Many people dealing with this don’t realize that the computer is the source of their issue. Typically, I’ll have people speculate that it’s from exercise, or sleeping position, or an old injury, but more often than not it’s from spending 12+ hours a day hunched over in one position:

Or:

Chronic neck and shoulder pain has a pretty profound impact on quality of life. The BEST treatment, of course, is quitting your job and spending the rest of your life lounging on a tropical beach. If that’s not a feasible option, there are some things we can do to manage it.

Sleep

I’m discussing sleep first, because for the vast majority of people, simply getting adequate sleep will be the most beneficial change they can make. Adequate sleep allows the muscles to relax so the body can repair. Perhaps more importantly, inadequate sleep can compromise the serotonin system’s ability to support pain inhibition with natural opioids (1). Getting adequate sleep normalizes neuroendocrine function and supports homeostasis (2). There’s evidence that duration and quality of sleep can have a strong impact on the experience of pain (3). 7-8 hours a night of restful sleep seems to be ideal for most people, although some can get by with less and a few need more. We tend to dismiss the importance of sleep, but it’s probably one of the simplest and most profound changes we can make to improve our quality of life.

Exercise

Simply getting up out of your chair several times a day will bring relief! But there are specific exercises you can do as well. In a 2008 study, participants engaging in a simple strength training protocol experienced a 75% decrease in neck and shoulder pain over 10 weeks. The protocol involved 5 exercises, performed for 20 minutes 3 times a week. The exercises were the dumbbell shrug, bent over row, lateral raise, upright row and reverse fly. All of these can be done with light to moderate dumbbells or resistance bands. In fact, you can keep a set of dumbbells at your desk at work and do these exercises during down time, that’s how simple they are. Harvard Medical School has a great description of the study and the exercise protocol here.

Stretching

Take a few moments each day to give your neck and shoulder muscles a good stretch. The Mayo Clinic provides a few in this tutorial video, here are some more from E-How Health.

Massage

Studies show that massage can improve functionality and the experience of pain (4), at least in the short term. Massage won’t bring permanent relief unless you are able to stop doing that which is causing the pain (which is usually not realistic, as most of us must use computers in our jobs), but it will bring temporary relief, and regular massage can help manage the pain and stiffness from computer use. There are even self-massage techniques you can utilize.

Ergonomics

Setting up your work station so that you are in a more natural position can be very helpful. If you habitually work on a laptop, use it at a table or desk rather than on your lap. UC Berkeley provides some simple tips for setting up an ergonomically correct workstation here.

Most importantly, I think, is simple mindfullness. Our bodies don’t do well when we don’t move, so be aware of how long you’ve been sitting in one position and make an effort to increase your physical activity during the day. We spend a tremendous amount of time and energy thinking about what we eat and how we exercise, but something as simple as how we sit at our desks can have a really dramatic impact on our quality of life. It doesn’t take heroic measures to change though, just a few simple tweaks can make a huge difference. And as an added bonus, several of the things that I’ve discussed here not only improve neck and shoulder pain, they also improve overall health and support the maintenance of a healthy weight!

There were only 10 middle aged men in this study. While it’s true that studies this small can’t automatically be extrapolated to apply to everyone, what I’m trying to show people through this series is that each small study serves as a data point in a broader constellation of evidence. There is quite a vast body of evidence that inactivity is a primary driver of metabolic dysfunction, and even though no single study can ever be taken of irrefutable evidence of anything, when dozens, hundreds or even thousands of studies all show similar results across population groups, one must sit up and take notice. You can prove pretty much anything if a single study is your litmus test (broccoli will kill you! I saw a study!). What does the weight of evidence say, though?

On to the study. 7 of the men in this study had mild NIDDM (non-insulin dependant diabetes mellitus) and 3 had impaired glucose tolerance (ie, they hadn’t been diagnosed with NIDDM yet but had the precursors). They were instructed not to change their diets over the course of the study, and kept food logs that were analyzed by a dietician to ensure that study results weren’t confounded by diet changes. They were given an initial Oral Glucose Tolerance Test, a physical exam (including blood lipid panel), and a maximal treadmill exercise test before study onset to establish baseline values.

The subjects engaged in a 7 day exercise program consisting of 50-60 minutes on a treadmill or ergometer, working at 60-70% of their maximum heart rate. On the 8th day they were given a second OGTT and exam. On the 9th day they were given a second treadmill test.

Results

VO2 max, body fat percentage and weight all remained unchanged after the 7-day exercise program, so those factors did not confound the results. There was a 36% decrease in plasma glucose, a 32% decrease in plasma insulin concentrations, and a 32% decrease in triglycerides.

What is notable here is that the subjects’ insulin response to a glucose load (from the OGTT) was significantly lower than it had been before the study. What this means: their bodies released less insulin in response to the same amount of sugar after exercising for 7 days. This is significant to the Great Sugar Narrative that holds that sugar is the driver of insulin production and release. Clearly exercise is a pertinent factor here that is ignored by the sugar-causes-diabetes contingent. Exercise can mitigate the insulin response to sugar.

Plasma glucose also decreased, even with a decreased insulin response, which indicates that the cells ability to respond to insulin also improved. From the study:

“The results of this study show that regularly performed vigorous exercise can result in a significant improvement in glucose tolerance in some patients with mild NIDDM. This improvement occurred despite a significantly smaller increase in plasma insulin levels. it appears that the improvement in glucose tolerance was due to a decrease in resistance to insulin.”

