Understanding Neck Pain and Ergonomics
Neck pain is a common issue that affects people of all ages. In our modern digital age, constant access to information means we are almost always connected. Whether we are checking mobile devices on the go or working on laptops, most of us spend hours looking down.
This constant bending (flexion) of the neck puts immense strain on the cervical spine, leading to widespread problems with neck pain and stiffness across the population.
Because of this phenomenon, practising good ergonomics in our daily activities has never been more important.
Setting Up Your Workspace for Success
Maintaining a good resting posture means keeping your neck in a neutral position—where your eyes look straight ahead rather than up or down.
If you work at a desk, the configuration of your chair, desk, and computer screen is crucial:
- Desk and Chair Height: Adjust these so that your elbows are fully supported by the desk at all times while using your computer.
- Screen Placement: Position the top of your computer monitor at eye level.
- Take Regular Breaks: Alongside setting up your workstation correctly, taking regular intervals to stretch your neck muscles can significantly alleviate aches and pain.
When Should You See a doctor?
- Most everyday neck pain is caused by muscle strains or cervical spondylosis (age-related wear and tear of the spinal discs). If your pain persists despite regular stretching and mild over-the-counter painkillers (analgesia), it is wise to visit your GP for an assessment. Your GP can examine you, arrange X-rays if necessary, and advise whether you need a referral to a specialist.
Red Flags: When to Seek Specialist Review
You should be reviewed by a specialist if you experience any of the following symptoms:
- Worsening Pain: Your pain is progressively getting worse, or your clinical scans and examinations show abnormalities.
- Sleep Disruption: The pain disrupts your rest or wakes you up at night.
- Travelling Pain (Radiculopathy): The pain starts to shoot or travel down your arms.
- Nerve Symptoms: You experience numbness in your arms or legs, or a loss of coordination and dexterity in your hands.
- Systemic Symptoms: Severe night pain accompanied by unexplained weight loss or a loss of appetite can indicate a serious underlying pathology, such as an infection or cancer. Seek medical advice as soon as possible if you notice these signs.
Diagnosis and Advanced Treatment Options
When neck pain is accompanied by numbness or weakness—particularly if the pain radiates down an arm—it usually means a nerve is being compressed. To address this, our clinic provides a thorough evaluation including a detailed clinical history, physical examination, and imaging such as X-rays and Magnetic Resonance Imaging (MRI) scans.
Treatment is always tailored to the individual patient.
Non-Surgical Management
Most patients with mild nerve impingement whose primary symptom is pain can be successfully managed with physiotherapy and targeted pain relief. If pain persists, treatment can be stepped up to include epidural steroid injections.
Surgical Management
If your pain worsens or you develop new neurological symptoms like weakness or numbness, surgery may be recommended to relieve the pressure on your nerves. Decompression surgery can be safely performed from either the front of the neck (anterior) or the back (posterior). Common procedures include:
- ACDF: Anterior Cervical Discectomy and Fusion
- ADR: Anterior Cervical Disc Replacement
- Posterior Decompression and Fusion
Spotlight on Cervical Myelopathy
A specific condition that deserves special mention is cervical myelopathy, which is common in older adults. This occurs when the spinal cord itself becomes compressed, often due to advanced cervical spondylosis or the hardening of spinal ligaments (Ossification of the Posterior Longitudinal Ligament, or OPLL).
Because it develops very slowly and gradually, symptoms can be insidious. Watch out for:
- Neck pain accompanied by weakness or numbness in the arms and legs,
- Frequent falls, unsteadiness, or a loss of balance
- Poor hand dexterity (e.g., struggling with buttons or handwriting)
Because these symptoms creep up slowly, many patients unfortunately seek help very late, which can limit how well they recover after surgery. The primary treatment for cervical myelopathy is surgery to decompress the spinal cord and prevent further nerve damage.
Management of this problem is with surgery, to achieve decompression of the spinal cord and to prevent further deterioration.
Dr. Fong Poh Ling is an esteemed Orthopaedic Surgeon who holds the distinction of being Singapore’s first female orthopaedic spine surgeon. Backed by credentials from the National University of Singapore, the Royal College of Surgeons of Edinburgh, and a prestigious fellowship in adult deformity spinal surgery in Bordeaux, France, Dr. Fong specialises in complex spinal reconstructions, total disc replacements, and advanced minimally invasive techniques. Beyond her clinical excellence in treating complex spine injuries, she is a driving force for clinical innovation, championed by her pioneering work in Enhanced Recovery After Surgery (ERAS) protocols and spinal cord injury quality improvement projects. A passionate advocate for medical education and the advancement of women in surgical fields, she shapes the future of healthcare as the Education Director for the SingHealth Duke-NUS Spine Centre, a dedicated clinical lecturer, and an award-winning educator recognized multiple times for academic excellence.
To get more information or to make an appointment for your spine issues, please contact us via WhatsApp at +65 8807 5086.
