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Human Kinetics Publishers, Inc.




By Vincent Fortanasce, David Gutkind and Robert Watkins
ISBN:   978-07360-9528-0
Binding: Paperback
Pages:   Approx. 216
Price: $19.95
Available: September 2011




Is your job a pain in the neck?

The three most common office set up errors to avoid


CHAMPAIGN, IL—Nagging pains in the neck, shoulder, and upper back leave many running to the doctor, but a simple office makeover could be the remedy. “Given today’s high-tech, computer-dominant world, in which sitting for prolonged periods at work is often followed by sitting for prolonged periods at home, the setup of your computer workstation can play a large factor in your ability to stay symptom free,” says Vincent Fortanasce, DPT, one of the top-ranked neurologists in the United States. In his upcoming book, End Back & Neck Pain (Human Kinetics, September 2011), Fortanasce and coauthors David Gutkind and Robert Watkins, MD, break down the three most common workstation trends that predictably lead to neck, midback, arm, or leg symptoms.


1.    Overreaching

Reach refers to the horizontal axis that is parallel to the floor. Common diagnoses associated with overreaching at a computer workstation include shoulder tendinitis, impingement, tennis elbow, and muscle spasm and tightness in the neck and midback. Overreaching occurs because of the position of items on the desktop such as a keyboard or mouse, phones, documents, and other desk items. “It is a common finding when a mouse and keyboard are positioned on the same surface, when the armrests on the chair do not lower to fit beneath the desktop, or when the arrangement of items on the desk is not appropriate,” Fortanasce explains. Most problems with overreaching are easily correctable. Rearranging the desktop or purchasing inexpensive products can solve many of these setup concerns.

Assess your workstation:

*Are the keyboard and mouse on the same surface?

*Are commonly used items such as the keyboard or phone closest to you?

*Does the chair fit you? Is the seat pan too deep or backrest not adjustable?


2.    Use of Incorrect Heights

Height refers to the vertical axis that is perpendicular to the floor. Common diagnoses associated with the use of incorrect heights include nerve compression syndromes (most often at the wrist) and neck compression problems, including stenosis and facet joint dysfunctions. Incorrect height occurs as a result of the positioning of the chair, including the armrests, seat back, seat pan, desktop where work is placed, monitor, and the surface holding the keyboard and mouse. Incorrect height may also refer to furniture and features of the work area that are not adjustable. “Incorrect heights are more difficult to correct than the other two ergonomic culprits,” Fortanasce explains. ”But, a proper chair is of critical importance.”

Assess your workstation:

*Is the chair adjustable (the seat pan, backrest, and armrests)?

*Is your workstation one continuous piece at the same height, or are there pieces with sections to accommodate various tasks (typing, writing, reading)?

*Is the top line of the text as displayed on the monitor at eye level?

3.    Unbalanced Work Area

An unbalanced work area refers to the transverse, or rotational, axis. Common diagnoses associated with an unbalanced work area include neural compression syndromes, overuse and repetitive motion syndromes at the shoulder and elbow, and neck compression syndrome. An unbalanced work area refers to the position of the items on your desktop. “About 87 percent of the population is right-handed, and issues arise when the right hand is used for all the desktop activities, resulting in pain in the right shoulder, neck, and elbow,” says Fortanasce. Off-center monitors can also pose a problem and should be placed central in the line of view.

Assess your workstation:

*Are the majority of desktop items off to the same side?

*Is your monitor centered on your desk, directly in line with your direction of view?

*Do you have commonly used items closest to you and reference items farthest from you?


“People need to understand that symptoms occur over time as a result of repeated exposure,” says Fortanasce. “Analyzing your work area for the three most common setup errors can help you make improvements and ease unwanted muscle pain.”


For more information, see End Back & Neck Pain.

About the Authors

Vincent Fortanasce, MD, is clinical and associate professor of neurology at the University of Southern California in the departments of neurology and physical therapy. He is ranked as one of the best medical specialists in North America and has treated such high-profile individuals as Pope John Paul II and Major League Baseball Hall of Famer Tommy Lasorda. Over nearly four decades, Dr. Fortanasce has treated Olympic and professional athletes as a world-renowned neurologist, neuro-orthopedist, and rehabilitation specialist. He has appeared as a medical expert on 60 Minutes, The Today Show, Dr. Phil, Dateline, CNN’s Paula Zahn Now, Hard Ball with Chris Mathews, XM satellite radio, and scores of national and local television and radio shows. Fortanasce was chief of neuro-orthopedics at Rancho Los Amigos Hospital at USC and neurological consultant to the spine centers at St. Vincent Medical Center and Casa Colina Hospital. He has been quoted in the New York Times, Sports Illustrated, USA Today, U.S. News & World Report, Time magazine, and many other prestigious publications. He also hosts his own syndicated radio program, St. Joseph’s Radio Presents.


