Movement is The Way Out of Pain: A Neuro PT's Guide to Pain, Stress & Movement at Work

Most of us don't think about work as something our bodies have to learn.

We sit in the same chair. We work at the same desk. We repeat the same movements—and often, the same positions—for hours at time.

But our bodies are constantly learning from what we do.

The nervous system takes in information from the world around us, responds to stress, interprets signals from the body, and helps shape the movement patterns we repeat. Over time, those repeated patterns can become habits. And those habits can influence how we feel.

So what happens when pain, stress, and movement patterns become part of the way we work?

We recently sat down with Dr. Mercia Martin, Doctor of Physical Therapy specializing in neurology based in Houston, Texas. With a focus on neurological rehabilitation and movement, Mercia joined us to explore what happens beyond muscles and joints when we experience discomfort at work. She shared her insights on how the nervous system influences the way we experience pain, why stress can change the way we move, and why regular movement may matter more than trying to hold ourselves in one “correct” position.

Continue reading to learn how understanding your nervous system can help you ease work-related tension.

 
Understanding Neuro PT

Q1: Most of us are familiar with standard physical therapy for a tight back or a stiff neck. But as a Neuro PT, your focus is on a completely different system. Could you introduce what you do and the types of patients you see in your practice?

Mercia: I work in an outpatient clinic where we see a wide variety of patients. When most people think of physical therapy, they picture orthopedic care—treating knee pain, post-surgery recovery, or common desk-worker aches. However, my specialty is neurological physical therapy. I treat patients who have congenital or acquired neurological injuries, such as strokes or spinal cord injuries. Unlike a localized joint issue, these conditions disrupt the nervous system's ability to communicate with the body, resulting in a spectrum of mobility deficits—ranging from reduced movement to complete paralysis. Beyond this clinical care, I also serve as an outreach coordinator, providing community health education and connecting people with local resources.

The Nervous System & Pain

Q2. When desk workers experience pain, tightness, or tingling, what might we miss if we only look at the muscles and joints?

Mercia: The biggest missing piece when we only look at muscles and joints is the nervous system, meaning your brain, spinal cord, and peripheral nerves. Ultimately, the brain is what interprets a signal as pain. For example, if you cut your finger while sitting calmly at your desk, you’ll feel it immediately. But if you were running away from a bear in the forest, your brain might ignore that same injury entirely because it's prioritizing survival.

Beyond the brain, our nerves themselves are also physical tissues that have length. When we feel tightness, our first instinct is to stretch the muscle. But nerves need care, too. The difference is that instead of a traditional muscle stretch, dealing with nerve tension often requires specific movements like nerve gliders.

What's going on with us psychologically actually affects our perception of pain; not only in the moment, but it also dictates our likelihood of developing chronic pain in the future. If someone is carrying a heavy psychological load, such as mental stress or past trauma, they are far more likely to experience amplified pain compared to someone facing the exact same physical injury without that mental burden.

(Note: Want to go deeper? Modern pain science has explored why pain isn't always a direct reflection of tissue damage. See ‘Moseley & Butler, Fifteen Years of Explaining Pain: The Past, Present, and Future’ in the references below.
https://www.sciencedirect.com/science/article/pii/S1526590015006823)

Why Pain Feels Different for Everyone

Q3: Why can two people with very similar desk setups and postures experience completely different levels of discomfort?

Mercia: No two people are ever exactly alike. Even with the exact same desk setup and posture, individual differences in height mean that everyone interacts with their workspace differently. Beyond those physical variations, we also have hidden variables, like undiagnosed scoliosis or lingering past injuries. But on top of all that, psychological state is a massive factor. And it’s not just about how much stress you're under; it's about your stress-coping mechanisms. Two people can face the exact same high-stress environment, but someone with strong coping tools will experience far less pain than someone who lacks them.

There is no single “perfect” setup that works for everybody. What feels comfortable can change depending on the person，and even depending on the day.

Q4: A natural follow-up is: sometimes with my chronic hip pain, it’s so hard to find a pattern, one day I feel totally fine, and the other I feel completely off. Why does that happen? How do I know if it’s the muscle or the nerve?

Mercia: Symptoms can definitely change day-to-day depending on the origin of the pain. As a general rule of thumb, purely musculoskeletal pain—caused solely by muscles or bones—usually has a clear, predictable pattern, like aching after sitting for a certain amount of time and instantly feeling better when you stand up. In contrast, pain that involves a nervous system component tends to have much more irregularity and unpredictability.
 

When Stress Changes How We Move

Q4: Why do we tend to tense up, clench our jaws, or lean to one side when we're stressed or focused?

Mercia: The best thing we can do for it is to be aware that it's happening. To combat it, try to actively seek movements out of your default position. If you notice your body tending to favor one side, consciously spend time rotating or moving the other way. While our bodies naturally have a preferred side and aren't perfectly symmetrical, significant strength imbalances associated with pain are worth addressing through targeted strengthening. 
However, modern research shows that regular movement is often even more powerful for managing pain than simply trying to fix asymmetry, as movement itself teaches your body out of pain.

The Myth of Perfect Posture

Q5: Do we really need to find and maintain the “perfect” posture?

Mercia: As physical therapists, we love to say that the best posture is always your next one. While things like ideal spinal curvature or lumbar rolls can be helpful, any position—even if it looks “perfect” on paper—will eventually hurt if you sustain it for too long. The goal isn't to hold your body in one ideal position. It's to keep changing positions and moving throughout the day. A supportive workspace should make those changes easier, rather than keeping you fixed in one posture.

