short hold feels easy, try holding a stretch for 20 to 30 seconds.

Pain rules

Rate your pain from 0 to 10. A score of 0 to 3 is minimal and 4 to 5 is acceptable. A score of 6 or more is too much.

• Try to keep your pain at 5 or below while you exercise.
• If it goes higher, do fewer repetitions, move more slowly or rest longer between movements.
• Your pain should be no worse the morning after.
• Stop if the exercises make your symptoms worse or cause new pain.

What about strengthening?

Stretches are a good start. For office workers with ongoing neck pain, reviews suggest that strengthening the neck, shoulder and upper back muscles helps reduce pain. A 2024 review rated the certainty of that evidence as low, so more research is needed. A physiotherapist can set strength exercises at the right level for you.

When to see a physiotherapist or doctor

NHS inform says the biggest change in a neck problem usually comes in the first couple of weeks. Most improve within 8 weeks. If yours has not, talk to a healthcare professional. Back pain also usually improves within a few weeks. See a doctor or physiotherapist sooner if the pain stops you doing everyday things, or if you are worried.

Get medical help urgently if you have neck pain and:

• Clumsiness, numbness, pins and needles or weakness in one or both arms that is getting worse
• Problems with balance or walking since the neck pain started
• A severe headache with the neck pain

See a doctor soon if you have neck pain and:

• You feel generally unwell
• You have blurred vision, ringing in your ears or dizziness

Go to the emergency department straight away if you have back pain and:

• Pain, tingling, weakness or numbness in both legs
• Loss of feeling around your genitals or bottom
• New trouble passing urine, or you cannot control your bladder or bowels
• Chest pain
• The pain started after a serious accident

Get urgent medical advice if you have back pain and:

• You feel hot, cold, shivery or generally unwell
• Severe pain starts suddenly or gets worse quickly

See a doctor if you have back pain and:

• You have lost weight without trying
• The pain does not ease with rest or is worse at night
• It is worse when you sneeze, cough or pass stools
• There is a lump or swelling on your back
• The pain is high up, between your shoulder blades

A note about FiixBE

If a physiotherapist gives you a neck or back programme, FiixBE can help you do it at home. You exercise in front of your phone or laptop camera. FiixBE counts your reps, checks your form in real time and sends each session to your physio. You can try it on the web.