What changes can be made to the workplace (ergonomic adaptations) to treat work-related complaints of the arm, neck or shoulder?

Key messages

• Ergonomic adaptations for people with complaints of the arm, neck, and shoulder (CANS) may have no benefit over no treatment or usual care for reducing pain or for improving function, recovery, quality of life or sick leave, measured up to three months after the adaptations. Findings are inconsistent for healthcare use. Ergonomic adaptations may improve quality of life compared to exercise.

• High-quality studies with a large number of people taking part are needed to understand the role of ergonomic interventions in managing CANS and to identify if this varies for different types of people.

What are work-related complaints of the arm, neck or shoulder?

Many people whose work involves repeated tasks, such as computer workers or manual labourers, develop pain in their arms, neck or shoulders due to repetitive movements, remaining in an awkward posture for a long time and external factors such as vibrating tools. Examples of these work-related complaints of the arm, neck and shoulder (CANS) are carpal tunnel syndrome in the wrist from frequent mouse-clicking, rotator cuff injury in the shoulder from repeated lifting, and more general aches and pains in the neck and upper limbs. CANS are common and have a considerable impact on individuals and society. They frequently result in lost working hours due to long-lasting sick leave.

How can they be managed or treated?

There are several ways in which CANS can be treated, such as taking frequent breaks or alternating tasks. Another way is to adapt the worker’s equipment and environment to ‘fit’ them better. This is called ‘ergonomics’. Ergonomic adaptations include:

• adjusting the height and layout of workstations;

• altering computer equipment and operator chairs; and

• educating people to change their behaviour where necessary, and be aware of their movements and posture.

What did we want to find out?

We wanted to know whether ergonomic adaptations in workplaces help people with work-related CANS. We were interested in whether they reduce pain and improve the ability to carry out tasks (function), and how they affect work-related measures like sickness absence, return to work, productivity loss at work and change of occupation.

What did we do?

We searched for studies that evaluated ergonomic adaptations in the workplace for adults with work-related CANS. People whose workplaces were not ergonomically adapted either received no treatment or a different treatment (for example, exercise).

We compared, analysed and summarised the results of the studies. We rated our confidence in the evidence, based on factors such as the number and quality of the studies.

What did we find?

We found 20 studies with 2478 people. Nine studies took place in Europe, six in North America, three in Asia and two in the Middle East. Sixteen studies included people with general pain in the neck, shoulder or hands and four included people with carpal tunnel syndrome and rotator cuff tendinitis. Thirteen studies included computer or office workers and seven included factory workers, sewing machine operators and slaughterhouse workers. Three studies included only women.

The studies compared ergonomic changes with:

• no treatment, placebo ('sham' treatment), being on a waiting list or usual care (12 studies);

• exercise (8 studies);

• another ergonomic change (6 studies); and

• active treatment such as customised glasses and supportive tape (2 studies).

Main results

The results below were measured up to three months after the intervention (short term).

Compared to no treatment or usual care, ergonomic changes for people with general work-related CANS:

• may make little to no difference to

  • pain (4 studies, 692 people); or

  • well-being (1 study, 68 people).

• probably make little to no difference in

  • functioning (1 study, 383 people); or

  • recovery (1 study, 386 people).

• probably makes little to no difference to sick leave (3 studies, 759 people) (sick leave was measured differently in one study of 98 people and the result was less certain).

• may reduce healthcare use or may make little to no difference to healthcare use depending on how healthcare use is measured.

Compared to exercise, ergonomic changes for people with general work-related CANS:

• probably make little to no difference to

  • recovery (1 study, 257 people); or

  • healthcare use (1 study, 217 people)

• may improve well-being (1 study, 61 people).

We do not know the effects of ergonomic changes compared to other active treatment for people with general work-related CANS or specific injuries on:

• pain (8 studies, 364 people); or

• functioning (3 studies, 180 people).

Compared to an ‘add-on’ treatment, we do not know the effects of ergonomic changes plus the same add-on treatment on pain (2 studies, 137 people).

What are the limitations of the evidence?

We are not sure about the findings of the review. Our confidence is affected by the:

• low number of studies;

• small number of study participants;

• poor quality of the studies;

• varied results across studies; and

• people taking part in the studies knowing what intervention they received, which may have affected how they judged their results.

How up to date is the evidence?

The evidence is current to 1 June 2026.