Written by the Phoenix Rehab physiotherapy and hand therapy teams. Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H; hand, wrist and elbow sections by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z. Last reviewed 6 October 2026.
Office syndrome is a popular name in Asia, not a medical diagnosis, for the neck, upper back, shoulder, wrist and lower back problems that come from long hours of sitting and screen work. Most of them come from holding one position too long: the head forward to a laptop, the mouse arm reaching, the hips bent in a chair.
By four in the afternoon, a lot of people in the towers around Raffles Place are rubbing the same spot: the top of the shoulder, where the neck meets it.
You will hear “office syndrome” in Singapore, Thailand and across much of Asia. It is a useful name for a cluster, and it tells you where to look. It also lumps five or six different problems together, and each one is assessed and treated differently.
The work itself is light. The day is long. Eight or nine hours with the laptop flat on the desk and your chin drifting towards it. The mouse a little too far to the right. A call taken with the phone wedged against your shoulder because both hands are typing. Then the MRT home, head down over the phone, and the sofa with the laptop on your knees.
No single hour of that hurts anyone. The total does. Neck pain is common in office and computer workers, in a 2008 review of neck pain at work.1 The table below separates the problems, by body part. For other jobs, see work injuries, by job.
The desk habits, and what they load
| Desk habit | What it loads | What it most often irritates |
|---|---|---|
| Laptop flat on the desk, or a screen set too low | Neck, upper back | Neck pain (text neck), headaches from the neck, ache between the shoulder blades |
| Mouse far out to the side or forward | Shoulder, upper back, forearm | Rotator cuff, rhomboid, outer elbow |
| Typing with the wrists bent back | Wrist, forearm, the nerve at the wrist | Wrist and forearm RSI, carpal tunnel |
| Scrolling with one thumb | Thumb base and the thumb-side wrist tendons | De Quervain’s, thumb base pain |
| Phone wedged between ear and shoulder | Side of the neck | Levator scapulae strain |
| Leaning on the elbows, or hard armrests | The ulnar nerve at the elbow | Cubital tunnel: tingling in the ring and little fingers |
| Sitting for hours without getting up | Lower back, tailbone, hips, knees | Low back pain, disc problems, tailbone pain, hip flexors, kneecap pain |
Every office syndrome problem, by body part
Start from where it hurts. Each linked row goes to the page that covers that problem in full.
| Where | Injury | How desk work usually causes it |
|---|---|---|
| Hand and thumb | Thumb base pain or arthritis (CMC joint) | Hours of pinching and scrolling with the phone thumb |
| Hand and finger | Trigger finger | Holding a grip for long periods, such as on a mouse or a phone |
| Wrist | Carpal tunnel syndrome | Wrists held bent back on the keyboard and mouse |
| Wrist and forearm | Wrist and forearm RSI (repetitive strain injury) | High keyboard and mouse volume, often in deadline weeks |
| Wrist | De Quervain’s tenosynovitis, on the thumb side of the wrist | Thumb-heavy phone and trackpad use |
| Wrist | Wrist ganglion (a fluid-filled lump) | Load on the wrist held bent back |
| Elbow and forearm | Tennis elbow, on the outer elbow (lateral elbow tendinopathy) | Gripping the mouse and lifting the wrist to type |
| Elbow and forearm | Cubital tunnel syndrome (ulnar nerve at the elbow) | Elbows resting on hard armrests or the desk edge, and elbows bent for long periods |
| Shoulder | Rotator cuff tendon pain | The mouse arm held out to the side with no support |
| Neck | Postural neck pain (text neck) | Hours looking at a screen set below eye level |
| Neck | Headache that starts in the neck (cervicogenic headache) | The same neck position held for long periods |
| Neck | Pinched nerve in the neck (cervical radiculopathy) | A head-forward posture held for long periods, loading the discs in the neck |
| Neck | Levator scapulae strain, at the side of the neck | A phone wedged between ear and shoulder |
| Upper back | Pain between the shoulder blades | Rounded shoulders at the desk |
| Upper back | Mid-back stiffness and joint pain (thoracic) | Long periods of sitting |
| Upper back | Rhomboid strain | The mouse arm held forward all day |
| Lower back | Low back pain (lumbar strain) | Long periods of sitting |
| Lower back | Slipped disc (lumbar disc herniation) | Sitting slumped forward for long periods |
| Lower back | Tailbone pain (coccydynia) | Long periods of sitting, more so on a hard chair or slumped back |
| Hip | Hip flexor strain or tendon pain (iliopsoas) | Hip flexors held short in a chair all day |
| Knee | Kneecap pain (patellofemoral pain) | Sitting with the knees bent for hours |
Not on the list, or not sure which row is yours? That is what the first appointment is for.
Text neck: the phone and the laptop
Text neck is another popular name, not a diagnosis. It means neck pain from long periods of looking down at a phone, a laptop or a tablet.
What it feels like. An ache at the base of the skull and across the top of the shoulders that builds through the day and eases overnight. Some people get a headache that starts at the back of the head and spreads forward to the forehead or behind one eye, covered in headaches that start in the neck. A pain on one side of the neck that pulls when you turn to check a blind spot is often the levator scapulae, the muscle a phone call wedged on the shoulder loads.
