Neck pain: desk work, headaches and what actually changes it

Why the afternoon is worse

Neck pain from desk work is rarely about a single wrong position. It is about holding any position for hours with almost no variation. Muscles that are asked to hold quietly for four hours will complain regardless of how correct the position looked at the start.

The head weighs several kilograms and sits on a small, mobile set of joints. Carried slightly forward of the shoulders, which is what screens encourage, the muscles at the back of the neck work continuously to stop it falling further.

The headache pattern

If your headache builds through the day, tends to one side, sits behind the eye or across the temple, and worsens with screen time, there is a good chance it starts in your neck. The muscles at the base of the skull and the upper trapezius refer pain into the head in patterns that feel exactly like a headache.

These respond to treating the neck. Headaches that begin suddenly and severely, come with visual changes or neurological symptoms, or wake you from sleep, are a different matter and need medical assessment first.

What treatment involves

Manual therapy to the stiff segments, soft tissue work to the muscles carrying the load, and specific strengthening for the deep neck flexors and the muscles between the shoulder blades. The strengthening is the part that changes recurrence.

Alongside that, two or three practical changes: screen height, how often you get up, and where your phone sits when you read it. Small, specific, and actually done, rather than a list of twelve ergonomic rules nobody follows.

Signs to get checked first

• Pain, numbness or weakness travelling into the arm or hand
• Dizziness, visual disturbance or unsteadiness with neck movement
• Neck pain after significant trauma, such as a road accident or a fall
• Fever, unexplained weight loss, or a history of cancer