how physiotherapists help patients with injuries working at home

Britain's shift to remote work has created a musculoskeletal health crisis affecting over half a million workers annually, and physiotherapy offers the most effective evidence-based treatment pathway. According to the Health and Safety Executive's 2024/25 statistics, 511,000 workers currently suffer from work-related musculoskeletal disorders (MSDs), with upper limb and neck conditions increasing as a proportion of all cases—a direct result of poor home workstation setups. CK Physiotherapy in West London provides expert assessment and treatment for remote workers experiencing back pain, neck strain, and repetitive strain injuries, using the multimodal approaches recommended by NICE clinical guidelines.

How Serious Is Britain's WFH Injury Problem?

The scale of work-related musculoskeletal disorders in Great Britain represents a significant occupational health challenge. HSE statistics for 2024/25 reveal that MSDs account for 27% of all work-related ill health, resulting in 7.1 million working days lost annually—an average of 14 days per affected worker. The financial burden falls heavily on individuals, who bear £13.4 billion of the total £22.9 billion cost.

The anatomical breakdown of these injuries demonstrates the impact of desk-based work. Back problems account for 43% of all work-related MSDs, affecting approximately 221,000 workers. Upper limb and neck conditions make up 41%—and critically, this figure has increased from 37% the previous year, signalling the growing impact of sedentary computer work on the remote workforce.

For the NHS, musculoskeletal conditions represent an enormous demand on resources. These conditions cost the health service approximately £5 billion annually and account for up to 30% of all GP consultations in England. Over 20 million people in the UK live with an MSK condition, with 18.4% of adults self-reporting long-term musculoskeletal problems according to government health profiles.

Why Hybrid and Remote Working Increases Injury Risk

The post-pandemic working landscape has fundamentally changed. Office for National Statistics data from late 2024 shows that 14% of UK workers are fully remote while 26% work hybrid, combining home and office attendance. This 40% total represents a dramatic shift from pre-pandemic levels when only 4.7% worked from home regularly.

The distribution of remote work is uneven across sectors and demographics. Information and Communication leads with 49% hybrid working, followed by Professional, Scientific and Technical activities at 42%. Workers earning £50,000 or more are nearly six times more likely to work hybrid (45%) than those earning under £20,000 (8%). Those with degrees are ten times more likely to hybrid work than those without qualifications—meaning West London's professional population is particularly affected.

Research increasingly links these working patterns to musculoskeletal problems. A 2023 systematic review published in peer-reviewed journals found that four out of five studies reported increased MSD risk in teleworkers and hybrid workers. The most commonly reported conditions were non-specific low back pain, cervical (neck) pain, and shoulder pain. A 2025 study of computer workers found that remote working showed a trend of increasing pain compared to office-only work, with longer remote hours and poorer workstation setups increasing risks.

The reasons are clear: up to 61% of workers transitioning to telework experience aggravated musculoskeletal pain. Key risk factors include makeshift workstations (kitchen tables, sofas, inadequate chairs), increased working hours with fewer breaks, reduced physical activity, and psychological stress from isolation. At CK Physiotherapy, we see these patterns daily in patients presenting with WFH-related pain at our West London clinic.

What Does Clinical Evidence Say About Effective Treatment?

NICE guideline NG59 for low back pain and sciatica provides the gold-standard treatment framework used by NHS practitioners and private physiotherapists across the UK. The evidence clearly favours active approaches over passive interventions, which is why CK Physiotherapy's treatment plans focus on getting patients moving rather than relying solely on hands-on therapy.

Exercise Therapy: The Strongest Evidence

Exercise therapy receives the strongest recommendation with moderate-to-high certainty evidence. NICE recommends group exercise programmes incorporating biomechanical, aerobic, mind-body or combination approaches, tailored to individual needs and preferences. A 2024-2025 network meta-analysis confirmed that all exercise types are more effective than minimal treatment, with no single approach demonstrating clear superiority. This means CK Physiotherapy's chartered physiotherapists can match exercise prescription to patient preferences without compromising outcomes.

