Neck and shoulders ache from desk work. What can I do?

If your neck and shoulders ache after a day at a desk, the pattern many people in Thailand call "office syndrome", the main things to look after are how you sit, where your screen and keyboard are, and short, frequent breaks to move and stretch. The UK's NHS lists bad posture, for example sitting at a desk for a long time, among the most common causes of neck pain, and advises not keeping your neck in the same position for a long time. For food, there is nothing special to add: the everyday advice is to eat a variety of foods from the 5 main food groups.

Why do my neck and shoulders ache when I sit at a desk all day?

The same position, and habits you don't notice

Doctors at Ramathibodi Hospital in Bangkok explain that aches from sitting in the same position for a long time are common among office workers and others who stay in one position for long periods. They mostly come from sitting or walking in poor postures that become a habit without you noticing, and are felt around the neck, shoulders and back.

Posture, screen position and staying still

Three things tend to come together at a desk:

• Posture. The NHS names bad posture, such as sitting at a desk for a long time, as one of the most common causes of neck pain.
• Where the screen is. The US Occupational Safety and Health Administration (OSHA) explains that a screen that is too high or too low makes you work with your head, neck, shoulders and even your back in awkward postures. When it is too high, you tilt your head and neck back, and working like this for a long time tires the muscles that support the head. Working with your head and neck turned to the side for a long time loads the neck muscles unevenly and increases fatigue and pain.
• Staying in one position. The NHS advises against keeping your neck in the same position for a long time, for example when sitting at a desk. OSHA adds that however good your posture is, working in the same posture or sitting still for long periods is not healthy.

This is why the practical steps below focus on the desk set-up, breaks and stretching.

How should I set up my desk, chair and screen?

The UK's Health and Safety Executive (HSE) sets out a standard workstation set-up for good posture, and OSHA describes similar positions and how to adjust your chair.

Doctors at Ramathibodi Hospital give a similar checklist: sit right back in the chair with your back against the backrest, knees and hips bent at about 90 degrees and feet on the floor; place the keyboard and mouse so your elbows bend at about 90 degrees, neither too far away nor too close; and adjust the height of the desk or chair to fit you.

How high should the screen be?

The HSE says the top of the screen should be level with your eyes. OSHA says the top of the screen should be at or slightly below eye level, with the centre of the screen normally about 15 to 20 degrees below your eye level. Ramathibodi Hospital's advice is to set the screen at eye level so that you neither bend your head down nor tip it up to look at it.

The common ground is simple: set the screen so that you look straight ahead or slightly down, without tipping your head up or bending your neck forward. OSHA notes that people who wear bifocals look through the bottom of their lenses and may tilt their head back to see the screen; lowering the screen or raising the chair can help them keep the neck in a comfortable position.

Screens off to the side, and laptops

OSHA advises keeping the screen in front of you, no further than 35 degrees to the left or right, because working with your head turned to the side for long periods tires the neck. For a laptop used for long periods, the HSE suggests using a separate keyboard and mouse so the screen can be raised on a laptop riser, or using a separate screen.

How often should I take breaks from the computer?

Short and often works better than long and rare. The HSE says there is no legal rule on how long and how often breaks should be, because it depends on the kind of work. It advises taking short breaks often, rather than longer ones less often: for example, 5 to 10 minutes every hour is better than 20 minutes every 2 hours.

For tired, dry eyes after a day at screens, see Tired, dry eyes from screens all day. What should I do?

What counts as a break

The HSE says breaks or changes of activity should let you get up from your workstation and move around, or at least stretch and change posture. In most jobs you can switch to other tasks, such as going to a meeting or making a phone call. It also notes that break-reminder software can prompt you to take regular breaks.

If you do not have such software, a timer on your phone is a simple alternative.

If you sit all day and barely exercise, see I sit at work all day and barely exercise. Where do I start?

Which neck and shoulder stretches can I do at my desk?

The NHS has short seated routines that suit a desk. Move slowly, and only as far as is comfortable.

The neck rotation and neck stretch come from the NHS flexibility exercises, which it describes as good for neck mobility and for loosening tight neck muscles. The chest stretch, which the NHS says is good for posture, and the upper-body twist come from its sitting exercises.

Before you start

For the seated routine, the NHS suggests a solid, stable chair without wheels, where you can sit with your feet flat on the floor and your knees bent at right angles. Many office chairs have wheels, so use a fixed chair if one is nearby. The NHS advises building up slowly, aiming for at least twice a week, and checking with a doctor or health professional if you are not sure the exercises are suitable for you. Stretching during the working day also gives you the change of posture the HSE recommends.

I sit at work all day. How should I eat?

For food, there is nothing special to add: the everyday advice for everyone applies. The NHS advises choosing a variety of foods from the 5 main food groups to get a wide range of nutrients.

The everyday basics

The NHS sets out these points for a balanced diet:

• Eat at least 5 portions of a variety of fruit and vegetables every day.
• Base meals on higher-fibre starchy foods, such as rice, bread, potatoes or pasta.
• Have some dairy or dairy alternatives, such as soya drinks.
• Eat some beans, pulses, fish, eggs, meat and other protein.
• Choose unsaturated oils and spreads, and eat them in small amounts.
• Drink at least 6 to 8 glasses of fluid a day.

It also advises having foods and drinks high in fat, salt and sugar less often and in small amounts.

Using your lunch break

A lunch break is also a natural break from the screen. Getting up to eat away from your desk is also a chance to stand up and move.

How can I look after my neck outside work?

The NHS gives some simple everyday steps for the neck:

• When sleeping, keep your head at the same height as the rest of your body, use a low, firm pillow and have a firm mattress.
• Don't sleep on your front, and don't twist your neck when you are in bed.
• Sit upright: roll your shoulders back gently and bring your neck back.
• Put heat or cold packs on your neck: a pack of frozen peas wrapped in a tea towel for 5 minutes, 3 times a day, or a hot water bottle wrapped in a tea towel for 20 minutes, 2 to 3 times a day.
• Don't wear a neck collar, because it is better to keep your neck moving, unless a doctor tells you otherwise.
• If you cannot move your neck, don't do anything that could be dangerous, such as driving or cycling.

When should I see a doctor about neck and shoulder ache?

The NHS says most neck pain only lasts a few weeks. Ramathibodi Hospital notes that early aches can go away on their own after resting or changing position. The NHS advises seeing a doctor if:

• neck pain or stiffness does not go away after a few weeks
• you are worried about the pain
• you have other symptoms, like pins and needles or a cold arm

The NHS notes that these other symptoms could be a sign of something more serious. Doctors at Ramathibodi Hospital also advise seeing a doctor promptly if the pain is bad enough to affect your rest and sleep, or if your neck, shoulders or back hurt while you are lying down. In Thailand, you can see a doctor at a hospital or clinic. Check with a doctor or pharmacist before using any medicine for the pain.