Tech Neck Is Real, But "Better Posture" Won't Fix It

I see probably five people a week who come in complaining of neck pain, upper back tension, or headaches. When I ask about their work setup, it's almost always the same story: laptop on a desk (or worse, on their lap), head craned forward for 8-10 hours a day, shoulders rounded, upper traps doing work they were never designed for.

"I know my posture is terrible," they'll say. "I just need to sit up straighter, right?"

Not really. And here's why the typical ergonomics advice you see online usually doesn't help much.

The Problem Isn't Just Posture

Yes, forward head posture is part of the problem. When your head is positioned forward of your shoulders, the muscles in the back of your neck have to work overtime to hold it up. Your head weighs about 10-12 pounds, but for every inch it moves forward, it effectively adds another 10 pounds of load on your neck muscles.

But here's what most ergonomics articles miss: you can have a perfect workstation setup and still develop neck and upper back pain if you're sitting static for hours at a time.

The human body wasn't designed to hold any single position for extended periods, even a "good" one. Tissues get stiff, blood flow decreases, muscles fatigue from sustained contraction, and your nervous system gets cranky from lack of movement variability.

So when people ask me, "What's the best posture?" my answer is: the next one. Meaning, change positions frequently rather than trying to maintain one "perfect" posture all day.

The Real Issues I See

When I evaluate someone with screen-related neck pain, I'm looking at several things:

Muscle imbalances from sustained positioning:

• Weak deep neck flexors (the muscles that stabilize your neck)
• Overactive and shortened upper traps, levator scapulae, and suboccipitals
• Weak scapular stabilizers (middle and lower traps, serratus anterior)
• Tight pecs and shortened anterior shoulder structures

These don't develop because you had bad posture for one day. They develop from spending 40+ hours a week in the same position, month after month, year after year.

Loss of thoracic spine mobility: Your upper back (thoracic spine) should have the ability to extend and rotate. But when you're hunched over a screen all day, those joints get stiff. Then when you try to sit up straight, you can't, your thoracic spine won't extend, so you compensate by overextending your neck or arching your lower back instead.

Breathing pattern dysfunction: Most people with chronic neck tension are chest breathers rather than diaphragm breathers. This keeps the accessory breathing muscles (scalenes, upper traps, sternocleidomastoid) constantly working, which creates more neck tension and pain.

What Actually Helps (Beyond "Sit Up Straight")

I'm not going to tell you ergonomics doesn't matter, it does. But it's one piece of a bigger puzzle.

1. Movement breaks matter more than perfect posture

The research is pretty clear: taking frequent short breaks is more effective at preventing pain than maintaining perfect posture.

Set a timer for every 30 to 45 minutes. Stand up, walk to the bathroom, get water, look out a window, anything that gets you out of that static position. Even 30 seconds of movement helps.

I know everyone says this, and I know it's annoying when you're deep in focused work. But the people who actually do this consistently have way fewer problems than those who power through for hours straight.

2. Your workstation setup needs to be realistic

The ideal ergonomic setup is: monitor at eye level, separate keyboard and mouse, adjustable chair with lumbar support, feet flat on floor, elbows at 90 degrees.

But here's reality: a lot of people work on laptops. Many don't have adjustable desks or chairs. Some work from couches or kitchen tables.

So work with what you have:

• If you're on a laptop, at minimum get an external keyboard and mouse so you can elevate the laptop on books or a stand
• If your chair isn't adjustable, use a rolled towel for lumbar support
• If you can't get your monitor to eye level, at least try to minimize how far down you're looking

Something is better than nothing. Don't let perfect be the enemy of good enough.

3. Address the actual muscle imbalances

This is where PT actually comes in. Stretching your neck when it's tight might feel good temporarily, but it doesn't address why those muscles are tight in the first place.

What usually helps more:

• Strengthening deep neck flexors (chin tucks, head lifts)
• Building scapular stability (rows, Y-raises, wall slides)
• Improving thoracic extension mobility (foam roller extensions, cat-cow variations)
• Releasing tight pecs and anterior shoulder structures
• Retraining breathing patterns

These take time. There's no quick fix. But if you spend 15 to 20 minutes, 3 to 4 times per week working on these areas, you'll notice a difference over a few weeks.

