The difference between feeling great and having chronic neck or back pain is literally a matter of inches, when it comes to posture and ergonomics in the workplace.

Even with innovations such as the exercise ball chair and the standing desk bringing awareness and providing relief at desk jobs, many people still suffer from ailments such as headaches, shoulder pain and backaches because of having improper posture.

“Eventually you will hurt if you don’t work on your posture. You might have to spend time at the doctor or in physical therapy, when it’s something you can prevent,” said Adam Rolf, physical therapist and athletic trainer at Lawrence Memorial Hospital.

Often the pain is caused by a muscle imbalance, Rolf says, with the muscles on the front of the neck and shoulders doing very little work while the muscles on the back of the neck and shoulders lean and strain continuously toward computer screens or mobile devices.

Rolf says that no matter what the office setup is, variety of positions is the key. Even standing desks should not be used all day. He recommends changing positions throughout the day by alternating between sitting straight upright and leaning back in a more recumbent position, while keeping the body aligned.

The best thing desk workers can do, Rolf says, is to take a “micro break” about every 20 minutes. He recommends setting a timer on a mobile device as a reminder to pause for 30 seconds up to two minutes do small stretches, look away from the screen and take a deep breath or two. Ideally, that micro break allows for standing up and stepping away from the desk, as well.

“If you take micro breaks throughout the day, by the end of the day you will have 20 to 30 minutes of light stretching. That will go a long way throughout the year,” he said.

Rolf has tips from head to toe for workers to keep their bodies in alignment — between those micro breaks, of course.

He says the best overall thing to do to improve both posture and alignment is to sit up taller. He tells his patients to think of extending their head toward the ceiling, and it applies to both sitting and standing.

“Keep your head back, not forward. Having your head forward is the number-one problem and one of the biggest things we do with mobile devices, as well,” Rolf said.

Desk workers should position their chairs so that their eyes are looking slightly down at the computer. The Mayo Clinic guidelines on workplace ergonomics recommend sitting about an arm’s length away (18 to 28 inches) from the monitor.

When working on the computer, Rolf says, workers’ ears should be aligned with their shoulders, and their shoulders should be in line with their hips. The shoulder blades should be back, not rounded forward. Workers should keep key objects, such as the stapler and phone, within easy arm’s reach as well, the Mayo Clinic advises.

Rolf recommends alternating between a straight-up sitting position and a recumbent sitting position throughout the day, while keeping the ear-shoulder-hip alignment in each position.

While sitting in their main desk chair, a worker’s knees should be slightly above his or her hips, to take pressure off the lower back. Feet should be flat on the floor; avoid crossing legs as much as possible, as that can lead to back issues. He recommends shifting weight on the feet periodically instead.

“Gravity is always working against us. We have to do our part to stay in a neutral position where our anatomy works for us,” he said. “Our bodies are amazing, but if we make these things better habits, that makes a big difference in the long run.”

Susan Marshall is a part-time psychology faculty member at KU and volunteers for her children’s activities, so she spends a lot of time on her home computer teaching online courses, grading and coordinating events.

She has had neck and shoulder pain for as long as she can remember and has tried massage, chiropractic care, ice and even muscle relaxers to help control her pain. But she says that nothing has worked as well for her as regular exercise that forces her to move and engage her neck and shoulders.

She knows that her work station most likely is not helping her pain situation, but she has sentimental attachment to her desk.

“I’ll be sitting and realize that my shoulders are by my ears. I’m probably not great about taking breaks,” she said. “I do things outside of my work environment that will help things not get too bad.”

Marshall’s shoulder tension has reached a point a few times that she thinks it caused headaches – that was usually the point when she sought help.

“I haven’t made adjustments to get a special chair or an exercise ball to sit on or anything like that,” she said.

Nor has she looked into a standing desk, which many companies and institutions, including Kansas University, are making available to their employees.

Rolf cautions against perceiving standing desks as a complete solution to posture problems.

“A standing desk is good for back and neck issues, but you can’t use a standing desk all day. You should change to a sitting position for part of the day, so you need to be able to set up the work station properly for both standing and sitting,” he said.

The hospital has a physical therapist who can go to workplaces and evaluate work stations, should anyone need that service, Rolf said.

“Pain affects so much, including mood and productivity. If you are in good shape and you feel your best, you’re going to perform your best. Always think about it from a positive standpoint,” Rolf said.