 
Why Floor Sitting Is Different

Q6: What happens when we move from a traditional chair to the floor?

Mercia: I enjoy sitting on the floor, too. Sitting on a firm, hard surface gives you a lot of proprioception, which is basically awareness of where your body is in space.

When you're sitting in a chair, it's mostly your bottom that's in contact with the chair. When you're sitting on the floor, more of your body is in contact with the ground--your legs, for example—so you're getting more feedback from the surface underneath you.

Floor sitting is also more challenging for your muscles because you have less support. You have to engage your trunk muscles a little bit more.

And when I say “core,” I mean it in a 360-degree sense. It's your abdominals in the front and your back extensors in the back. You're using your trunk muscles a little bit more because you don't have as much support.

Another thing I like about sitting on the floor is that you're more likely to move.
You're more likely to adjust your position, move your legs, or shift around. And because we know that the body lacks variety, that's another reason why sitting on the floor can be beneficial.

It can also act as a little psychological break.

From a nervous system standpoint, you're getting a lot of information from the receptors in your body. Your nerves are kind of like the highway carrying that information to your brain, so you're constantly giving your brain more information about where your body is and what's happening.

Of course, it needs to be comfortable enough for you. If you're uncomfortable on the floor, you're just going to focus on the fact that you're uncomfortable.

Q7: If a stress response or movement pattern becomes a habit, can we actually teach our bodies to move differently?

Mercia: Absolutely. Our bodies are extremely adaptable, and that's both a blessing and a curse.
We're really good at learning new things. If we have a tendency to move one way, clench our jaw, or hold tension in one area of our body, and we keep doing that over time, eventually, that becomes our default system. It's what we resort to every time we're stressed.
The first step is always bringing awareness to it.
But what's great is that the same way our body can adapt and learn these patterns, we can teach our body something new. We can unlearn the same things that we just learned.
That's done through motor learning—our bodies learning movement and movement preferences. And one of the key principles is repetition.
So if there's a movement pattern we want to change, we have to consciously give ourselves repeated opportunities to move away from that pattern and practice something different.
That's how we start fighting against the patterns we've learned.

Small Changes for Desk Workers

Q8: If you've been sitting for three hours, your neck is hurting, and you're feeling stressed, what's the first thing you would actually tell someone to do?

Mercia: The first thing I would say is, if it's possible, stand up.
For anybody who works primarily at a desk, I like to tell people to stand up about every hour. Depending on the work that you do, it may not always be doable, but if possible, set a little alarm and stand up for about two minutes. It makes a world of difference because you're forcing yourself to change out of the position you've been holding. Then try to move around. Walk around your office. Just move.
The next thing I would do is actively relax the areas where you tend to hold tension. Everybody is different, but a clenched jaw is a pretty common one. Try to lower your jaw and let it relax.
The shoulders are another common area. If you've been hiking your shoulders up, consciously lower them and do some shoulder circles to get some movement in there.
Neck circles are important, too—both clockwise and counterclockwise. You can also do a sustained stretch by bringing your neck into side flexion on both sides.
If something is causing a symptom, stay away from it.
And something I really like to teach people is vagal breathing, because it can help get you out of stress very quickly.
The vagus nerve is a cranial nerve that's involved in autonomic function and relaxation. One way we can tap into it is through breathing where the exhale is a little longer than the inhale.
So after you've stood up, moved around, done your shoulder circles, neck circles, and a little stretching, sit down. Inhale through your nose for 3 seconds, and then exhale through your mouth for 4 seconds.
Run through about four cycles of that. The key part is that your exhale is just slightly longer than your inhale. That should help you relax your body.

A Neuro PT's Everyday Desk Essentials

Q9: Are there any small tools or products you really enjoy or recommend for someone who spends eight hours a day working at a desk?

Mercia: I would definitely recommend a standing desk. Having the ability to stand at work makes a world of difference.
Ideally, you're taking a break to stand specifically for the purpose of standing and moving. But realistically, people have work to do. So if you're standing and working, at least you're standing.
The second thing I would recommend is getting on the floor.
You can use something simple like a yoga mat to get down on the floor and stretch. And if you have a desk that happens to let you get on the floor and stand, it's even better.
A lumbar roll can also be helpful if you tend to slouch and round forward. You don't even have to buy something—you can use a rolled-up towel in your low back. The caveat is that even if something puts you into a better “posture,” my recommendation is still going to be to try to get out of the chair and move.

It's less about having the perfect chair that hugs all of your spinal curves, and more about ditching the chair and just moving. 

 

The Takeaway: A Different Way to Understand Pain and Movement

Our conversation with Mercia sheds new light on how we perceive pain, and how we understand our bodies.
Pain isn't always a straightforward reflection of what's happening in our muscles or joints. Stress, the nervous system, movement habits, and the way we respond to them can all shape how we experience our bodies.
And perhaps more importantly, our bodies are adaptable. Movement isn't simply something we do; it's one of the ways our bodies learn.
That perspective changes how we think about a workday. Instead of focusing on holding the “right” posture, we can create more opportunities to move, shift, and check in with our bodies.
That's where the workspace matters. Ultimately, it's not about finding one perfect way to work. It's about understanding your body well enough to keep it moving.

 
Reference:
Moseley GL, Butler DS. Fifteen Years of Explaining Pain: The Past, Present, and Future. The Journal of Pain, 2015. Read the full article: https://www.sciencedirect.com/science/article/pii/S1526590015006823