Sometimes work is a real pain in the neck—literally. Creating an ergonomically optimal work space is not always easy or possible, and the result can be pain and tension in the cervical spine, the seven vertebrae in the neck on which our heavy heads balance.

“With the neck in the neutral position (not rotated and held so that the eyes face straight forward), each vertebra rests comfortably on the level below, and minimal muscle tone is needed to maintain the posture,” explains Dr. Todd Stewart, a neurological surgeon specializing in spine surgery at Missouri Baptist Medical Center. “If one tilts the head forward, then the muscles in the back of the neck have to contract to hold the 10- to 15-pound cranium in an offset position.”

Ergonomics are aimed at minimizing muscular tension while performing job duties. To achieve an ergonomically correct position, ears should be directly above the shoulders, and you should be looking slightly down, Stewart notes. The screen should be 20 to 60 inches away from your face and directly in front of you so that the neck is not turned one way or another for an extended period of time.

“The keyboard should be separate from the monitor so the arms can rest comfortably beside the body with the forearms extending forward at 90 degrees,” Stewart says. “If the keyboard is too high, you’ll find yourself continually holding your shoulders up to type.” For this reason, he notes that laptops located on a desk may not allow the arms to be in the preferred position.

Most people who develop neck pain find that with over-the-counter pain relievers and rest, the pain resolves on its own within 10 days, says Dr. Gurpreet Padda, an anesthesiologist who is board-certified in pain medicine and serves as medical director of the Padda Institute Center for Interventional Pain Management.

“A smaller portion of neck pain that exists beyond 10 days or is so excruciating will require medical care,” Padda says. “Those patients typically need simple things, and we frequently use biomechanical manipulation either through physical therapy or chiropractic.”

However, a small number of patients may develop cervical dystonia, a condition in which neck muscles contract involuntarily, causing the head to turn to one side. These patients often miss work and experience searing pain.

Severe neck pain that radiates down the arm may indicate nerve compression and also is cause for more aggressive medical intervention. And sudden neck pain associated with pain in the jaw, left arm and chest, nausea, as well as sweating, should be evaluated immediately to rule out a heart attack.

Both Stewart and Padda recommend frequent movement to help maintain spine health. Do not sit at a desk for more than an hour at a time before getting up, moving around, stretching and doing some simple neck rolls. In addition, Padda notes that smoking can decrease blood supply to the disks that cushion the vertebrae, increasing pain. Additionally, extra body weight places a tremendous load on the spine.

“If you’re one pound overweight, you put about an extra 20 pounds of force on your spine,” Padda says. “If you’re 10 pounds overweight, you put an extra 240 pounds of force on your spine. And if you’re 40 pounds overweight, you have almost 1,000 pounds of extra force on your spine. Even though the weight is down in the abdomen or somewhere else, that force trans-mission occurs through the whole spine.”

To sum up, Stewart says, “the best things to fend off muscular neck pain are reducing stress levels, maintaining good posture, and frequent stretching of the neck and shoulders. Core strengthening can also help to fend off spine pain in general.”

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