Physiotherapy for office workers: prevention and treatment

Office work can lead to muscle and joint pain. Static postures, repetitive movements, and the way tasks are organized can contribute to discomfort. This pain does not automatically mean that your body is deteriorating. In a study of 107 adults over the age of 45, neck curvature was not associated with the presence or intensity of neck pain¹. A curvature that differs from the average is therefore not sufficient to explain a person’s symptoms.

A study conducted among 99 office workers at an industrial company in Iran found that approximately 81% of participants experienced muscle or joint pain². The neck was affected in 58.6% of participants, the lower back in 52.5%, and the shoulders in 37.4%.² These figures apply to this group of people aged 20 to 50, not to all office workers. Physical therapy can help reduce some of these pains and enable people to resume activities that have become difficult.

Why might office workers need specialized care?

Office workers may need specialized care when pain, stiffness, or numbness limit their ability to perform their tasks. The physical therapist assesses your symptoms, range of motion, and workstation. Together with you, they will identify helpful changes in exercises, postures, and the distribution of your tasks.

Stagnant positions and a lack of movement

A review, which compiles the results of several studies, reports that office workers spend, on average, about two-thirds of their work time sitting³. It notes associations between back pain, certain postures, and movement patterns, but finds conflicting results regarding sitting time alone. The assessment may examine several areas:

The hip flexors are the muscles that bring the thigh forward. Sitting keeps the hip bent. If this area feels stiff, a physical therapist will assess its range of motion before selecting exercises. Sitting alone does not necessarily indicate permanent shortening.

The deep back muscles help support and move the spine—the series of bones that make up your back. The physical therapist assesses your strength and endurance—that is, your ability to sustain an effort. Exercises are selected based on these abilities, without assuming that all office workers have weakened muscles.

The muscles around the shoulder blades move and stabilize these flat bones at the back of the shoulders. The upper back and chest muscles work together when you use the keyboard or mouse. A comfortable forearm rest and a mouse within easy reach can reduce the effort required to hold your arms up.

The discs between the vertebrae are resilient cushions that distribute the load between the bones of the back. Body position and movement alter this load. Pain while sitting does not, by itself, indicate that a disc is damaged. Changing positions can help you find a more comfortable posture.

Repetitive motions and work organization

Typing on a keyboard, clicking a mouse, and turning your head involve repetitive movements throughout the day. The duration of tasks, breaks, and the amount of force required can all affect comfort. A workstation can therefore contribute to pain without necessarily causing minor injuries or chronic inflammation in the muscles, tendons, and joints. Inflammation is the body’s response to injury, which can cause symptoms such as heat and swelling. A tendon is the tissue that connects a muscle to a bone.

Pain that recurs or limits your ability to work should be evaluated. Treatment may begin with workplace adjustments and exercises. New, severe pain, or pain accompanied by other symptoms, may sometimes require medical attention; warning signs are listed below.

What health issues can office workers face?

Problems that can affect office workers include neck pain, back pain, wrist or shoulder pain, as well as eye strain and headaches. Carpal tunnel syndrome, described below, is a possible cause of symptoms in the hand. Not all of these pains are necessarily caused by the workstation.

Neck Pain (Cervicalgia)

Holding the same head position for a long time can become uncomfortable. The physical therapist examines neck movements, symptoms, and the activities that affect them. In a study of 1,108 17-year-olds, the groups defined by their sitting posture did not differ significantly in terms of neck pain or headaches⁴. This study measured posture and symptoms at the same time; it could not establish a cause. A review also concludes that the causal link between tilting one’s head toward a phone and neck pain has not been established⁵. That doesn’t mean you shouldn’t adjust a posture that’s causing you pain.

Excessive cell phone use is associated with neck pain, but this association does not prove that it causes it. A meta-analysis of seven retrospective studies—which analyze previously collected data—reports an adjusted odds ratio of 2.34⁶. An odds ratio compares the number of people with pain to the number of people without pain. The ratio of 2.34 compares these odds between the groups after certain statistical adjustments. It does not mean that the probability of pain is exactly 2.34 times greater.

• Your neck may feel stiff when you wake up, but it may become more flexible as you move around.
• The pain may radiate toward the shoulders or between the shoulder blades.
• Headaches can start at the base of the skull.
• Turning your head may be difficult or painful.