What is usually going on. When the head drifts forward, the muscles at the back of the neck hold its weight for longer. Neck tissue copes with brief loads well. It complains about the same load held for hours. Our full guide to neck pain covers the other causes, and how to tell them apart.
What we measure. Neck range in each direction, how long the deep muscles at the front of the neck can hold the head steady, upper back movement, and the nerve signs in both arms: sensation, reflexes and strength.
This week. Raise the phone to eye level instead of dropping your head to it. Put the laptop on a riser with a separate keyboard and mouse. Get up and change position every 30 to 45 minutes. Pain, pins and needles or weakness traveling down one arm is a different problem, a pinched nerve in the neck.
The common ones, in more detail
Between the shoulder blades
What it feels like. A burning or aching spot between the shoulder blades, often on the mouse side, that you try to reach with a door frame or a massage ball by mid-afternoon.
What is usually going on. Rounded shoulders and an arm held forward all day load the muscles and joints of the upper back. See pain between the shoulder blades, rhomboid pain and our upper back physiotherapy page.
What we measure. Upper back rotation and extension, shoulder blade control as you lift the arm, and whether pressing on the joints reproduces the pain.
This week. Bring the mouse in close so the elbow rests by your side. Stand up and turn your upper body each way a few times every hour. Pain between the shoulder blades that comes with chest pain or breathlessness is in the doctor-first list below.
Lower back from sitting
What it feels like. Stiffness when you stand up from the chair, an ache that builds through the afternoon, and a back that feels better walking than sitting. Some people get tailbone pain on hard chairs.
What is usually going on. Sitting for hours, often slumped back or perched forward, loads the lower back and the discs in one position. Most office back pain is a strain of the muscles and joints; see lower back pain in Singapore and our lower back physiotherapy page. Pain that travels down a leg points towards a slipped disc. Pain at the very bottom of the spine when you sit is covered in tailbone pain.
What we measure. How far you can bend in each direction and which movement brings the pain on, the nerve signs in both legs, and how long you can sit before it starts.
This week. Sit back in the chair with the backrest supporting your lower back. Stand for phone calls, walk to the pantry, and get up every 30 to 45 minutes. Keep walking. Bed rest slows most back pain down.
Wrist and forearm (RSI)
Seen by our hand therapy team.
What it feels like. An ache, burning or tightness in the forearm and wrist that builds through the week, worst in a deadline week, and eases on holiday.
What is usually going on. Repetitive strain injury is a name for overuse of the tendons and muscles of the forearm, wrist and hand by repeated movements, here typing and mousing. Our repetitive strain injury page covers it in full.
What we measure. Grip strength in kilograms on both hands, wrist range in each direction, and which tendon or muscle reproduces the pain when it is loaded.
This week. Keep the wrists straight on the keyboard, with the keyboard close and low. Do not rest the heel of your hand on a hard desk edge while you type. Spread the heavy typing across the day instead of saving it for the evening.
Carpal tunnel: tingling at night
Seen by our hand therapy team.
What it feels like. Pins and needles or numbness in the thumb, index and middle fingers. It wakes you at night and you shake the hand out to settle it. During the day you may drop things or fumble with buttons.
What is usually going on. The median nerve is squeezed where it passes through the wrist. Holding the wrist bent for long periods, at the keyboard or in bed, adds to the pressure. Desk work is one of several things that load it. Our carpal tunnel syndrome page covers the rest.
What we measure. Sensation in each finger, pinch and grip strength, the bulk of the muscles at the base of the thumb, and the tests that bring the tingling on.
This week. Keep the wrist straight at the keyboard and mouse, and stop sleeping with the wrists curled under you. Our hand therapists make custom night splints that hold the wrist straight. Numbness that never goes away, or weakness and thinning at the base of the thumb, is in the doctor-first list below.
Mouse elbow and phone thumb
Seen by our hand therapy team.
What it feels like. Pain on the outer elbow when you grip the mouse, lift a kettle or shake hands is usually tennis elbow. Pain on the thumb side of the wrist when you scroll or lift a cup is often De Quervain’s. An ache deep at the base of the thumb on pinching is thumb base pain. Tingling in the ring and little fingers after leaning on your elbows is the ulnar nerve, covered in cubital tunnel.
What is usually going on. Each is a tendon, joint or nerve asked to hold the same position or repeat the same movement for longer than it currently tolerates.
What we measure. Grip and pinch strength in kilograms on both hands, the movement that reproduces the pain, and the sensation in each finger.
This week. Hold the phone in two hands and use both thumbs, or use voice for long messages. Move the mouse in close and switch hands for some tasks. Pad hard armrests, or lower them so you are not leaning on your elbows.
Setting up the desk
None of this needs special equipment. A stack of books works as well as a branded riser.
- Screen. The top of the screen at or slightly below eye level, about an arm’s length away. With two screens, put the one you use most straight in front of you.
- Laptop. Raise it on a riser or books so the screen meets that height, and use a separate keyboard and mouse. Working all day on the laptop’s own keyboard puts the screen too low.
