In the evening, as you close the laptop, your neck feels stiff. A tightness at the base of the skull, a dull ache between the shoulder blades. Not real pain. Just enough to notice, and regular enough that you have stopped blaming chance.

Neck pain is one of the most common musculoskeletal complaints in the world. The World Health Organization estimates that around 222 million people live with it, among the 1.71 billion affected by a musculoskeletal condition. In France, these disorders, known as TMS, account for roughly 90% of recognised occupational diseases, and the national health insurer (Assurance Maladie) reports they rose 6.7% between 2023 and 2024.

Surveys conducted during the pandemic also documented the problem at home. In a study of 4,112 homeworkers, 71.9% reported neck or shoulder pain, either mild or severe enough to interfere with work. In France, an analysis of the national CONSTANCES cohort found that, since the first lockdown, new neck pain had appeared in 2.1% of men and 4.4% of women; among women, teleworking more than half the time was associated with a higher risk of neck pain. The association was not significant in men. Time spent working from home may therefore matter, though it is not the only factor.

01. Why the neck is the weak link

An adult head weighs several kilograms. When it tips toward a screen that sits too low, its centre of mass moves farther from the neck. The extensor muscles then have to work harder to hold it.

Ergonomics has a name for this posture: forward head posture. A systematic review with meta-analysis found that, in adults, it is associated with neck pain: people with neck pain show more of it than those without, and its magnitude correlates with how intense the pain is. This is an association, not proof of cause: it is not always clear whether the posture precedes the pain or follows from it. The review found this association in adults, but not in adolescents.

The further the neck bends, the greater the leverage the head exerts on the vertebrae, and the harder the neck extensor muscles must pull to hold it up: an experimental study measured that both the gravitational moment and the activity of those muscles rise as the flexion angle increases. An EMG-driven biomechanical model estimates that at 45 degrees of flexion, compression on the cervical spine is roughly 1.6 times higher, and shear on the upper neck vertebrae about four times higher, than in a neutral posture.

02. Why the laptop, specifically

The laptop's ergonomic problem comes from its design: the screen and keyboard are one piece. You cannot adjust one without throwing off the other. If the keyboard sits at the right height for your hands, the screen is too low for your eyes; if the screen is at the right height, the keyboard is out of reach.

This constraint has been documented for decades. As early as the mid-1990s, studies comparing laptops and desktop computers found significantly greater neck flexion and head tilt on a laptop. More recent motion-capture work puts a number on it: working on a flat laptop adds, on average, about ten degrees of neck flexion compared with a properly positioned desktop screen.

Where you put the machine matters as much as the machine itself. A study by Japan's occupational-health institute measured, with the same laptop, near-neutral neck flexion on a table and around 27 degrees on a sofa. Of the four pieces of furniture tested with that laptop, the sofa produced the greatest neck flexion.

Putting the laptop on a desk does not solve the joined screen-and-keyboard problem. For prolonged use, you need to adjust screen height separately from hand position.

03. The most direct adjustment

The correction comes down to two gestures. Raise the laptop screen so its top edge reaches eye level or just below. And plug in a separate keyboard and mouse, kept flat on the desk, so the hands stay low while the eyes come up. A laptop alone cannot create that separation between screen and hands.

In a small experiment with 25 office workers, raising the laptop on a stand, with an external keyboard in every condition, reduced self-reported neck discomfort from 4.9 to 2.7 on a 10-point scale. Another study measured less head flexion and lower activity in some neck and shoulder muscles as screen height increased; upper-trapezius fatigue did not change significantly. A separate keyboard remains necessary if you want to raise the laptop without lifting your hands.

This logic matches official guidance. France's INRS (the national institute for occupational health and safety) advises keeping the top of the screen below the horizontal line of sight and an eye-to-screen distance of about 50 to 70 centimetres, roughly an arm's length. It is also what people do on their own when allowed to set their own screen: they place it slightly below eye level, since a screen set too high produces more visual strain. The options for raising it range from a simple riser to an articulated arm; the rest of the workstation is covered in our home-office ergonomics guide.

04. Moving matters more than sitting up straight

Adjusting the workstation reduces one load, but it does not make a static posture harmless. INRS therefore recommends breaking up sitting time and taking active breaks. Our article on remote-work exercises details a short, equipment-free routine.

In a cluster-randomized trial of high-risk office workers, 17% of participants prompted to take active breaks or shift position regularly developed neck pain over six months, compared with 44% in the control group. A 2025 Cochrane review nevertheless found the overall effect of additional breaks on neck and back pain to be very uncertain. The trial tested a specific intervention in a high-risk group; the review found too little evidence to set an ideal break frequency or duration. INRS recommends active breaks ideally every 30 minutes.

Over the medium term, strengthening is the best-supported intervention. A systematic review of 27 randomized trials concludes, with moderate-quality evidence, that neck and shoulder strengthening exercises reduce neck pain in office workers who already have it; the largest effects appeared in studies with the highest participation rates. In another four-week trial, participants were asked to stretch twice a day, five days a week. Their pain and neck function improved more than with an ergonomics brochure alone.

05. When it is no longer a matter of adjustment

A discomfort that appears at the workstation may change after an adjustment or more movement, but that does not establish its cause. Ergonomics has limits, and it is important to recognise them.

Ask for medical advice if pain persists, worsens, or interferes with daily activities despite the adjustments. Seek prompt care after a significant injury, or if pain travels down the arm with tingling, numbness, or loss of strength. This article describes general ergonomic principles; it is not a substitute for an examination or a diagnosis.

The neck, finally, cannot be fixed in isolation. Visual fatigue makes you crane forward without realising it; a chair with no lumbar support collapses the lower back, and the upper body follows. The boundary between work and rest matters just as much: a workstation you never truly leave keeps a low background tension alive. That is also why the home should remain a place of rest, and not just one more desk.

In practice: where to start

If you were to act this week, start by raising the laptop screen and adding a separate keyboard and mouse. Place the screen about an arm's length away, then build movement into the day: stand up regularly, walk during a call, or stretch between meetings. If your neck already hurts, ask a health professional for advice before starting a strengthening programme.

These adjustments have a modest role: they reduce one mechanical load and make position changes easier. They do not diagnose or treat persistent pain on their own.