Neck and shoulder strengthening exercises can reduce pain in office workers who already have neck pain⁷. The 2018 review assigned moderate certainty to this finding. A 2024 review also found improvements in pain and functional ability in daily activities, but with limited certainty regarding these findings⁸. In a trial involving 96 employees who had experienced neck pain for at least three months, adding stretching exercises to an advice sheet reduced pain by an additional 1.4 points out of 10 after four weeks, compared to the advice sheet alone⁹. Daily functioning and physical quality of life also improved to a greater extent.

To learn more about the causes and treatments: Neck Pain: A Comprehensive Guide

Low Back Pain (Lumbago)

Back pain depends on several factors; the number of hours spent sitting is not enough to explain its cause. For a recent episode with no specific underlying condition identified, continuing normal activities within the limits of the pain yielded better results than two days of bed rest in a trial involving 186 workers¹⁰. Pain, functional ability, and return to work were assessed at three and twelve weeks.

• You can change your position if sitting for a long time makes the pain worse.
• You can adjust the seat height to keep your feet supported.
• You can try a comfortable support for your lower back.
• You can move the screen closer or enlarge the text so you can read without having to lean forward.

A review found no strong evidence that sitting at work, on its own, causes low back pain.¹¹ A study of 2,082 German workers also finds varying associations between time spent sitting and symptoms in the back, neck, and shoulders¹². The assessment also takes into account movement, physical activity, and work organization.

Learn More: Back Pain: A Complete Guide

Carpal Tunnel Syndrome and Wrist Pain

Carpal tunnel syndrome occurs when pressure on the median nerve in the wrist causes symptoms in the hand. This nerve transmits sensations from the thumb, index finger, middle finger, and part of the ring finger. It also plays a role in certain thumb movements. Pain, tingling, or numbness can make it difficult to grasp objects. Studies do not clearly show that ordinary use of a keyboard or mouse alone causes this syndrome. Tasks that involve high repetition and significant force pose a more well-established risk. A review focuses on computer use¹³ and another on occupational factors¹⁴.

Symptoms and diagnosis are not assessed in the same way. In a Turkish survey of 151 hospital administrative staff, 74.1% reported symptoms suggestive of carpal tunnel syndrome¹⁵. In another survey, conducted in the United States among frequent computer users, 10.5% met the clinical criteria and 3.5% had a diagnosis confirmed by a nerve conduction test¹⁶, which measures the transmission of signals through the nerve. These percentages come from two different groups. Wrist pain may also have another cause; the examination helps determine the appropriate treatment.

A review describes the mechanisms, symptoms, and possible treatments for carpal tunnel syndrome¹⁷. To improve comfort at your workstation, you can adjust the keyboard, move the mouse closer, and support your forearms. These adjustments may help alleviate some pain, but their effectiveness depends on the specific problem and the intervention¹⁸. Seek medical advice if numbness or weakness worsens, persists, or does not respond to home care. A splint—a support that keeps the wrist straight—can be worn at night to keep the wrist straight and reduce pressure on the nerve¹⁹.

More information: Wrist and Hand Pain: A Comprehensive Guide

Shoulder pain

Shoulder pain can limit arm movement at work or at home. It can particularly affect the rotator cuff tendons—the group of muscles that help move and stabilize the shoulder. Tendinopathy is pain accompanied by difficulty using a tendon. Bursitis is the inflammation of a small sac that helps tissues glide smoothly. Shoulder position alone is not enough to diagnose these problems. The British National Health Service (NHS) describes the possible causes of shoulder pain²⁰.

• Raising your arm above your head may cause pain.
• Everyday movements may be accompanied by a feeling of weakness.
• Sleeping on your shoulder can cause pain that wakes you up.
• Movements may be accompanied by cracking or clicking sounds, though these alone are not enough to indicate an injury.

See: Shoulder Pain: A Complete Guide

Eye strain and headaches

Eye strain can be accompanied by headaches and discomfort in the neck or shoulders. Glare, difficulty reading, or improper vision correction may cause you to lean forward to see better. Adjust the brightness and font size, and then have your eyes checked if the discomfort persists. The Canadian Centre for Occupational Health and Safety also recommends looking at a point about six meters away for twenty seconds, at least every twenty minutes²¹.

How does physiotherapy treat pain related to office work?

Physical therapy treats pain related to office work through an assessment, tailored exercises, advice on work tasks, and, if necessary, manual therapy. The physical therapist uses their hands to guide certain movements or work on muscles. The treatment plan aims to reduce pain and improve the activities that are causing you problems.

