Setting up a laptop at home so your neck stops hurting

Around seven out of every ten patients we treat have a spinal problem of some kind, and in a large proportion of them the way they sit is part of the story. Since a good deal of work moved into spare rooms and onto kitchen tables, that proportion has not improved.

The core problem is simple. A laptop puts the screen and the keyboard in the same place. If the screen is at the right height for your eyes, the keyboard is too high for your hands. If the keyboard is right for your hands, you are looking down. You cannot have both, and over several hours a day the compromise is what starts to hurt.

The four changes that matter

Raise the screen. Put the laptop on a stand, or on a stack of books if that is what you have. The top of the screen should sit just below eye level, so that you are looking very slightly down rather than dropping your chin onto your chest.

Add a separate keyboard and mouse. This follows from the first change and is the part people skip. Raising the screen without separating the keyboard simply moves the problem from your neck to your shoulders. A basic keyboard costs very little and is the single best value purchase you will make for your spine.

Support your lower back. Your chair should support the curve of the lower back and be at a height where your feet are flat on the floor and your forearms are roughly level with the desk. A rolled towel behind the lower back does a surprisingly good job if the chair will not adjust.

Get your elbows supported. Arms hanging unsupported all day loads the muscles at the base of the neck continuously. Armrests or a desk at the right height take that weight.

The change that matters more than all of them

Move. No position, however well set up, is a good one for three hours without interruption. The evidence points consistently towards changing position regularly being more important than finding a perfect one, which is good news, because a perfect one does not exist.

Aim to get up at least every thirty minutes, even briefly. Stand for phone calls. Put the kettle in a different room from your desk. If you find that difficult to remember, set something to prompt you, because willpower has a poor record here.

Why the arm pain

People are often surprised that a sustained neck position produces pain in the shoulder, the forearm or the hand. It happens because the nerves supplying the arm come from the neck, and a neck held in a poor position for long periods can irritate them. Treating the arm alone rarely works when this is the cause. Treating the neck usually does.

What helps once it hurts

If the pain has started, changing the set-up is still the foundation, but it does not undo what is already irritated. Hands on treatment, mobilisation, massage and specific exercises are all useful, and most people improve quickly once the cause has been dealt with alongside the symptoms.

Physiotherapy for this kind of problem is not mysterious. We work out which structure is irritated, ease it, and then make sure you are not reproducing the cause eight hours a day. For further practical guidance on workstation set-up, the Health and Safety Executive publishes clear advice on display screen equipment.

When to see somebody

If neck pain has lasted more than a few weeks, if it comes with headaches that are becoming regular, or if you have pain, pins and needles or weakness in an arm, it is worth being assessed rather than persevering.

Our pages on workstation and posture pain and neck pain cover what treatment involves, and back and neck physiotherapy is the service behind both. If your problem is in the lower back and travelling down a leg instead, our page on sciatica is the more relevant one.