Neck and Back Pain while Working From Home
SEASON 1 EPISODE 10
with Sophia Barlow
In this episode of Neighbourhood Nutritionist, I talk to Sophia, an osteopath, about the good, the bad and the painful of working from home.
In my conversation with Sophia, we talked about:
Why is back pain important?
Correct Equipment to have when working from home and how to set it up
Poor posture, why it happens, and what to do about it
The naughtiest, most painful desk working habit and how to avoid it
The impact of stress on our bodies and how to alleviate it
Sophia's top tips on how to stop feeling pain while working from home
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If you want to connect with Sophia, you can find her on:
Facebook: https://www.facebook.com/sophiabarlowosteopath
LinkedIn: https://www.linkedin.com/in/sophia-barlow-979890118/
Website: https://sophiabarlowosteopath.com
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Sophia’s Journey to Osteopathy
I have been an osteopath for 12 years. And I actually studied later in life. So I before that, I was actually a recruitment consultant. And I worked in London. And then I worked overseas in Sydney, which I really enjoyed. Yeah, I just had that moment, I was like, I just, I just want to use my brain a little bit more and descend a little bit cheesy, but I was like, I think I do want to help people. And I did really enjoy helping people find jobs. But I just, I guess I just wanted something different. And something, you know, that was a bit more flexible in terms of lifestyle. And at the time, I mean, luckily, Flexi workings really coming through now, isn't it? Yeah, and we'll get on and talk about working from home and that kind of thing. But at the time, you know, it was much more structured. And I was like, you know, at some point, I will maybe want to start thinking about sort of having a family and not doing this nine to five. So when when another I decided on osteopathy, and then I did that. So this study is four years full time or five years kind of part time. Or some of it's part time, and I did that actually had my first child while I was studying. And then yeah, graduated 12 years ago, and I just absolutely love it. And I kind of just got to a place where I say the same things a lot to my patients, I see hundreds 1000s of patients every year. And I do end up saying the same kinds of things. And I'm just like, you know what everyone needs to know these things. I guess that's why I'm going out there a little bit at the moment and just talking to people about how they can avoid back pain in the first instance, and all sorts of other pain, and just get to know their bodies a little bit better. So yeah, that's why I'm here.
The Prevalence of Back Pain
Dipping my toe in the in the corporate world to begin with, I guess that's probably the best place to start really to give you an idea about the kind of the impact of back pain is that is actually the second most common reason that an employee will take a day off work, you know, so that's the Office of National Statistics day. So yeah, the first reason is common cold, minor illness. And then yeah, the second reason is back pain. The third reason and his other, which is Yes, quite a mixed bag, that group, and then the fourth is mental health. So there's a lot in the media, and rightly so about mental health. And we will touch a little bit on that as well, because of course, our physical selves and our mental health are very much interlinked. But yeah, back pain is has definitely been kind of like taking a backseat a little bit. And actually, it's really important. And of course, with people working from home at the moment, it's something that people are becoming, you know, a bit more interested in. So, yeah, I tend to get the most patients with back pain. So that's partly it. And of course, that doesn't extrapolate into the working world.
The Best Work from Home Setup
Basically is, it's nothing that you wouldn't know really, a lot of the time a desk set up quite often you get given some guidelines from work, but I think sometimes people do over complicated a little bit. So it's kind of basically it's around 90 degrees at the arm. And what you need to have is your computer screen in your eyeline so that you know when you're standing up kind of recently straight, you're literally kind of looking at the screen so that what you don't want is screaming having to tilt your head up, which is a lot less common thing that I see more is actually when the screen is down. And so you're kind of looking looking down towards the screen as you would do, for example, you're on your phone or something like that. And you end up having a little bit of protracted posture, what you want is to have your screen eyeline in terms of your chair. Actually, support is really important. So people quite often talk to you about your chair that can twist around, yeah, so that you don't have to rotate your body as much, you're not getting quite so much kind of rotational sort of torsion, the chair kind of like does it for you. What I would say about that is yes, that is really handy if you've got a double screen setup, which is, I guess, maybe historically, it might have been more office space if you had that. But more and more, I'm seeing people at home with two screens. So that can be super helpful if you've got two screens. But what I would say is don't have a swingy chair at the expense of having a supportive chair. Because actually, if your muscles can't kind of relax a little bit, as you're sitting, you will end up kind of like clenching your buttocks kind of hanging on. And actually, that can put a little bit of strain through your low back. So really, the most important thing in terms of seat is actually to have something that's quite nice and supportive and feels quite firm. So to be honest, quite often, like a good solid, maybe old fashioned Dining Chair, can be just as good as a really expensive office chair. So yeah, that's just that's something to kind of think about.
