Your computer may be a pain in the neck

Hunched shoulders and a craned neck can lead to major discomfort for office workers.

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.

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