Assessment of Posture, Movements, and Tasks

The physical therapist begins by assessing your symptoms, how they have progressed, and their impact on your work. He or she observes your posture, your movements, and the effort required to perform tasks. The examination includes the following elements, among others:

• The physical therapist observes the position of the head and the curves of the upper and lower back.
• It measures how far your joints can move comfortably.
• It measures the strength and endurance of the muscles that support movement.
• He observes how you adjust your movements to avoid pain or complete a task.
• He checks your muscle flexibility and how movement affects your symptoms.

The assessment helps determine which exercises, workplace accommodations, and care measures are appropriate. The results are reevaluated throughout the follow-up period. Any sign that suggests another health issue may require a medical evaluation.

Manual therapy to release tension

A Review of Nine Studies on Manual Therapy²² reports a reduction in neck pain, with widely varying techniques, comparator treatments, and outcomes. A 2025 Cochrane review examines manual therapy combined with exercise in greater detail²³. After about four weeks, this combination may improve pain and daily functioning compared to no treatment. Compared to a sham treatment—designed to resemble the actual therapy without applying its techniques—it may improve functioning, with no clear difference in pain. Confidence in these results remains limited. These findings primarily concern persistent neck pain and do not guarantee a lasting effect for every individual.

Joint mobilization involves movements that the physical therapist guides with his or her hands to help a joint move more comfortably. These movements may involve the neck, upper back, or lower back, depending on the symptoms.

Manual therapy can target sensitive areas such as the trapezius muscles —located between the neck and shoulders—the muscles running along the back, or the rotator cuff muscles. The choice depends on the examination and your response. Physioactif does not use myofascial release, a technique that targets the fascia—sheets of tissue found primarily around the muscles.

Spinal manipulations involve applying a brief movement to a joint in the back or neck. The physical therapist will determine whether this option is appropriate for you and discuss the benefits and risks with you. Mobilizations and manipulations can complement exercises; no single technique is automatically suitable for everyone.

Targeted therapeutic exercise program

Strength training and endurance exercises develop the abilities needed for work and daily activities. The 2018 review supports strength training and general physical activity as ways to reduce neck pain in employees who are already experiencing symptoms, with strength training having a greater effect⁷. In a trial involving 180 female office workers aged 25 to 53 with persistent neck pain, strength and endurance programs reduced pain and daily difficulties after one year²⁴. For prevention, another review of five trials²⁵ found fewer new episodes of neck pain with exercise, lasting up to twelve months. The review included adults who were pain-free at the start of the study, about 80% of whom worked in an office setting.

Neck exercises help build strength, endurance, and control of movement. The longus colli is a deep muscle located in front of the cervical vertebrae. The suboccipital muscles are located at the back of the head, beneath the skull. Depending on the results of your evaluation, your physical therapist may teach you a simple head movement or have you perform exercises against appropriate resistance.

Strengthening the area around the shoulder blades can target the rhomboids and the middle and lower portions of the trapezius, located in the upper back, as well as the serratus anterior, along the side of the ribs. These muscles help guide the shoulder blades during arm movements. Exercises may include a modified pull-up or pressing your hands against a wall.

Core exercises develop the ability to control movements of the lower back. The transverse abdominis is a deep muscle that surrounds the abdomen. The multifidus muscles run along the vertebrae of the back. An exercise may involve moving an arm or a leg while keeping the core stable, with an appropriate level of difficulty.

Stretches can target the hip flexors, the pectoral muscles at the front of the chest, or the muscles at the back of the thigh when stiffness is limiting your movement. For example, gently bringing your shoulder blades together with your hands behind your head can stretch your chest. Don’t force it, and stop if a stretch causes pain²⁶.

Choosing Supplemental Health Insurance

Some approaches use TENS, a device that sends an electrical current through the skin; therapeutic ultrasound, which uses sound waves; laser therapy, which produces a beam of light; or dry needling, in which needles are inserted without injecting medication. Physioactif does not use any of these four techniques. The treatment plan may include information about pain, manual therapy as needed, and exercises selected based on the assessment.

For the hand and wrist, an eight-week study involving 62 employees with carpal tunnel syndrome symptoms²⁷ examined seven exercises. The 49 participants who performed them at least three times a week showed improvement in certain measures of strength and their daily functional abilities. The other 13 performed them less frequently. Pain did not decrease significantly in either group, and strength measures did not differ significantly between the groups. Since the groups were divided based on exercise participation, this study does not prove that the exercises alone account for the improvements. Treatment is tailored to the severity of symptoms.