Manual Therapy: Effective When Combined With Exercise

Manual therapy receives conditional support but only as part of a treatment package including exercise with or without psychological therapy. Systematic reviews from 2018-2025 show manipulation and mobilisation likely reduce pain and improve function for chronic low back pain compared to other active therapies. However, the critical caveat is that manual therapy alone is not recommended—it must be combined with exercise and potentially cognitive behavioural approaches for optimal outcomes.

Treatments That Evidence Does Not Support

NICE guidelines also identify treatments that should not be routinely offered for low back pain:

• Acupuncture for back pain
• Ultrasound therapy
• TENS (transcutaneous electrical nerve stimulation) as a standalone treatment
• Interferential therapy
• Traction
• Belts, corsets or foot orthotics for back pain

For neck pain specifically, European guideline consensus recommends reassurance and education, manual therapy (mobilisation/manipulation), and referral for exercise programmes. Dry needling, low-level laser, electrotherapy, ultrasound, traction and prolonged cervical collar use are not recommended for routine neck pain management.

Practical Home Workstation Setup: What the Regulations Require

The Health and Safety (Display Screen Equipment) Regulations 1992 apply to home workers using DSE daily for continuous periods of one hour or more. Employers must conduct workstation assessments, reduce identified risks, provide training, and plan work to include breaks or activity changes. Understanding proper setup is the first step—but as noted above, it must be combined with movement and exercise.

Monitor and Screen Position

Your screen should be positioned at approximately arm's length (40-75cm) from your face, with the top of the screen at eye level. For dual monitors, position the main monitor directly ahead, or if using both equally, centre the gap between screens to your nose. For laptops used exceeding one hour, HSE regulations require a separate keyboard and raised screen—a laptop riser or stand is essential for home workers.

Chair and Seating Setup

Your seat height should be adjusted so elbows are horizontal with the keyboard and thighs parallel to the floor. There should be a 2-3cm gap between the front of the seat and the back of your knees. Full back contact with the backrest is essential, with lumbar support maintaining the spine's natural S-curve. Feet should be flat on the floor or on a footrest—dangling feet place additional strain on the lower back.

Keyboard and Mouse Placement

Position both keyboard and mouse on the same surface, close enough to maintain elbows at approximately a 90-degree angle. The keyboard should sit 10-15cm from the desk edge with wrists straight and floating—not resting on the desk or a wrist rest while typing. This positioning helps prevent the repetitive strain injuries that our physiotherapists treat regularly at CK Physiotherapy.

Break Frequency: The Most Important Factor

HSE guidance emphasises that short, frequent breaks are better than longer, infrequent ones. Evidence-based recommendations suggest micro-breaks every 10-20 minutes (hands off keyboard, posture correction), regular breaks every 30-60 minutes lasting 5-10 minutes (standing, walking, stretching), and the 20-20-20 rule for eyes (every 20 minutes, look at something 20 feet away for 20 seconds). The Chartered Society of Physiotherapy recommends specific desk exercises including chest stretches for rounded shoulders, quadriceps stretches for hip flexor tightness, and gentle neck rolls held for 10-15 seconds.

Simple Desk Exercises Recommended by Physiotherapists

The Chartered Society of Physiotherapy recommends incorporating these movements throughout your working day. While these can help prevent problems, if you're already experiencing pain, a personalised physiotherapy assessment will identify the specific exercises most beneficial for your condition.

Source: Chartered Society of Physiotherapy desk-based exercise recommendations

When Should You See a Physiotherapist for WFH Pain?

While minor aches may resolve with improved workstation setup and regular movement, certain symptoms warrant professional assessment from a chartered physiotherapist. At CK Physiotherapy, we recommend seeking treatment if you experience:

• Persistent pain lasting more than two weeks despite self-management
• Numbness, tingling or weakness in your arms, hands or fingers
• Pain that disturbs sleep or worsens at night
• Headaches associated with neck stiffness or tension
• Difficulty performing work tasks due to pain or restricted movement
• Symptoms of carpal tunnel syndrome including wrist pain and hand weakness

For carpal tunnel syndrome specifically, NICE guidance recommends night splinting in a neutral wrist position for mild-to-moderate cases, alongside activity modification and ergonomic workplace assessment. Referral for surgical decompression is indicated when symptoms are severe or constant, there's progressive motor or sensory deficit, no improvement after three months of conservative treatment, or thenar muscle wasting is present. CK Physiotherapy can provide initial assessment and conservative treatment, referring onwards when surgical intervention is indicated.

