Is your desk giving you pain? How sedentary work causes postural pain and what physiotherapy can do about it
- May 5
- 7 min read
Updated: May 6
In our last post, we explored cervicogenic headaches — a type of head pain that originates in the neck and is frequently triggered by sustained poor posture and prolonged desk work. If that post resonated with you, this one goes even deeper into the root cause.
Because cervicogenic headaches are just one of many problems that can develop when we spend too much of our day sitting still in the same position. Neck pain, lower back ache, tight shoulders, mid-back stiffness, wrist pain — these are all part of the same story, and it's a story that's becoming increasingly common.
If you work at a desk, spend long hours on a laptop, or have been working from home since the pandemic shifted the way we all work, your body has almost certainly felt the effects. Here's what's actually happening — and what you can do about it.
Why sedentary work is hard on your body
The human body is designed to move. Our muscles, joints, spinal discs and nervous system all function best when they're loaded and unloaded regularly throughout the day — not held in one fixed position for hours at a time.
Musculoskeletal disorders are increasingly prevalent in sedentary occupations due to inadequate ergonomic design and prolonged static postures. Prolonged exposure to occupational risk factors increases the likelihood of developing conditions including lower back pain, carpal tunnel syndrome, tendinitis and neck strain.
When you sit at a desk, several things tend to happen to your posture without you realising:
Your head gradually drifts forward. Forward head posture is one of the most commonly observed postural abnormalities, with its prevalence notably increasing in modern society due to widespread screen use, prolonged screen time and sedentary behaviours. For every centimetre your head moves forward of its neutral position, the effective load on your neck roughly doubles — so a head that sits 5cm forward can feel like it weighs significantly more than it actually does.
Your shoulders round forward. As the chest tightens and the upper back weakens, the shoulders follow the head — rolling inward and creating compression across the upper back and shoulder blades.
Your lower back loses its natural curve. Most people sink into their chair over time, losing the lumbar lordosis that protects the discs and joints of the lower back. Prolonged sitting leads to a slumped posture, which influences spinal curvature and increases low back and hamstring stiffness.
Your deep stabilising muscles switch off. The muscles that are supposed to hold your spine upright — your deep neck flexors, your core — fatigue and disengage when you sit for long periods. The body then compensates by overloading other muscles not designed for this role, which is where the aching and tightness comes from.
The work-from-home factor
Working from home has made postural pain significantly more common — and for understandable reasons. Office environments, for all their faults, tend to have reasonably adjusted desks, ergonomic chairs and a reason to get up and move (walking to meetings, the kitchen, a colleague's desk). Home setups are often improvised: a kitchen table, a couch, a laptop balanced on a pillow.
The boundaries between work and rest have also blurred. Many people working from home report sitting for longer uninterrupted stretches than they ever did in an office — without the natural movement breaks that a shared physical space provides.
The result is a population of people spending more time than ever in postures their bodies were never designed to sustain.
Where postural pain typically shows up
Postural-related pain can develop almost anywhere in the body, but the most common presentations we see at Colab Health Group include:
Neck pain and stiffness — often one of the first signs that your workstation setup or screen height needs attention. Can develop gradually over weeks or months before becoming significant.
Cervicogenic headaches — as we discussed in our previous post, these headaches originate in the upper cervical spine and are directly linked to sustained forward head posture and neck muscle tension.
Upper back and shoulder pain — tightness across the upper trapezius and between the shoulder blades is extremely common in desk workers. The rhomboids and lower trapezius — the muscles that should hold the shoulder blades back and down — become weak and overstretched, while the chest and front of the shoulders tighten.
Lower back pain — the most reported musculoskeletal complaint globally. Maintaining a seated posture for a long time makes it very difficult to maintain correct posture. People tend to change their posture according to habit — slouching and crossing the legs — and maintain poor posture regardless of their awareness of it. If incorrect postures become habitual, the strain on the spine, pelvis, muscles, tendons, joints, bones and discs can lead to fatigue and pain.