Remote monitoring to facilitate access to exercises

Tele-rehabilitation allows patients to participate in exercise sessions remotely with a professional. In a trial involving 120 employees with persistent neck pain and no specific identified cause²⁸, all received training in ergonomics—that is, adapting the workplace to the individual. Interactive 45-minute sessions, held three times a week for six weeks, resulted in greater improvements in pain, neck mobility, and daily functioning than home exercises alone or training alone. This specific program does not represent a mandatory frequency for everyone, and its long-term effects have yet to be studied.

Workstation Adaptation

Adjusting the chair, monitor, keyboard, and mouse can improve comfort. In a study of 64 employees, the group whose workstations had been adjusted reported less pain in the neck, shoulders, upper back, and wrist or hand than the control group²⁹. However, there was no clear difference in pain progression over time between the groups, and nearly half of the participants were no longer assessed at 36 weeks. A review of 24 trials across various occupations found a small average benefit of ergonomic interventions on pain³⁰. The results depend on the specific intervention and are not limited to office workers.

Active Breaks Throughout the Day

An active break involves taking a short walk or doing some exercises to break up prolonged sitting. A review of six controlled studies involving 232 participants describes potential benefits regarding discomfort and fatigue, with different break formats³¹. For example, you can take a short walk or gently roll your shoulders. The duration and frequency should be tailored to your tasks and comfort level.

In a study of 31 employees with no comparison group, an eight-week active break program was followed by a reduction in discomfort in the neck, lower back, and throughout the body³². Participants who took more than 80% of the scheduled breaks also reported improvements. This finding does not prove that this threshold is necessary, nor that the breaks alone account for the changes. Stress levels did not clearly decrease across the entire group.

Another review found that active breaks involving changes in position can reduce discomfort and certain types of pain, without clearly reducing productivity³³. The findings regarding pain are less consistent when all types of breaks are grouped together. This does not guarantee an increase in productivity.

A reminder can help you take breaks. You can use an alarm or an app, and then adjust the reminder to fit your tasks. A break can also be an opportunity to go get a document or talk to a coworker while walking.

What results can you expect from physiotherapy?

Physical therapy can reduce certain types of pain, improve your ability to perform daily activities, and give you tools to manage your symptoms at work. Results depend on the specific issue, the treatment you choose, and how well the treatment is tailored to your needs over the course of your care.

Measurable improvement in pain

A 2024 Review of Manual Therapy²² reports reduced neck pain across all the trials analyzed, but results vary widely between studies. The expected benefit depends, in particular, on the technique and the treatment with which it is compared. The studies on neck exercises described above also show potential improvements.

For back pain that has lasted more than twelve weeks and has no specific identified cause, a Cochrane review of 249 trials finds that exercise likely reduces pain more than no treatment, standard care, or a sham treatment³⁴. At the first follow-up, the average difference was about 15 points out of 100 for pain. The improvement in daily activities was smaller, about 7 points out of 100. These results do not allow us to promise every employee an improvement within four to six weeks.

Tangible Functional Gains

The follow-up also evaluates specific goals chosen in consultation with you:

• You can try to make your workday more manageable by taking appropriate breaks.
• You can learn how to change positions more comfortably.
• The plan may be designed to reduce the pain that disrupts your sleep.
• Follow-up care can help prepare you to return to sports, gardening, or playing with your children.

Long-term Prevention

The plan helps you manage your symptoms and maintain healthy habits after your sessions. It may include the following:

• The physical therapist will design an exercise program that fits your schedule, with a frequency that suits your needs.
• You'll learn how to adapt your workstation using the resources available.
• You incorporate breaks and changes in position into your routine.
• You'll learn to recognize when symptoms return and the signs that indicate you should see a doctor.

In an ergonomic training trial involving workstation adjustments³⁵, 98 employees at a Malaysian university provided the data analyzed. At the six-month mark, 23.3% of the trained group reported neck symptoms, compared with 65.5% of the group that received only a pamphlet. The difference between the groups was therefore 42.2 percentage points. Symptoms in several other areas also decreased, but days of absence and measures of psychological well-being did not show a clear improvement. While this result is encouraging, it does not guarantee the same effect in all settings. The quality of evidence on ergonomics varies depending on the interventions studied¹⁸.

What are the most common questions asked by office workers?

Frequently asked questions from office workers include the frequency of sessions, insurance coverage, exercises to try, timeframes for progress, posture, and support from the employer. The following answers may help you prepare for your follow-up appointment.

How often should I see a physiotherapist?

The frequency of sessions is determined in consultation with the physical therapist based on symptoms, goals, and the exercises to be learned. These sessions are primarily used to assess progress and adjust the treatment plan. Pain that has recently developed and pain that has been present for several months may require different follow-up approaches; there is no one-size-fits-all number of sessions.

