Systematic review found that in office workers with chronic neck pain there is very low certainty evidence that strengthening exercise improves neck pain and disability compared to no intervention.

Neck pain is a common in people in ‘office workers’ working in offices or at home. A previous systematic review showed that exercise reduced pain but there was significant heterogeneity between studies, with many studies having low sample sizes. This systematic review is an update of the evidence. The review aimed to estimate the effects of exercise compared to any non-exercise comparator on pain (primary outcome), disability and quality of life (secondary outcomes) in office workers with chronic neck pain.

Ten databases were searched for randomised controlled trials (RCTs) published in English. Eligible studies included people aged ≥18 years, with self-reported chronic neck pain (lasting ≥6 months) who are currently working in an office-based occupation. Excluded studies were any diagnosis of spinal pathology (e.g., radiculopathy, whiplash, tumour, fracture, dislocation, infection, or systemic disease). The intervention was any form of neck exercise (e.g., strengthening, motor control) or physical activity (e.g., aerobic exercise), conducted in any setting, performed for a minimum of two-weeks without any other additional treatment besides advice or education. The comparator was no intervention or any non-exercise training intervention. The outcomes were neck pain intensity (primary outcome), disability and quality of life (secondary outcomes). Study selection, data extraction and assessment of Risk of Bias, using the Cochrane Risk of Bias 2.0 tool, were performed by two authors. For each outcome, trials were pooled in a meta-analysis using a random effects model, using forest plots. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Eight studies, involving 1112 participants were included. Studies were from Denmark (n=2), China (n=2), Finland (n=2), Thailand (n=1) and South Korea (n=1). The workplace included people working in office buildings (n=3), university admin staff (n=2), occupational healthcare centres (n=2) and elementary school workers (n=1). Exercise programs were diverse (including progressive resistance training, scapular function training, endurance training, thoracic extension exercises, and exercises with biofeedback) and ranged from being performed 3 times per week to daily, with a treatment duration from 4 to 12 weeks. All studies were judged to have high risk of bias.

All studies included in the meta-analysis and GRADE synthesis compared exercise to no training. Heterogeneity across the studies was significantly high. There was very low certainty evidence that exercise improved pain intensity (MD = 7.3, 95% CI 5.0 to 9.7, 4 studies, n=296, I2 = 95.3%) and disability (neck disability index) (MD = 13.8, 95% CI 2.7 to 24.8, 3 studies, n=249, I2 = 99.7%). One study assessed quality of life, and no meta-analysis was performed. The study found no significant difference in quality of life for strengthening exercises.

In office workers with chronic neck pain the evidence is very uncertain about the effect of exercise for pain, disability and quality of life compared to no treatment or no exercise.

Jones LB, Jadhakhan F, Falla D. The influence of exercise on pain, disability and quality of life in office workers with chronic neck pain: A systematic review and meta-analysis. Appl Ergon. 2024: 117: 104216. doi: 10.1016/j.apergo.2023.104216

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