Wrist, forearm and elbow pain — repetitive keyboard and mouse use in a poorly set up workstation loads the forearm tendons and nerves in ways that can lead to conditions like carpal tunnel syndrome, tennis elbow or general forearm tendinopathy.
How physiotherapy helps
The good news is that postural pain responds very well to physiotherapy — particularly when it's caught before it becomes chronic. Your physio will assess not just where it hurts, but why: what's weak, what's tight, what's being overloaded and what your day-to-day setup looks like.
Treatment at Colab Health Group typically involves a combination of the following:
Postural assessment and workstation advice
Your physio will assess your posture in detail and discuss your work setup — screen height, chair position, keyboard placement, how long you're sitting without a break. Sometimes small adjustments make a very significant difference. Ergonomic modification of the workstation and workplace exercises including stretching reduced musculoskeletal pain in similar ways — suggesting that both the environment and the movement habits of the worker need to be addressed together.
Manual therapy
Hands-on treatment to release tight joints, reduce muscle tension and restore normal movement in the neck, thoracic spine and shoulders. This is particularly important where pain has been present for some time and the tissues have become stiff and sensitised.
Targeted exercise prescription
Physiotherapy-based interventions, especially strengthening and stretching exercises, are widely recommended for postural correction. Strengthening aims to activate underused musculature like the deep neck flexors and lower trapezius, while stretching alleviates tightness in muscles such as the pectoralis major.
Your physio will prescribe a specific programme addressing your individual pattern of weakness and tightness — not a generic set of stretches, but exercises chosen for your body and your goals.
Movement habit retraining
Micro-breaks are beneficial to employees in sedentary work — an active workout and micro-break programme in the workplace that includes stretching, strengthening and torso stabilisation should focus on the needs of each individual. Your physio will help you build sustainable habits: how often to move, what to do during short breaks, and how to maintain better postural awareness throughout your workday.
Practical tips you can start today
While nothing replaces a proper physiotherapy assessment, here are a few evidence-informed habits that can make a meaningful difference in the short term:
Set a movement reminder every 30–45 minutes. Even standing up and walking to the kitchen and back interrupts the prolonged static loading that drives postural pain. The goal is movement variability, not perfection.
Check your screen height. The top of your screen should be roughly at eye level. If you're using a laptop on a desk without a stand, your head will be angled downward all day — one of the most common contributors to neck pain and cervicogenic headaches.
Sit back in your chair. Allow your lower back to make contact with the lumbar support rather than perching on the edge of your seat. This simple adjustment reduces the load on your spinal discs significantly.
Bring your keyboard and mouse closer. Your elbows should be at roughly 90 degrees with your forearms resting comfortably. Reaching forward all day to use your keyboard loads your shoulder and upper trapezius.
Strengthen your back. No amount of postural awareness will compensate for weak upper back and core muscles in the long run. A physio-prescribed strengthening programme is the most sustainable long-term solution.
When to see a physio
Don't wait until the pain is severe. If incorrect postures become a habit, individuals may adapt and consider them comfortable — which can cause strain on the spine, pelvis, muscles, tendons, joints, bones and discs that leads to fatigue and progressive deformation. The longer postural pain is left unaddressed, the more the body adapts around it — and the more work is required to unwind those adaptations.
See your physio if:
You have pain or stiffness in your neck, back or shoulders that is worse at the end of the workday
You're getting headaches that seem to start at the base of your skull or neck (read our cervicogenic headache post for more on this)
You've noticed your posture has changed — rounded shoulders, chin poking forward
You've recently moved to working from home and your pain has increased
Pain is waking you at night or affecting your sleep
The Colab approach
At Colab Health Group in Balwyn, we see postural pain every day — and we know that the best outcomes come from understanding the full picture. Your physio will take time to understand your work setup, your movement habits, your history and your goals before developing a plan that addresses the cause rather than just the symptoms.
Whether you've been managing niggling discomfort for months or you're dealing with something more acute, we'd love to help.
References
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Korshøj M, Holtermann A, Søgaard K. Effect of physiotherapy interventions through active micro-break activities for employees with sedentary work. Healthcare. 2022;10(10):2073. https://doi.org/10.3390/healthcare10102073
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