4. The stretches that actually help during the workday

Not all stretches are created equal for desk workers. Here's what I actually recommend:

Chin tucks: Pull your chin straight back (like making a double chin) and hold for 5 seconds. This activates deep neck flexors and stretches the suboccipitals. Do 10 reps every hour or two.

Doorway pec stretch: Stand in a doorway, arm at 90 degrees on the door frame, lean forward gently. Hold 30 seconds each side. Your pecs get shortened from hunching forward all day; this counteracts that.

Thoracic extension over a foam roller or rolled towel: Lie on your back with a foam roller positioned horizontally under your mid-back. Let your arms fall to the sides, breathe, and allow your upper back to extend over the roller. 1 to 2 minutes. This helps restore extension mobility that gets lost from hunching.

Scapular squeezes: Squeeze your shoulder blades together like you're trying to hold a pencil between them. Hold 5 seconds, repeat 10 times. Wakes up the middle traps and counteracts the rounded shoulder position.

5. When ergonomics isn't the main problem

Sometimes people come in with neck pain and I look at their workstation setup, and honestly, it's fine. The problem isn't ergonomics, it's stress, poor sleep, or underlying issues like cervical disc problems or arthritis.

If you've addressed your workstation, you're taking movement breaks, you've been doing strengthening exercises, and your pain is still significant or getting worse, you need an evaluation. Self-management only goes so far.

What About Standing Desks?

People ask me about this all the time. Standing desks can be helpful, but they're not a magic solution.

Standing in one position all day is just as problematic as sitting in one position all day. The key is variability, alternating between sitting and standing throughout the day.

If you get a standing desk, start with short periods (15 to 30 minutes at a time) and gradually increase. And make sure you're not just replacing sitting with slouched standing.

Also, if you already have foot, knee, or lower back issues, prolonged standing might make those worse. It's not for everyone.

The Honest Truth About Screen Time and Pain

Look, if you work on a computer 40+ hours a week, you're probably going to have some neck or upper back discomfort at some point. That's just reality.

The goal isn't to be pain-free 100% of the time, it's to prevent chronic, limiting pain and to have strategies to manage minor discomfort when it pops up.

Perfect ergonomics, regular movement breaks, and targeted strengthening can significantly reduce your risk, but they're not bulletproof. Sometimes people do everything right and still develop issues that need professional treatment.

And that's okay. That's what we're here for.

When to Actually See a PT

You should consider getting evaluated if:

• Neck or upper back pain that lasts more than 2 to 3 weeks despite self-management
• Pain that radiates down your arm or causes numbness/tingling
• Headaches that are increasing in frequency or severity
• Pain that's affecting your sleep or limiting your activities
• You've tried ergonomic changes and exercises but aren't seeing improvement

We can assess your specific movement patterns, muscle imbalances, and limitations, and give you a targeted program rather than generic advice.

The Bottom Line

"Tech neck" is real, and screen-related neck and upper back pain are incredibly common. But the solution isn't just "sit up straight."

You need movement variability, realistic workstation modifications, targeted strengthening of weak muscles, and strategies to manage symptoms when they arise.

Will these strategies prevent all screen-related pain? No. But they'll significantly reduce your risk and give you tools to manage minor issues before they become major problems.

And if you're already dealing with persistent pain, don't just suffer through it hoping it'll go away on its own. Get evaluated so we can figure out what's actually driving your symptoms and how to address it effectively.

Dealing with persistent neck or upper back pain from screen time?
At Spectrum Therapeutics of NJ, we evaluate the actual causes of your pain, not just your desk setup, and create targeted treatment plans to address the underlying issues.

Spectrum Therapeutics of NJ
601 Hamburg Turnpike, Suite 103
Wayne, NJ 07470

Phone: (973) 689-7123
Email: spectrum@spectrumtherapynj.com
Web: spectrumtherapynj.com

Sometimes better ergonomics isn't enough. Let's figure out what else is going on.