Shoulder and neck pain lasting more than two weeks without improvement should not be overlooked.

In an episode of the “She Health” program, Lin Kuan Yu, attending physician in the Department of Physical Medicine and Rehabilitation at National Taiwan University Hospital and director of Grand Chong-Ren Rehab Clinic, highlights the importance of early attention and self-care. Persistent discomfort may indicate underlying issues that require medical evaluation to prevent the development of chronic problems.

Prolonged use of computers and smartphones has become a major contributor to shoulder and neck issues in modern life. Lin emphasized the importance of maintaining good posture, noting that keeping the chin slightly tucked can help reduce discomfort. In contrast, slouching or poor sitting habits often lead to increased pain.

Posture Tips for Electronic Device Users

• Tuck Your Chin: Keep your chin gently tucked in while sitting upright.


• Pull Your Shoulders Back: Your ears should be vertically aligned with your shoulders—not leaning forward past them. This alignment helps prevent the common “tech neck” posture, where the head juts out and places strain on the neck and upper back.


• Maintain 90-Degree Angles: While working in a seated position, aim to maintain the following three 90-degree angles at the same time:

Elbows: Keep your elbows at a 90-degree angle while typing. Ensure your desk is at a height that allows your arms to be comfortably supported.

Lower Back: Ensure your desk is at the appropriate height to support an upright sitting posture with proper lumbar alignment.

Knees: Bend your knees at a 90-degree angle. If your chair is too high, use a footrest to help achieve the posture.

When standing at a desk, follow the same principles for your upper body: keep your elbows at a 90-degree angle and maintain an upright, aligned spine.

A case-control study of 78 people found that patients with shoulder impingement syndrome exhibited a greater thoracic kyphosis angle—a measurement of the natural outward curve of the middle portion of the spine. The findings suggest that maintaining proper thoracic posture may help improve thoracic range of motion, thereby contributing to the management of shoulder impingement.

3 Simple Exercises for Daily Posture Care

Unconsciously shrugging the shoulders is one of the most common posture issues among office workers, Lin noted. Over time, the habit can place excessive strain on the neck and shoulders. He recommends fostering a supportive work environment where colleagues can casually remind each other to relax their shoulders during the day.

For those working alone, placing a mirror in front of the desk can serve as an effective self-check tool. Checking your reflection from time to time can help you catch and correct shoulder shrugging more easily. Keeping your chin gently tucked is also important to help maintain good posture alignment.

Lin recommends daily neck and shoulder exercises to relieve tension, suggesting 10 repetitions per exercise, three times a day:

1. Forward Head Stretch

Place both hands on the back of your head and gently bend your upper body forward. Hold the stretch for five to 10 seconds.

2. Lateral Neck Stretch

Use one hand to hold the opposite side of your head and gently pull your head toward your shoulder until you feel a mild stretch. Hold for five to 10 seconds, then switch sides and repeat.

3. Upward Neck Stretch

Tilt your head back and look upward, keeping your head centered without turning or tilting to either side. Hold the position for about five to 10 seconds.

Tips for Choosing the Right Pillow

The pillow you sleep on can significantly affect both the quality of your sleep and how your body feels the next day, Lin said. Using the wrong type of pillow can result in neck and lower back pain upon waking.

Key Points for Choosing a Pillow:

• Minimizes the Gap: Choose a pillow that reduces the space between your neck and the pillow when lying down. Proper support in the neck area helps maintain spinal alignment and reduces neck strain.


• Relaxes Your Neck: Your neck should feel completely relaxed when resting on the pillow. If you are unsure, you can ask someone to gently check whether your muscles are tense.


• Keeps Your Chin Slightly Lower:  Your pillow should be high enough to support the neck, but low enough that your chin stays slightly below your forehead. Having your chin 3 to 5 degrees lower helps prevent your head from tilting backward, which may cause discomfort and interfere with sleep quality.


• Avoid Pillows That Are Too Soft: Overly soft pillows may cause the neck to extend excessively, leading to strain and poor sleeping posture.

Diagnosis and Treatment Options

For persistent shoulder and neck pain, Lin recommended starting with a visit to a family medicine clinic. In cases involving a history of physical trauma, it may be more appropriate to consult a rehabilitation or orthopedic specialist directly. For people with a relevant medical history—such as previous neck surgery—it is advisable to consult the treating surgeon for further evaluation.

Diagnosis typically begins with a thorough review of the patient’s medical history. If the physician suspects a fracture or nerve compression due to trauma, an X-ray may be ordered to check for fractures or vertebral slippage. Depending on the results, an ultrasound may be used to evaluate for signs of arthritis, bone spurs, cysts, or tumors.

Shoulder and neck pain are generally divided into two types:

Acute Pain: Pain for less than two weeks, often due to strain, trauma, or poor posture

Chronic Pain: Associated with degenerative spinal changes such as bone spurs or herniated discs

Initial Treatments

Management typically begins with oral medications such as anti-inflammatory drugs or muscle relaxants combined with physical therapy using therapeutic devices.

For acute strains, treatment may include heat therapy, electrotherapy, or cold compresses. In cases involving chronic spinal narrowing or nerve compression, cervical traction or other forms of traction therapy may also be recommended.

Advanced Treatments

If the response to initial treatment is limited or slow, injection therapy may be considered, especially for pain originating from small facet joints. A newer technique known as ultrasound-guided injection allows medication to be delivered precisely to the affected area under real-time imaging. This approach improves accuracy and ensures the medication directly targets the injured tissue.

Although injections may cause temporary soreness, they are generally safe when guided by ultrasound, which allows experienced physicians to avoid nearby nerves, Lin noted. In higher-risk cases, patients may be referred to specialists in surgery, neurosurgery, or orthopedics for further evaluation and care.