Part of Desk job pain: neck, back and wrist aches sorted by body area
Work from home ergonomics: how to set up a home desk that suits your body
Warning signs, and when to get help
What does good work from home ergonomics look like?
Less than the furniture catalogs suggest. A good home setup lets you sit without twisting, reaching or peering, and makes it easy to get up and change position. That is the whole job. Everything else is detail.
It helps to be honest about the evidence. A Cochrane review of office workers found the evidence that ergonomic changes prevent arm and neck problems was mostly low quality and pointed in different directions (Hoe and colleagues, 2018). The one combination with moderate-quality support was an arm support used with an alternative mouse, which reduced new neck and shoulder problems in two studies. So fix what is clearly forcing an awkward position on you, spend little, and put the rest of your effort into moving.
The national guidance is similar wherever you are. OSHA in the US, the Health and Safety Executive (HSE) in the UK, the Government of Canada and Safe Work Australia all describe much the same setup, and the sections below draw on them. In the UK and Australia, an employer's duties toward a screen worker generally still apply when that person works from home, so ask your employer what equipment they can provide before you buy any yourself.
Chair: height, seat and back support
Start with your feet. They should rest flat on the floor, or on a footrest, with your thighs roughly level or sloping slightly down toward your knees. If raising the chair to suit the table leaves your feet hanging, put a box, a sturdy step or a stack of books under them, which is what the Canadian guide suggests.
Sit back in the seat so the backrest can do its work. A small gap between the front edge of the seat and the back of your knees stops the edge pressing into your legs. If your chair has armrests, they should let your shoulders relax rather than hitch them up.
A dining chair with no adjustment can still work: a firm cushion raises you, and a rolled towel behind your lower back adds some support if that feels better. Treat that towel as a comfort measure. Our page on back pain when sitting explains why a lumbar support is not a treatment.
Where should the keyboard and mouse go?
Close to you and low. OSHA describes the working position as shoulders relaxed, elbows close to your body and bent between 90 and 120 degrees, and wrists straight and in line with your forearms. In practice that means the keyboard sits at about elbow height when your arms hang loosely, near the front edge of the table.
Keep the mouse right beside the keyboard, at the same level, so your arm stays near your side rather than stretching out. Resting your forearms on the table or on armrests while you use the mouse is fine. In two studies, an arm support used together with an alternative mouse reduced new neck and shoulder problems, the one combination in the review with moderate-quality evidence of a benefit, although the reviewers called the evidence on arm supports and mouse designs inconsistent overall (Hoe and colleagues, 2018). Wrist or forearm pain that builds with typing and mouse work has its own page in this hub, wrist pain from typing.
How should you set up a laptop at home?
The laptop is where home setups go wrong most often. Its screen and keyboard are joined, so whichever one you get to the right height, the other ends up wrong. Flat on the table, you look down at the screen; propped up on books, you type with your shoulders lifted and your wrists bent.
The fix is to split them. HSE guidance says a separate keyboard and mouse should be used where a laptop is used for long spells, and the Canadian guide says the same about a docking station or a full-size keyboard and mouse. Then the laptop can go up on a stand, a shoebox or a stack of books, and the screen can come up toward eye level. In practice, a basic plug-in keyboard and mouse cost little and usually change more than any other purchase.
Until you have them, keep laptop-only spells short. The Canadian guide also suggests using the laptop's portability to switch between sitting and standing at a surface of suitable height, such as a kitchen counter, for part of the day.
Screen and lighting
Keep this part simple. Put the screen straight in front of you, at roughly arm's length, with the top line at or a little below eye level. OSHA gives a comfortable viewing distance of 20 to 40 inches (50 to 100 cm), and Safe Work Australia says about one arm's length. If you wear bifocals or varifocals, OSHA suggests a lower screen, tilted up toward you, so you are not tipping your head back to read through the bottom of the lens.
Glare makes people lean and squint. OSHA suggests placing the screen at a right angle to a window rather than facing it or with the window behind it, and using blinds when the sun is low. A desk lamp aimed at your papers rather than at the screen helps on dark evenings. If your neck is the part that aches, working from home back and neck pain looks at that in more detail.
Kitchen table, sofa and shared spaces: what works?
A kitchen table is built for eating, not typing, so check where your elbows land when you sit at it. If the keyboard ends up near your chest, a cushion on the chair brings you up, and something under your feet brings the floor up to meet them. Add the raised laptop and separate keyboard, and a dining table can work well for a full day.
The sofa and the bed are fine for reading an email, and poor for a working day. Both tip you backward and leave you craning forward at a laptop on your knees, and it is easy to stay curled up like that for an hour without noticing. In a shared space, keep a small kit in a box: the keyboard, mouse, a laptop riser or a few books, and a cushion. Setting it up each morning takes very little time and saves you from working in whatever position the room happens to allow.
What to fix first, and what costs nothing
If you change only a few things, change them in this order:
- Turn the screen and chair so you face the screen straight on, with no twist in your neck or back.
- Give a laptop a separate keyboard and mouse, then raise the screen on books or a box.
- Support your feet if they do not rest flat on the floor.
- Bring the keyboard and mouse close, so your elbows stay by your sides.
- Get up and move every so often, because no setup makes hours of stillness comfortable. The desk stretches and movement breaks page has a short routine.
If you are thinking about a standing desk, read standing desk back pain first, as the research on what it does for your back is mixed. To practice finding a comfortable, upright sitting position between changes, the correct sitting posture exercise walks you through it. The hub page sorts other desk aches by body area.