David Gutkind, DPT, is a doctor of physical therapy and an orthopedic clinical specialist. During his professional career, he has specialized in ergonomics as a treatment intervention for both the cause and prevention of musculoskeletal injury to the lumbar spine. He has taught ergonomics at the university level, provided on-site training programs that emphasize spinal care and injury prevention at the corporate level, and conducted hundreds of individual and group training classes on lumbar lifting and body mechanics techniques. Gutkind lives in Southern California and continues to practice orthopedic physical therapy along with ergonomic instruction.


Robert Watkins, MD, is a spine surgeon and codirector of the Marina Spine Center at Marina Hospital in Marina del Rey, California. He is the former chief of spinal surgery at USC. His expertise ranges from innovative spine surgeries to treatment of sport-related injuries. In his practice, he treats collegiate, professional, and Olympic athletes across the United States. He has served more than 25 years as a spine consultant to the Los Angeles Dodgers, the Los Angeles Kings, the Los Angeles Angels, the Los Angeles Lakers, the Anaheim Mighty Ducks, and golfers on the PGA Tour. He has extensive experience in spinal surgery and postoperative rehabilitation of professional athletes, returning most athletes to full performance. As a surgeon, he has participated in more than 11,000 spine surgeries in a career that has spanned 30 years, and he currently completes nearly 250 surgeries a year. He has also developed an extensive coordinated core nonoperative program of rehabilitation without surgery.




Part I Why Does It Hurt?

Chapter 1. Understanding Back and Neck Pain

Chapter 2. Listening to the Voices of Pain


Part II Helping Yourself

Chapter 3. Using First Aid for Fast Relief

Chapter 4. Stretching and Exercising

Chapter 5. Making Lifestyle Choices to Ease Pain

Chapter 6. Learning Correct Body Mechanics

Chapter 7. Adapting Office Ergonomics


Part III Working With Your Doctor

Chapter 8. Choosing a Doctor

Chapter 9. Getting the Right Diagnosis

Chapter 10. Taking Medication for Spinal Pain


Part IV Exploring Surgical Options

Chapter 11. Getting Injections for Spinal Pain

Chapter 12. Considering Surgery



Questions for Vincent Fortanasce

  • With 80% of adults experiencing back or neck pain at some point in their lives, these problems have reached epidemic proportions. How do you explain this phenomenon?
  • What are the warning signs that your pain is more than “ordinary” spine pain and that you should take an immediate trip to your doctor’s office or emergency room?
  • What are some things to look for when choosing a physician to diagnose and treat your pain?
  • How effective are some of the home remedies for back pain, such as bed rest or warm compresses?
  • In the book you talk about the voices of pain. What do you mean by that?
  • What are some of the best ways to avoid back or neck pain in the first place?
  • You and your coauthor Dr. David Gutkind write that poor workstation setup is a leading cause of pain. What are some of the common mistakes people make in setting up their computer workstations?
  • How will you know that it’s time to consider surgery for your back or neck pain?


Background Facts

  • It is estimated that 95 percent of the population will have at least one serious episode of spinal pain in their lives, and 84 percent will suffer multiple episodes. Of those, 33 percent will suffer from chronic pain and 7 percent will be substantially limited in their ability to work.

  • Spinal pain is the second most common reason for a medical office visit and the most common reason for emergency room consultations in the United States, totaling 6 million per year.

  • Spinal pain costs an estimated $110 billion per year, with another $40 million accrued in lost business expenses.

  • The incidence of spinal pain and location vary according to occupation and sex. The low back area constitutes 70 percent of all cases, the neck 22 percent, and the midtorso 8 percent.

  • Men are twice as likely to have repeated spinal pain attacks, occurring in 50 percent of those who do hard labor. Women in the white collar workforce (administrative personnel, lawyers, and teachers, for example) more often have neck and shoulder blade pain. An estimated 50 percent of them have other difficulties as well such as chronic headaches, carpal tunnel, and thoracic outlet syndromes.

  • It is estimated that the number of people with spinal pain at any one time is about 60 million. An estimated 40 million suffer from chronic spinal pain.

  • Disc dysfunction is more prevalent in males than females and is most common in the 25-to-50 age group and is also associated with a flexion-biased lifestyle. Usually the onset of most discogenic conditions is nontraumatic, occurring gradually over time instead of resulting from a one-time traumatic event such as a fall or car accident.

  • Spinal pain arising from adaptive shortening typically occurs in people in their 30s and older. It is most prevalent in those over 50 years of age. Those with a generally sedentary lifestyle and those who tend to maintain the same position for most of the day are susceptible, especially as they age.

Facts taken from End Back & Neck Pain.




“This must-have guide will eliminate your back and neck pain and prevent it from recurring.”


Tommy Lasorda

Legendary MLB Manager, LA Dodgers

Inductee, National Baseball Hall of Fame

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