- Chair. Feet flat on the floor or on a footrest, hips level with or slightly above the knees, and the backrest supporting your lower back. Sit back in the chair instead of perching on the edge.
- Keyboard and mouse. Close to you, with the elbows by your sides and bent to roughly a right angle, and the wrists straight.
- Armrests. Soft, or set low enough that you are not leaning your elbows on them.
- Phone. Use earphones or the speaker for calls instead of wedging the phone on your shoulder, and lift the phone to eye level to read.
- Breaks. Change position every 30 to 45 minutes. Stand for calls, walk to the printer or the pantry, take the stairs for one floor.
- Hot desks and home. On a hot desk, adjust the chair and screen each morning. At home, the dining table and the sofa are the two setups we see most often behind a neck flare.
Back to full workdays on tests, not dates
Before you go back to full days at the desk without changes, these should be true:
What our patients say
Google reviews from our clinics in Singapore.
- A full workday with symptoms that stay mild and are gone by the next morning.
- Neck turning and tilting about equal to each side.
- Grip strength close to the other hand (within about 10%), measured in kilograms.
- Night tingling no longer waking you.
- An hour of typing or a long call with no symptoms traveling into the arm or hand.
In The Phoenix Recovery Protocol, this is Return & Perform, the last of the four stages after Calm & Protect, Move & Mobilize, and Rebuild & Strengthen. For desk work, Return & Perform means holding up through a deadline week, not a quiet one.
Is this normal?
Usually expected: stiffness at the end of a long day that eases once you move and is gone by morning, or a sore neck after a deadline week that settles over the weekend.
Worth getting checked: pain that is there before you start work, tingling or numbness that wakes you at night, dropping things, pain traveling into an arm or a leg, or symptoms still there after two weeks of desk changes and regular breaks.
When to see a doctor first
- Call 995 for chest pain or pressure, pain spreading into the arm, jaw or between the shoulder blades with breathlessness or sweating, or sudden weakness of the face, arm or leg, slurred speech, or a sudden, severe headache unlike any before.
- Go to the emergency department now for back pain with numbness between the legs, new problems passing urine or stool, or weakness in both legs. The same for a headache with fever and a stiff neck.
- See a doctor the same day for new weakness in an arm or hand, such as being unable to grip a cup, or a foot that drops or catches when you walk.
- See a doctor soon for numbness in the fingers that never goes away, weakness or thinning of the muscles at the base of the thumb (your GP can refer you for nerve conduction studies), clumsy hands in both hands with changes in balance, a wrist lump that grows or hurts, night pain that does not change with position, or unexplained weight loss with back or neck pain.
Questions people ask
What is office syndrome?
Office syndrome is a popular name in Asia, not a medical diagnosis. It usually means a cluster of neck, upper back, shoulder, wrist and lower back problems from long hours of sitting and screen work. Each problem is assessed and treated differently, so the first step is working out which ones you have.
What is text neck?
Text neck is a popular name, not a diagnosis, for neck pain from long periods of looking down at a phone, laptop or tablet. It usually feels like an ache at the base of the skull and across the top of the shoulders that builds through the day. Some people get headaches that start at the back of the head.
How should I set up my laptop to reduce neck strain?
Raise the laptop on a riser or a stack of books so the top of the screen sits at or slightly below eye level, about an arm’s length away. Use a separate keyboard and mouse, kept close with your elbows by your sides and wrists straight. Change position every 30 to 45 minutes.
Is tingling in my fingers at night caused by desk work?
Pins and needles in the thumb, index and middle fingers that wake you at night are a common sign of carpal tunnel syndrome, where the median nerve is squeezed at the wrist. Desk work is one of several things that load it. Numbness that never goes away or thinning at the base of the thumb needs a doctor.
When should I see a doctor about neck or back pain from desk work?
Call 995 for chest pain or pain spreading to the arm or jaw with breathlessness or sweating. Go to the emergency department for back pain with numbness between the legs or new bladder or bowel problems. See a doctor the same day for new weakness in an arm, hand or foot.
Where are you with this right now?
1. It is settling on its own
If it eases over a couple of weeks after you change the desk and start taking breaks, you are on the right road. Keep the changes when the pain goes; the desk did not change. You do not need us for this, and we would rather say so.
2. It has stopped improving
Monday is fine and by Thursday it is back. You have moved the mouse to the other hand, you sleep in a wrist brace, or you stretch at your desk every hour and it returns by the afternoon. That pattern is usually a strength and load problem that desk changes alone do not reach. It is worth measuring. If it has been months, the Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a neck or wrist does across a working week cannot be read in one visit.
3. You have had surgery, or you have a date
A carpal tunnel release, a cubital tunnel release, a trigger finger release or a lumbar microdiscectomy each has a shape, with protected weeks before full days at the desk. See hand therapy after surgery, physiotherapy after surgery and the recovery programs. All of it runs on the four stages of the Phoenix Recovery Protocol.
Next step
Find out which stage you are in
The same ache by four o’clock, every workday. Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
Sources
- Côté P, van der Velde G, Cassidy JD, et al. The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S60-S74.
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Clinics across Singapore
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