It might not be your home desk setup. Breathing and sleeping habits, the weight of your bag, and your vitamin D levels also can contribute to neck and back pain.

If you’ve been experiencing more pain in your neck or back recently, you’re not alone. Research has found that changes in behavior during the pandemic, such as more time spent sitting and less time engaged in physical activity, has led to more new-onset back pain as well as more severe chronic back pain. For example, a September 2021 study involving 232 telecommunications company workers found that 39 percent of the participants reported stronger pain in their lower back and 46 percent in their neck and upper back after they shifted to working from home during the pandemic.

The usual suspects are poor ergonomics while working from home, “pandemic posture” (bad habits such as slouching at a desk or table or on the couch), more sedentary physical activity patterns (which leads to deconditioning), not paying attention to how you perform household tasks (such as loading the dishwasher or taking out the trash), weight gain (which places more stress on the spine and throws posture out of its proper alignment) and increased levels of stress (which can lead to muscle tension). “All of that comes together to make a worse milieu for back and neck issues, which are very common,” says Mohamad Bydon, a professor of neurosurgery at the Mayo Clinic in Rochester, Minn., and medical editor of “Back and Neck Health: Mayo Clinic guide to treating and preventing back and neck pain.” “Times of stress are times of increased pain.”

Also, many people are putting in longer hours while working from home — there was an average increase of 49 minutes in the length of the workday early in the pandemic, according to research from Harvard Business School. And there’s no sign of that easing up, experts say. “A lot of people feel like they have to make up for lost time by doing twice as much now because we basically lost 2020,” says Jon Cinkay, a physical therapist and body mechanics coordinator at the Hospital for Special Surgery in New York.

But there are other, lesser-known factors that could be influencing your back pain, such as your breathing, your bag and your vitamin D levels. Here are some essential strategies to help prevent or ease flare-ups of neck and back pain from a variety of sources:

Check your posture during the day. If you’re sitting in a slouched position for hours at a time, your chest and abdominal muscles and your hip flexors will get tight, while your back and shoulder muscles will get stretched out, all of which can trigger back pain and stiffness. “Some people don’t have the muscle memory for good posture — but they can develop that,” says Carol Frey, an orthopedic surgeon and co-director of the West Coast Sports Medicine Foundation. Here’s how: Wherever you are sitting, pause periodically and adjust your posture so that your neck is in line with your shoulders, your shoulders are in line with your hips, and your knees are a little lower than your hips. It’s best if you place your feet flat on the floor, adds Naresh C. Rao, an osteopathic primary-care sports medicine physician in New York City. Crossing your legs, he says, throws your pelvis out of its natural alignment, which can lead to low back pain. When loading the dishwasher or taking out the trash, avoid twisting motions for your back’s sake, Cinkay advises: Step toward what you’re picking up or putting down and bend from the knees (not the waist).

Stop looking down at your screen(s). You’ve probably heard it’s important to position your computer screen so that it’s at eye level, even if that means propping it up on books or shoe boxes. The same is true if you’re looking at your cellphone or tablet or even reading a book: It’s best to raise it to eye level, says Cinkay, because bending your neck to look down places increased pressure and strain on the neck and shoulders. You can either hold the device level with your face or prop it up on a stand or against a stack of books.

Tend to your breathing. The pandemic has brought us an unparalleled period of prolonged stress, which may be contributing to people’s neck and back pain. “If someone is stressed, they will have a certain amount of tension in the upper back, neck and shoulders,” Rao says.

But there’s another factor at work, according to Stacey Pierce-Talsma, an osteopathic physician and associate dean of academic affairs at the University of New England College of Osteopathic Medicine in Biddeford, Maine: shallow breathing. When stressed, people tend to breathe from the chest (thoracic breathing) rather than from the abdomen (diaphragmatic breathing). Breathing from the chest not only inhibits the proper exchange of oxygen and carbon dioxide that would help relieve stress, but it also can place additional strain on the upper back and neck muscles, she adds.

That’s why it’s smart to engage in mindful breathing exercises throughout the day, experts say: Pause what you’re doing for a few minutes, place your hand on your belly, and inhale deeply through your nose so that your belly inflates, then exhale slowly through your mouth, letting your belly deflate.

Vary your position. During the pandemic, many people have gone from one video meeting to another with hardly a break in between; at the office, they at least had to stand up and walk from one meeting to another. “Being in any one position for long periods of time leads to stress and strain on your muscles and joints,” as Pierce-Talsma noted in an email. She advises frequently shifting between sitting and standing or spending some time sitting on a balance ball, which requires you to maintain balance and engage your core muscles.

Take regular movement breaks. Experts recommend setting a timer on your computer or watch to signal you every one to two hours to get up and move. Walk around your home or outside. Do some gentle stretches for your hip flexors (with lunges or pigeon pose), your back (with child’s pose), your neck (tucking your chin to your chest) and other stiff areas. Strengthen your core, which will help prevent back pain, with planks, abdominal curls and moves such as bird dog and Superman.

Doing a short yoga workout can help, too, according to a study in this month’s issue of the journal Human Factors. When people who switched to telework during the pandemic did a 10-minute daily yoga routine that was made available through an online platform, they experienced significant reductions in their head, neck, and back discomfort and improvements in their moods after a month. To prevent back pain, it’s important to strengthen your core by doing planks, abdominal curls, and moves such as bird dog and Superman, Frey says.

Weigh your bag. If it weighs more than five pounds on a bathroom scale, it’s time to lighten the load. Frey says that carrying an overly heavy purse or other bag causes biomechanical errors — such as leaning to one side or the other — and places excessive pressure on the shoulders and neck, which can lead to pain. If what you need to carry weighs more than five pounds, she recommends wearing a backpack so long as it doesn’t exceed 15 percent of your body weight or 20 pounds, whichever is less. If you need to tote around more than that, she recommends using a bag with wheels.

Get good sleep, and with the right pillow. “During sleep, the body rehabilitates itself and repair processes occur that are fundamental to good pain management,” says Bydon, so get enough shut-eye. It’s also important to consider your sleep position, he says. “If you sleep on your back, use a relatively flat pillow, so that your neck is in a relatively neutral position, not too extended or flexed.” If you tend to sleep on your side, it’s better to have a pillow with a bit more cushion to keep your neck in the optimal position. Sleeping on your stomach is not recommended, because it throws your spine out of its natural alignment, which can lead to back or neck pain.

Get enough vitamin D. “We are seeing more vitamin D deficiency, which can weaken bone health and contribute to worsening neck and back pain,” Bydon says. Research has linked low vitamin D with greater pain levels.

Being overweight is another risk factor for back pain, so if you’re both carrying pandemic pounds and deficient in vitamin D, you may have a greater chance of developing back pain. The good news: A study in a 2019 issue of the Journal of Steroid Biochemistry and Molecular Biology found that when overweight adults with vitamin D deficiency took daily vitamin D supplements for 16 weeks, those with vitamin D levels under 30 nmol/L at baseline experienced greater reductions in their back pain disability after vitamin D supplementation, compared with those who were given a placebo.

If you have back pain, Bydon recommends having your vitamin D level checked and, if it’s low, taking calcium and vitamin D supplements. You can also increase your intake of vitamin D by consuming fortified milk and fatty fish (such as trout and salmon) and by taking a daily walk in the sunlight, which helps the skin synthesize vitamin D.

Stacey Colino is a writer in Chevy Chase, Md., specializing in health and psychology, and an ACE-certified health coach.

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