Are Standing Desks Better?
They're good in that anything that gets you moving basically at work is a good thing. So anything that might make you change me from sort of standing to sitting and of course, some people use like a, like a treadmill, while working and stuff and you know, people trying to literally multitask with their bodies, which is fine that that can work for some people. But they i I'm going to come on now a little bit to about posture.
It's the same thing really, for when you're sitting. So you know, I mentioned about having the if you put the screen down here, now, obviously, if you've got your laptop in the screen is going to be here. So you start up like this for example, what also happens that you end up with, like the kind of, you're kind of basically seven people that aren't watching this on video, what I'm doing is I'm basically slumping forward a bit. And the thing is that because your arms obviously come out of your shoulders, rather than coming out here, like your ears, you, you don't need the screen, right here in front of you. And then you keyboard here, you need a space between them. Yeah. And if you squish the thing that you're working on to here, you end up having to sort of squish yourself. So really important to have a separate keyboard. So if you're going to invest in something way, before you consider getting a stand up desk, I would literally just get a cheap plugin keyboard into your laptop, separate keyboard so that you can have that distance between your head and your hands. And getting onto standup desks, that's what's really important is because quite often and honestly, it does great me a little bit. Sometimes I see them, you know, LinkedIn and stuff. There'll be photos, like advertisements for stand up desk, and they'll be someone working on a laptop. And of course, just because you've got a stand up test doesn't mean you don't still need that distance between, from where you're looking at the screen to where you've got your hands kind of like in a neutral position. So that is a reason if you like the poor posture is not having that distance. But just to sort of step into other other reasons like actually what's happening physically because you can have the perfect setup, right, you can have the put the screen in the perfect place, you can have key pivot place, you know, good desk, nice, solid, supportive chair, and you can still by the end of the day feel like oh my goodness, my shoulders are killing me, I've got this headache. So you know what actually is going wrong? People quite often say Oh, it's my posture, which is bad, but just to pick that apart a little bit. So what happens and when patients show in the clinic comes sort of like so how do you sit at your desk they always say here like perfectly but actually and I you know, we all do it. What happens over time is your abs bowed. So, met the main kind of muscle group, if you like that is holding you up right and secure while you're working. It's kind of like your abdominal muscles and your back muscles kind of working together, but particularly your abs, right? So with the best will in the world. They are just not strong enough to literally hold your whole body literally upright like this very long. So yeah, sure, half an hour but after half an hour, you're gonna find that you are kind of bending for like this sometimes like a Lego or equal making. Like up on the desk, you know, people will literally do anything and that's when people kind of like they cross their legs. They're trying to get comfy. And people be like, Oh no, I'm doing this really naughty thing. I'm crossing my desk, my legs all the time at the desk and like that might be a habit. But more often is because literally those that muscle group, it can't do it anymore. So the most important thing, really is to get up and have a walk around.
And actually, yeah, some of the lumbar support cushions can can kind of keep you a little bit more comfortable for a bit longer. But it is exactly that. I mean, it's the whole sort of Pilates idea is where they took like core support. And the idea is that you've got that lovely, strong framework. And that's why I talk a lot about you know, with just having like a really solid chair, so you've got your feet on the ground, you've got a good solid support there, and then you've got your strong abs there. And that really is the support structure for your shoulders to sit comfortably on top. And really, you should not be feeling like you've kind of have to hang on. And you're absolutely right in terms of that kind of like musculoskeletal chain working it all its way up. So I'm going to then put on top of it so and then we can pick apart the sort of biomechanics of like the whole chain.
