6 Things Physios Want You To Know After A Year Of Working From Home

Memo: your desk setup probably isn't the cause of your back and neck pain.
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Physiotherapists have noticed a surge in back and neck pain in the past year – and with so many working from home, it can’t be a happy coincidence. Google search data analysed by the Chartered Society of Physiotherapy (CSP) revealed searches for ‘back pain relief’ and ‘back pain exercises’ shot up by a third during the first lockdown. Meanwhile, as the ‘stay at home’ message was drummed into us, the number of people seeing their GPs plummeted.

Fast forward a year and while plenty of people have already headed back to physical workspaces, a large portion of society are still working from home for the foreseeable. And with remote or flexible working now the (not so) new normal, others have been told they won’t be returning to an office at all.

How do we stop making the same work from home mistakes? Experts have shared some key advice – as well as learnings from the past year – to help.

1. Back and neck pain has been rife.

If there’s one thing physios agree on, it’s that back and neck issues are the most common pain complaints that patients have brought up during the pandemic, and both are often attributed to working from home.

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Occupational health physiotherapist Ashley James tells HuffPost UK: “Generally what we’ve seen is an increase in musculoskeletal complaints, throughout the body, [but] probably more so in the lower back and the neck just because of the nature of what people have been doing. They’ve been sitting down more and moving much less.”

James notes there has also been more knee and shoulder pain, while Chris Martey, a physiotherapist in Bristol, also reports a rise in hand and wrist problems associated with repetitive strain.

2. Your desk setup may not be the cause.

Who knew that a year of nipping from your bed to a desk to a dining table to the kitchen counter would cause so many issues for your body? Well, okay, maybe we all suspected. What still might surprise you, however, is that it’s not necessarily posture issues causing that pain you are experiencing.

“It’s not about the posture per se, it’s actually more about just the fact you’re sitting longer and people aren’t taking movement breaks,” says Chris Martey.

This isn’t just some wild theory on his part. Other physios agree. “Desk setup and how you sit is probably much less likely to impact your musculoskeletal health than other things,” says James. “Think of a pyramid: how we sit and our desk setup and laptop height is probably the tip of that pyramid – a very small part of the contributing factor towards why you might get pain or discomfort.”

Of course, poor posture can wreak havoc on your body – we’ve probably all seen the terrifying image of “office worker Susan” – enough to give anyone nightmares. But issues arise from holding your body in one position for long periods, rather than the occasional slouch or not having your laptop at eye level, physios suggest.

“When it comes to sitting at our desks, there isn’t any one position that’s worse than another,” says James. “What does matter is how long you hold the position for. If I sat hunched over my desk for eight hours and didn’t move, of course my back would ache. But equally if I sat bolt upright in what we would consider a ‘perfect’ posture for eight hours, I would also probably be in some pain and discomfort.”

It’s “absolutely ok to slouch”, he adds, as long as you move regularly and change your position often.

3. Our lack of movement is the real problem.

If there’s one thing we all know, it’s that we’re moving far less than we were before the pandemic. With gyms closed, people’s exercise routines have taken a hit and even our incidental movement – the stuff we’d do on a daily basis and don’t think much about, like our commutes – has been greatly impacted.

Referring back to his pyramid of wellbeing, James says that below the smaller top section that relates to work from home desk setups and posture, the bigger sections of the pyramid with more impact on your health and wellbeing are getting a good night’s sleep and regularly exercise.

The NHS advises us to take 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. James says that, ideally, people should be doing two resistance training sessions – where you lift some form of weights, if you can – per week too. This strengthens your core.

But this has been increasingly difficult for people in lockdown. Many of us may be doing 100-200 minutes less physical activity a week, he notes, and when we take away incidental movement as well – the walk from your car to the office, or to a nearby Pret for lunch, or even to meetings with colleagues in the office – it’s no wonder we’re struggling.

“We’ve massively reduced even those smaller movements that we probably don’t notice everyday,” says James. “We’ve taken those away by just waking up and going to sit at our desks.” And it’s this that is likely to be the key pain contributor, he says, rather than working at a laptop.

Remember: motion is lotion. If we’re moving regularly and changing our position often, standing up and sitting down, taking regular breaks, “that’s absolutely the best form of prevention for getting musculoskeletal problems when we’re at our desks all day”, he adds. “And if we’re adding in some more regular exercise, resistance training, good diet and sleep, we’re onto an absolute winner there.”

4. Look after your mind as well as your body.

Physios have touched on posture, movement and even the importance of sleep to minimising pain, but a lot of people don’t quite realise how much of an impact stress can have on the body.

“This is a really common misconception that we want to get people to be aware of. People always think with back and neck pain, there’s something wrong with their spine or the body’s tissues. But it’s often bio-psychosocial,” says Martey, and these the factors have also been “massively impacted” by Covid-19.

“Psychologically, we might feel more stressed working from home, we might feel more pressure from bosses as we’re not in the office and they’re checking up on us more, we might be worrying about not seeing relatives or not being able to see them,” he says. “Having kids around when you’re working from home can contribute to stress and anxiety. Then socially we’ve been isolated from our colleagues, friends and family for almost a year in lots of circumstances – and all of those things contribute towards pain. It’s not just the physical stuff that matters, it’s everything.”

The link between mental and physical health cannot be underestimated – and in the pandemic, our stress levels have ramped up another notch. If you are stressed, Martey recommends making sure you are factoring in activities into your day to distract the mind: this could be getting outdoors, cooking, reading, or trying mindfulness or relaxation techniques.

“With nine out of 10 patients I speak to, I will discuss mental health as well,” says Martey. “Yes, we can talk about posture and moving more often and exercise, but if you’ve also ramped up the stress recently and you’re not sleeping as well, this will put your body in more of a prime state to have physical problems.”

5. You need to make changes going forward.

A year ago many of us were flung into a state of working from home and we didn’t really adapt our lifestyles to our new daily and weekly routines. Moving forwards, physios are keen that people start to make changes.

You need to consciously make an effort to consider your health while you work from home. “For a lot of people [life] changed suddenly and they maybe haven’t considered this new way of working and they’ve just carried on. But now I’d say, consciously make an effort to think: what is it that I need to do to stay fit and healthy?” says Martey. “And the biggest thing is move more every day.”

If you aren’t moving as much as you once were, it’s hugely important to build activity – both incidental movement, but also actual exercise – back into your life. It might help to get up earlier to squeeze in an extra walk or cycle, set alarms throughout the day to encourage yourself to move about, and obviously factor in physical exercise around your work day too. Build up a routine again that works for you and prioritise taking time away from your (WFH) desk.

6. Don’t be afraid of your pain

The good news is that most musculoskeletal pain is ‘self-limiting’, say physios.

This means complaints tend to get better on their own as long as we keep our movements regular, we’re not sitting in one position, and we’re not too stressed. “Even though it’s really uncomfortable and can be excruciatingly painful, most of the time back pain gets better within six weeks,” explains James.

“The best thing you can do if you get some discomfort – particularly back pain or neck pain – is try and get back to your normal and everyday movements as much as possible,” he adds. “Pain doesn’t equal damage and damage doesn’t equal pain.”

Doing some gentle exercise or getting out on that walk will, in most cases, be safe and even beneficial, he adds. “Reassure yourself that it will get better in six weeks – movement is a good thing and it will help.”

If you are worried about any pain you do have, don’t be afraid to speak to your GP about it who can refer you to a physio. Find out more about managing pain at home on the Chartered Society of Physiotherapy website.

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