What to Expect From Physiotherapy Treatment for WFH Injuries

At CK Physiotherapy, treatment for work-from-home related musculoskeletal problems follows the evidence-based multimodal approach recommended by NICE guidelines. This typically combines several elements tailored to your specific condition and needs.

Initial assessment involves a thorough evaluation of your symptoms, work setup, movement patterns and lifestyle factors. Your physiotherapist will conduct physical tests to identify the specific structures involved and any contributing factors. This allows us to create a personalised treatment plan rather than a one-size-fits-all approach.

Exercise prescription forms the cornerstone of treatment, as this has the strongest evidence base for musculoskeletal conditions. You'll receive a tailored programme of strengthening and mobility exercises designed to address your specific weaknesses and imbalances. These exercises can typically be performed at home around your work schedule.

Manual therapy techniques including joint mobilisation and soft tissue work may be used alongside exercise to reduce pain and improve movement. As noted in NICE guidelines, these hands-on techniques are most effective when combined with active rehabilitation rather than used in isolation.

Education and self-management ensures you understand your condition and how to prevent recurrence. This includes workstation optimisation advice, movement habits throughout the working day, and strategies to maintain the improvements achieved through treatment. CK Physiotherapy's goal is to help you manage your condition independently—not create dependency on ongoing treatment.

Frequently Asked Questions

The Growing Need for Physiotherapy in the Hybrid Working Era

The convergence of sustained hybrid working patterns and rising upper limb and neck conditions creates unprecedented demand for evidence-based physiotherapy services. With 173,000 new MSD cases annually and upper limb disorders increasing as a proportion of all work-related musculoskeletal problems, physiotherapists are uniquely positioned to deliver the multimodal interventions that clinical guidelines support.

The key clinical takeaways from current evidence are clear: exercise therapy remains the gold-standard intervention with the strongest evidence base; manual therapy is effective only when combined with exercise; standalone ergonomic advice without prescribed exercise shows limited benefit; and early intervention through physiotherapy can reduce the substantial working days lost to musculoskeletal conditions.

For West London's professional workforce—among the most likely to work hybrid given the demographics of the area—these statistics represent both a health challenge and an opportunity for proactive prevention. CK Physiotherapy provides expert assessment and treatment for remote workers experiencing pain, helping patients return to comfortable, productive work as quickly as possible. If you're experiencing persistent symptoms from your home working setup, contact us to discuss how physiotherapy can help.

References and Sources

1. Health and Safety Executive (2025). Key figures for Great Britain 2024 to 2025. https://www.hse.gov.uk/statistics/overview.htm
2. Office for National Statistics (2024). Who are the hybrid workers? November 2024. https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/whoarethehybridworkers/2024-11-11
3. National Institute for Health and Care Excellence (2020). Low back pain and sciatica in over 16s: assessment and management [NG59]. https://www.nice.org.uk/guidance/ng59
4. Health and Safety Executive (2025). Home working: guidance on display screen equipment. https://www.hse.gov.uk/msd/dse/home-working.htm
5. Chartered Society of Physiotherapy (2025). Desk-based exercises. https://www.csp.org.uk/public-patient/keeping-active-healthy/staying-healthy-work/desk-based-exercises
6. Tavares AI et al. (2023). Musculoskeletal disorders in teleworkers: a systematic review. International Journal of Environmental Research and Public Health. https://pubmed.ncbi.nlm.nih.gov/36981881/
7. Health and Safety Executive (2025). Costs to Great Britain of work-related ill health and injury. https://www.hse.gov.uk/statistics/cost.htm

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