Most Frequent Causes for a Trip to the Osteopath
Quite often people then they've been at their desk for ages, they're already stooping over a bit, they're clenching their jaws really hard, because they're concentrating. So sometimes, you know, that is to do with stress that can be linked to stress. But quite often, you know, you're just concentrating and people don't even realise they're doing it. And basically, then what happens is you've got your tight jaw, and then you've got your sternocleidomastoid muscle, which basically attack sort of from the jaw down here. And then you've got your scaly muscles, which attached sort of to the neck and to the upper ribs, they're kind of hanging on. So you've got almost like a vise situation happening. And then in your midnight, you've probably just got a few joints that actually are functioning. But the rest of it is pretty much locked. And then these are patients that come and see me who actually won those few joints in the mid neck, they've kind of given up the ghost, they're like, You know what, we just can't do any more, because everything else is fixed as I turn to the left or to the right and pick something up in my neck when it's those patients who have been kind of, you know, just habitually parked in the jaw, keeping their shoulders super tight. So it's what I sometimes say to my patients wearing their shoulder earrings. So just sort of picking that apart. And then of course, that you're literally you've got that thoracic spine lock. So you've got your sort of upper mid back kind of hunched over if you like, because it's kind of trying to sort of hold you up, as you said, because the abs have kind of given up a little bit. So you've got this whole kind of really rigid space. And actually, the body is meant to be moving, isn't it. And of course, the joints need to move comfortably. And they've all got a tiny little job to do. So all those tiny little facet joints coming, which are basically the joints that kind of limit movement and kind of and help with movement, from the neck through the mid back into the low back. They all do a tight each little vertebral kind of segment each has a little job to do. And actually if some of those are taken out of the system, then of course you do end up getting injuries. And if these things sort of happen chronically, then of course, you know, it's just more and more likely to get injured, more and more likely to kind of have chronic pain. And of course, it's been harder to pick apart. So we sort of get into like, that's the worst case scenario, just to layer it on. One more thing is that actually, if you're stressed at work, your tissue healing isn't as good. So what you know, you think about the sort of corticosteroids washing around your body when you're stressed. So cortisol kind of puts a little bit of a damper on tissue healing, because it wants to reduce inflammation in once your body's resources doing other things. So over time, you know, your tissue healings kind of not so good either. So it's almost like and people sort of come in they're like, I don't know what went wrong. You know, I just, I went to twist and do some gardening or this and suddenly when it wears off got no idea why. But of course, it's this whole build up this whole kind of picture. And I am seeing it more and more. With Nixon people are saying, you know, I've just, on the one hand, it's great working from home. And I think when you kind of utilise it Well, I think it's just fantastic all sorts of different reasons. But I think you can also get a little bit locked into a project, you haven't got other, you know, as many kind of external things happening. So you can end up just like this for ages and ages. So yeah, all those things do create a bit of a perfect storm.
Neck Pain from Looking Down at Devices
There's some really good little visual diagrams, you can see about that online. So yeah, of course, you've got that slightly increased flexion down. And the area that it hits is cool, particularly, is your CT joint. So it's your cervical thoracic level, which is basically what we call like a hinge point. So it's where your neck kind of, in your net, you've got like a curve like this. So what we call like a lordosis. And then you've come gradually into the thorax, which is your mid upper mid back. And that's the kyphosis. And your CT junction, is that junction there, and it's the kind of bubbly and that you just get so much loading onto that CT, when you're looking looking down at your screen. And yeah, there's various different sort of theories of exactly how many extra kilogrammes of weight. But it's true, essentially, is that you are getting a lot of loading there. And of course, you know, that is absolutely fine, as long as you're not doing it all day. But if you're doing a lot of the time, then of course, these things build up. And I mean, it's like, you know, I see quite a lot of teams at the moment, which, you know, slightly different, but they're, you know, they're looking at screens, they're looking at their computer screens kind of in the evening, you know, having fun gaming and stuff. But you know, I'm seeing a lot more repetitive strains in forearms. Yeah. And also, I mean, not just teens, but I think also from texting or being on the phone all the time. So I'm seeing a lot of kind of injuries of what we sort of classically call like tennis elbow, into your wrist extensors here, because you're kind of basically just using your wrist the whole time.