Are treatments covered by insurance?

Many group insurance plans cover physical therapy. Check with your insurer to find out the coverage amount, reimbursement requirements, and whether a prescription is needed. You can also ask your employer if a program covers a workplace assessment.

Can I do something today to reduce my pain?

You can adjust your screen, take breaks, and try some comfortable positions starting today, provided you don't have any of the warning signs described below:

1. Adjust the screen so you can read comfortably, with the top of the screen at eye level or slightly lower. If you wear progressive lenses, you may need to position the screen lower.
2. Get up and move around regularly—for example, by walking over to do another task.
3. Try gently raising your shoulders and then relaxing them, or bringing your shoulder blades together to stretch your chest. Stop if the movement causes pain.

A helpful change improves your comfort or your ability to perform a task. If the exercises make the pain worse, stop doing them and ask for advice on how to modify them.

How long before I see improvements?

Initial progress may be noticeable within the first few weeks, but the timeframe depends on the specific issue. For example, the neck stretching trial assessed results after four weeks, and the remote follow-up trial did so after six weeks. Some strength or endurance goals require a longer follow-up period. The physical therapist will check in with you to see if your pain and activities are progressing as expected.

Can physical therapy help after years of maintaining the same posture?

Physical therapy can help you move more comfortably and build the strength you need for your daily activities, even after a long period of maintaining the same habits. The goal isn’t to stay perfectly upright all the time. The treatment plan focuses on finding positions that work for you, then adjusts the exercises and posture based on your response.

Can my employer do anything to prevent these problems?

The employer can facilitate workstation adjustments, breaks, and task variety. A sit-stand desk can be used to alternate positions; it does not replace opportunities to walk or move around. An ergonomic assessment or workshop can help the team implement these adjustments. The results of these measures vary, as shown by the studies described above. Talk to Human Resources about specific challenges and possible accommodations.

How do you get started with physical therapy?

Treatment begins with scheduling an appointment at one of our clinics in the Greater Montreal area, followed by an assessment of your symptoms and needs. During the first session, we’ll discuss your goals and begin the appropriate treatment.

Seek medical advice when the pain returns, worries you, or limits your activities. You don’t have to wait until it becomes constant to ask for help. The warning signs listed below require medical attention rather than just adjusting your workstation.

At Physioactif, our physical therapists understand the unique challenges faced by office workers. We offer:

• The physical therapist can assess your workstation using photos or videos, if they are helpful.
• The treatment plan takes your goals and schedule into account.
• The program may include exercises that can be done at the office.
• Follow-up visits allow us to adjust your care based on your progress.

You can schedule an appointment at one of our clinics in the Greater Montreal area to discuss these issues and begin an evaluation.

When should you seek medical care without waiting for the exercises?

If you have back pain, go to the emergency room if you experience pain, tingling, weakness, or numbness in both legs; loss of sensation around the genitals or anus; difficulty urinating; or loss of control over urination or bowel movements. A change in sexual sensation or a new difficulty achieving an erection or orgasm also requires urgent evaluation. Chest pain or back pain following a serious accident also warrants an emergency visit. If you have back pain, seek medical attention promptly if severe pain begins suddenly, if the pain worsens rapidly, or if you experience hot or cold flashes, chills, or general discomfort³⁶.

For shoulder pain, seek medical attention right away if the pain is sudden or very severe, if you cannot move your arm, if your arm or shoulder becomes misshapen or severely swollen, or if it feels hot or cold to the touch. Persistent tingling, loss of sensation, pain following an injury, severe pain in both shoulders, a feeling of fever, or general discomfort also warrant medical attention²⁰.

A sudden and extremely painful headache requires emergency care. A headache accompanied by seizures, weakness or numbness in the face or body, loss of vision, confusion, drowsiness, or difficulty speaking, walking, maintaining balance, or remembering things also requires emergency care. A headache following a head injury within the last three months also requires emergency care. Even without a head injury, a headache accompanied by a very high fever, a stiff neck, sensitivity to light, or a rash that does not fade when pressed with a glass also requires emergency care. For a headache accompanied by eye or vision problems, vomiting, jaw pain when eating, or a tender scalp, seek medical attention promptly. Do the same if the headache is triggered or worsened by coughing, sneezing, exertion, or bending over³⁷. Call 911 if emergency transportation is needed, and do not drive yourself.

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Our physical therapists defined the research strategy, plan, and clinical content of this article. An AI tool assisted with the literature review and text editing to ensure consistency in content and writing style.