Also of note: triglycerides decreased 32% with no change in diet.

Bottom line: exercise reduces insulin response AND makes the body more sensitive to the action of insulin. Exercise does lots of other groovy things too.

Keep moving.

Today’s post is PCOS specific, a subject I take special interest in as I lived with symptoms of PCOS for nearly 25 years before putting the pieces together and taking the steps necessary to overcome my symptoms. (You can read about my experience with PCOS here.)

PCOS is a metabolic disorder with a strong insulin resistance component. Many women with PCOS eventually develop diabetes as well. Addressing the insulin resistance is key.

Metabolic and cardiopulmonary effects of detraining after a structured exercise training programme in young PCOS women.

In this study, 64 young, overweight women with established PCOS were divided into 2 groups: one recieved 24 weeks of exercise training, the other recieved 12 weeks of exercise training followed by 12 weeks of de-training (they stopped exercising). Metabolic parameters were assessed at baseline, at 12 weeks, and again at 24 weeks.

At the 12 weeks assessment, both groups showed significant improvements in insulin sensitivity and glucose levels, lipid profile, and cardiovascular health. At the 24 weeks assessment, the first group (24 weeks of training) showed even greater improvements, and the second group (12 weeks training, 12 weeks detraining) showed no improvement over the baseline assessment. They lost all the gains they had made during the first 12 weeks of training.

The moral of the story here is that regular exercise is key. In my personal experience, type and intensity of exercise is far less important than consistency. It matters less what you do, just do something, and keep doing it.

I’m not a scientist, I’m a lowly little Personal Trainer and Massage Therapist. I don’t perform studies (other than my N of 1 ones), I don’t write research papers, I don’t have a degree in anything health related.

What I do do is read a lot. Blogs (I’ve got a few of them listed in my blogroll), news articles, and most importantly, science. I try to find and read as many sides of an issue as possible.

And one thing I have, that a lot of people don’t, is an ability to think critically.

There’s a Diet War going on out there. One faction would have you believe that primitive man spent most of his time lolling about the savannah, working on his tan, only getting up off his ass long enough to throw a spear at a passing buffalo, then sitting back down to gorge himself and get back to the serious business of lazing about. Sounds pretty idyllic. Sign me up! Oh yeah, and that buffalo was made out of bacon.

Building on this belief system, they argue that modern humans are therefore primed for a life of blogging and bacon eating. It’s the true path to optimal health! See, our bodies are made to sit and eat fat, so when we eat carbohydrates, everything goes haywire. Insulin resistance, diabetes, obesity, cancer, DEATH.

‘Course, there’s all that pesky scientific data that suggests that increasing physical activity improves metabolic function (don’t believe me? Google ‘exercise and insulin resistance’, or check out my pinterest board on the topic). How can that be, if the body’s natural state is lolling about the savannah? If our bodies are designed to sit, why would moving improve metabolic function?

Do you REALLY believe primitive man spent most of his time on his ass? I don’t, not for a minute. I believe primitive man spent most of his time on the move. I believe the human body’s natural state is one of almost constant motion. When we move, we metabolize carbohydrate just fine. In fact, science holds carbohydrate is the brain and muscles’ preferred fuel (yep, I’m aware of the studies that suggest otherwise. Guess what? So far, they’re outliers). ‘Course, if we’re not moving, carbs can cause problems. But is eliminating carbs the answer? Only if you believe our bodies are designed to sit all day. If you believe that our bodies are designed to move, then eliminating carbs is a band-aid. A band-aid that might allow you to sit on your ass a few more years before disease sets in, but that ultimately doesn’t address the CAUSE of the disease: exercise deficiency. That’s right folks, I’m calling it like I see it: Metabolic Dysfunction is a disease of exercise deficiency, not of carb intolerance.

“But modern lifestyles make adequate exercise nearly impossible!” they claim. Bullshit. I have kids, a job, a household to manage, and a social life, and I am able to include adequate exercise into my daily routine. I also manage to maintain a blog! Yes, you too can blog AND exercise.

“But only young people and endurance athletes can eat carbs safely!” they counter. Bullshit, again. I’m 40. I exercise 30 minutes a day on average.

“But…but…some of us are so damaged by obesity and the Standard American Diet that we simply can’t ever eat carbs again!”. Bullshit, times 3. I was obese for 3 decades. At 35, I had a whole laundry list of metabolic issues: PCOS, high blood pressure, blood sugar regulation control problems, low HDL, and obesity (not to mention depression, panic attacks, migraines, hair loss, cyctic breasts and acne and much, much more). I reversed it ALL while eating carbs.

Ask yourself: which is more likely the natural state of the human body:
a. sitting and eating only one or two macronutrients, to the exclusion of thousands of edible energy sources
b. moving and eating whatever is easiest to find (which, where I live, would be mostly plants, with some rodents, insects and perhaps an occasional bit of larger game thrown in to supplement)

I choose b, and live accordingly (minus the rodents and insects). And you’ve seen my pictures. I suspect I look a lot more like the mythical Grok(ette) than most basement dwelling, bacon eating bloggers.