What also happens over time is actually your pecs because your sort of long pack attaches here into the shoulder and then your short peg attached here sort of in the coracoid process, which is so basically what happens is they short overtime because they eat, they're more used to being here. So a little bit what we call like a protective posture. And of course, then it's not just when you're at your desk, because it is when you stand up, you're just walking around, and you're getting a little bit more hunched over. And it's like, well, you know what, that's not the end of the world. Because bodies are all different. And, and that's absolutely fine, as long as your body can compensate you, you know, it doesn't really matter at all. But if it is starting to cause pain, you know, these kind of little loops can start and get worse and worse and worse. And, you know, you, I won't go into all the various things you can get, you can get, you know, different pain for all sorts of different reasons, because you've got some really important nerve bundles here, basically right at the front of the shoulder here. So, you know, you then start to get the symptoms into the arms. And, as I've mentioned, that kind of biomechanical change the net, you know, it's all, it all adds up, basically. And so he can, I won't go into kind of tiny, complex details, although I do enjoy it. But the thing is, really, and I think that's the point as well, is that yes, it is very complicated. There's all kinds of super interesting, you know, biomechanics going on. But actually, the way to alleviate it is quite straightforward and simple. And I think, you know, that's really worth saying, because there are loads of simple things that you can do to kind of stop that happening. And so yeah, I guess what I've talked about in the first instance, is the desk setup, and all that kind of, and that's, that's super important. So it's like the equipment you've got, and then it's how you're interacting with the equipment. So when I was talking about sort of, maybe not clenching your jaw, but also not spending too much time in this perfect desk setup situation, because however perfect it is, your body's need to move. And that's well, you know, that's just really worth remembering.
When Do We Need Medical Attention?
So what I do, kind of what we're trying to do is in the first instance, look out for red flags. And I think that is part of it. So I mean, basically, the fact is that most people come into me really concerned, and they're kind of like, oh, this is the end, I'm not gonna be able to do whatever it is I've been enjoying, because my knees have just given up now this. So normally, they come in more concern than they need to be. But I guess my job as a health professional, and I think this is also super important is that you have to start at the at first base. And first base is basically red flags are in our jobs. So first base is, you know, new pain that you haven't experienced before. symptoms. So in what I do, that don't correlate to just a straightforward musculoskeletal presentation. And, of course, so people would be looking at this podcast. And I would say to everybody, that if you have got any new symptoms that you're concerned about, if you've got any increasing symptoms, that you are not, that you're concerned about, if you've got a change in symptoms that you've had before, you're like, oh, that's just a bit different. And basically, if you have just got that feeling of, it's just just not quite right. I just don't know what it is. These are the things that patients say to me, even though I like to think I do a very thorough case history. Sometimes when they're leaving, they say, we didn't want to trouble the doctor, but, and they'll say to me, X, Y, Zed, and these are the things in the first instance, you need to go and see your GP about. So we're very lucky in the UK, in that everyone has got access, you know, you pay taxes, go and ask your GP at the moment people, you know, it's a real concern at the moment because people are not accessing their GP quite as readily as they maybe would do because of COVID. So they are kind of holding back a little bit. And that's a concern. So you are absolutely right, in the sense that, you know, people need to know a bit more about their bodies and stuff. But what I wouldn't want is that people are like, right, I'm just gonna work out what's going on myself, because there's no GPS are really good at doing that stuff in the first instance. And then they're just experienced, and that's what they're there for. They're basically a safety net, but the other 95% of what's going on, then we just need to dive in and look after ourselves. You know, to sum it to a massive extent, really, there's an enormous amount you can do yourself, as I was saying, and obviously you're a big advocate. That is not to say that once you've had your diagnosis, and everyone knows exactly what was going on, and then it's like, right, what can I do with this straightforward musculoskeletal low back pain presentation that I've had for ages and I want to get rid of there. As I say there is absolutely load and you can you know, stop yourself having to get in pain and need to go and see anyone.
Eye Pain or Eye Stress?