When to see a physio (physical therapist)
Book an appointment if an ache has lasted more than two or three weeks after you have sorted out the obvious setup problems and started moving more, or if it keeps coming back. In practice, a setup change that is going to help usually makes things easier quite quickly. When it does not, the desk is probably not the main cause.
Go sooner if pain, pins and needles or numbness spread into an arm or a leg, or if a hand or arm feels weak. A physio will look at how you move and how you work, and some will look at photos or a video of your home setup. The warning signs below come first, at the speed each one gives.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away. With neck pain, these can rarely come from a tear in an artery in the neck.
- Emergency: neck, jaw or arm pain that comes with chest pain, shortness of breath, sweating or feeling sick. Call emergency services.
- Emergency: pain, tingling, numbness or weakness in both legs, numbness or altered feeling around your genitals or bottom, or new trouble peeing or controlling your bladder or bowels. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away. These can be signs of pressure on the nerves at the base of the spine (cauda equina syndrome).
- Emergency: new problems walking, for example your legs feel stiff, heavy or weak or you have become unsteady on your feet, new trouble controlling your bladder or bowels, or hands that suddenly become clumsy, for example you can no longer do up buttons. Call emergency services straight away. These can be signs of pressure on the spinal cord in the neck.
Get help today
- Same day: hands that have slowly become clumsy, for example trouble doing up buttons or dropping things, or numbness in both hands. Get medical advice the same day. These can be signs of pressure on the spinal cord in the neck (cervical myelopathy). If the clumsiness or numbness gets worse quickly, call emergency services straight away.
- Same day: pain or tingling in both arms at the same time, rather than in one. Get medical advice the same day. This can also be a sign of pressure on the spinal cord in the neck.
- Same day: an arm or hand that is getting weaker. Get medical advice the same day.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: severe pain that comes on suddenly or is getting worse quickly. Get medical advice the same day.
- Same day: pain that is worse at night, or does not ease at all when you rest. If you are being treated for cancer now, contact your cancer team the same day.
- Same day: pain that is worse at night, or does not ease at all when you rest. If you have had cancer, now or in the past, or you have lost weight without trying, get medical advice the same day.
Book an appointment
- Within a few days: pain that is worse at night, or does not ease at all when you rest. See your doctor within a few days.
Common questions
How high should my monitor be?
The usual advice is to have the top line of text at or a little below eye level, with the screen straight in front of you rather than off to one side. OSHA in the US puts the comfortable viewing distance at 20 to 40 inches (50 to 100 cm) from your eyes, and Safe Work Australia's workstation guide says about one arm's length. If you wear glasses with a reading section at the bottom (bifocals or varifocals), you may need the screen lower still so you are not tipping your head back to read it. Treat these as starting points and adjust until you can read the screen without leaning in.
How do I set up a laptop to work from home?
For anything longer than a short session, separate the screen from the keyboard. Put the laptop on a stand, a box or a stack of books so the screen comes up toward eye level, and use a plug-in or wireless keyboard and mouse on the table in front of you. UK and Canadian government guidance both advise a separate keyboard and mouse, or a docking station, when a laptop is used for long spells. If you have no extra kit yet, take more frequent breaks and switch between tasks so you are not hunched over the laptop for hours at a time.
Do I need a lumbar support or a footrest?
A footrest, or anything firm to rest your feet on, is useful if raising the chair to suit the desk leaves your feet dangling; a box, a sturdy step or a stack of books does the job. Back support is a matter of comfort. A rolled towel or small cushion behind your lower back makes a long sit easier for some people, but there is no good evidence that a lumbar support prevents back pain, so do not buy one expecting it to. If you already have a sore back, our page on back pain when sitting covers what helps.
Can I work from the sofa or the kitchen table?
For short spells, yes, as long as you keep changing position. The problem with the sofa is that it tips you back and pushes your head forward to see a laptop on your knees, and most people end up curled in that shape for far longer than they planned. A kitchen table can work well with a few changes: a cushion to bring you up so your elbows sit at about the height of the keyboard, something under your feet if they no longer reach the floor, and the laptop raised on books with a separate keyboard. If the space is shared, pack it all away when you finish work, and setting it up properly becomes part of your morning.
References
- Occupational Safety and Health Administration. Computer workstations eTool: workstation components (monitors, keyboards, chairs) and good working positions. https://www.osha.gov/etools/computer-workstations
- Health and Safety Executive. Work routine and breaks: display screen equipment (DSE). https://www.hse.gov.uk/msd/dse/work-routine.htm
- Health and Safety Executive. Working with display screen equipment (DSE) at home. https://www.hse.gov.uk/msd/dse/home-working.htm
- Safe Work Australia. Working from home: WHS duties. https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/working-home/whs-duties
- Government of Canada, Environment and Climate Change Canada. Home office ergonomics: your prolonged remote work from home guide. 8 April 2020. https://www.canada.ca/content/dam/eccc/documents/pdf/corporate-info/covid-19/2020-04-08_Ergo_TeleworkTips_E.pdf
- Safe Work Australia. Setting up your workstation (infographic). July 2023. https://www.safeworkaustralia.gov.au/sites/default/files/2023-07/workstation-set-up_infographic_july2023.pdf
- Hoe VCW, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database of Systematic Reviews. 2018;(10):CD008570. https://doi.org/10.1002/14651858.CD008570.pub3
- van Duijvenbode IC, Jellema P, van Poppel MN, van Tulder MW. Lumbar supports for prevention and treatment of low back pain. Cochrane Database of Systematic Reviews. 2008;(2):CD001823. https://doi.org/10.1002/14651858.CD001823.pub3
- NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/
- NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-16.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.