So just talking about posture, coming up really, from that shoulder tension all the way up through that muscular skeletal chain, you're basically getting a lot of tightness through the muscles that run up the back of the neck, and then over, and basically like fascia that comes across the top of your head, and it just gets really sort of tight and constricted. And you get that whole headache kind of wash all the way over. But actually, your CT vertebrae does refer pain to the can refer pain to the back of the eye. So you've just got, as I mentioned, you've just got these few joints that are kind of literally just doing all of the work and just getting really uncomfortable. And then when kind of push comes to shove, and everything literally sort of constricts right in, you've got that see to coming and referring that pain right to the back of the eye, and it can just be so uncomfortable. And literally, you have to just then start to unwind that old chain. So I do a lot of work with patients getting rid of kind of like jaw tension. Just getting them into kind of new habits, getting them a little bit more self aware of, you know, exactly sort of how they're using their body and that kind of thing, and just kind of getting them to relax talking about all that abdominal strength and stuff. But then yeah, there are just these kind of pain part refer pain pathways, and that all that biomechanics of that whole kind of like muscular skeletal chain tension build up. That yeah, it's just, I could see it more and more commonly.
Key Takeaways
Here are Sophia’s three actionable steps for you:
Listen to the clues that your body is giving you.
Things that are new things are getting worse things that you don't have before, you need to get that information and do something with it. And so they do something with it, is go and see a GP, but day to day, you need to listen to your body, and you need to be thinking, just become a little bit more aware of it. So am I clenching my jaw? have, you know, am I have I become like this? Do I need to get up and take a break? And it's just getting more in tune with your body. And, you know, patients often ask me how, how do I do that. And you it doesn't have to be a conscious thing to begin with. And it's a bit kind of contrived. But sometimes you do have to have like a reminder, you know, on your phone, or it might be part of like, if you do like the miracle morning or something like that, you know, just going on doing bit of meditation, going onto something, there's loads of apps, but like the headspace app, or something of that type two, which does like a really good body scan, where you're just becoming a bit more aware of your physical selfTry not try not to exploit your body.
People do think of their bodies as just this kind of machine, almost not even part of them that they can just kind of do whatever they like with and then it's only when it breaks that they're like, oh, that's cheating, you know, kind of do something about it. And then you know, you're into that situation where you're, you know, you're off to the doctor and they're busy and you're busy and you're in pain and it's all just, you know, it's not a great situation to be in.Nurture your body.
That does go hand in hand with nurturing your mind and your mental health as well. But just putting stuff into your body, so, you know, really looking after your body. And, and it is it is a mental shift, because, you know, I see a lot of it quite a few at who they may be very in tune with nutrition, they may be very in tune with things, but they're still just looking at it is, you know, a part of the function if you like, their bodies, and they're still looking at it as what I can get out of my body in a very kind of black and white way. And then they kind of reach a point. And it's like, Okay, where can I go from here, because I've used all my resources. And actually, sometimes you have to go a little bit further for your body than just fulfilling its needs, sometimes you need to literally just kind of be really kind to your body and nurturing your body. And it's a mental, you know, it's a mental shift. And that's reflected in so whether you're doing a lot of training, and rather than sort of, you know, pushing yourself right to the limits, and you're in pain, you're really listening to your body. And then you're thinking, right, how can I really give my body extra, instead of just kind of keeping it like head above water. So it is a mental shift, you know, in the old days used to see a lot of people, you know, no pain, no gain, and all that kind of exercise and stuff. And that really isn't the way to actually ironically get really good results and meat and you know, long term results, you're just going to get quick results like that, and likelihood you're going to get injured. So it's just taking, I would say a more mindful approach to your health really
The One Food that Takes You To Your Happy Place
I think it's the foods that bring back happy memories, isn't it? So for me, it's actually just really simple. Stewed apples with cloves. And it's just one of those is a family taste. I suppose that I I remember my grandmother always used to stew hers and often she'd have clothes in there. And it's quite it's such a perfume being kind of bait is a really specific taste, isn't it? And my father used to do the same. And I do now. It's these kinds of whispers of memories, isn't it with food sometimes. So that's mine.
