Effectiveness of micro-exercises for managing neck/shoulder pain in sedentary workers: a systematic review and...

This systematic review and meta-analysis evaluated the effectiveness of micro-exercise interventions on neck/shoulder pain, neck disability, muscle activity, quality of life, and work-related outcomes among sedentary workers. PubMed, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) from inception to July 2025. Nineteen studies (n = 2732) met the inclusion criteria. A meta-analysis was conducted using Comprehensive Meta-Analysis software. Micro-exercises significantly reduced combined neck/shoulder pain (4 studies; g = -0.79, 95% CI -0.98 to -0.60; I² = 39%), neck pain (11 studies; g = -1.36, 95% CI -2.09 to -0.64; I² = 98%), shoulder pain (2 studies; g = -0.81, 95% CI -1.59 to -0.03; I² = 96%), right shoulder pain (3 studies; g = -1.72, 95% CI -2.90 to -0.55; I² = 98%) and left shoulder pain (3 studies; g = -1.83, 95% CI -3.05 to -0.62; I² = 98%). Improvements were also found in neck disability (4 studies; g = -0.45, 95% CI -0.73 to -0.17; I² = 29%) and overall quality of life (2 studies; g = -0.57, 95% CI -0.94 to -0.20; I² = 0%). Negative values indicate benefit favoring the intervention. No significant effects were found for muscle activity (2 studies). Work-related outcomes were mixed, as work disability (1 study) measured by Disabilities of the Arm, Shoulder and Hand (DASH) indicated significant reductions in two of three intervention groups in one study (- 4 points, 95% CI - 8 to - 1; p < 0.05 and - 7 points, 95% CI - 10 to - 3; p < 0.01), while work ability and absenteeism showed no significant change (each 1 study). The certainty of evidence ranged from moderate (for combined neck/shoulder pain and neck disability) to very low (for shoulder pain, muscle activity, and work-related outcomes) according to the certainty of evidence (GRADE) approach. Substantial heterogeneity and potential publication bias (Egger's p = 0.028; Begg's p < 0.001) suggest that the pooled estimates should be interpreted with caution. Micro-exercises appear beneficial for reducing neck/shoulder pain and improving function among sedentary workers, with effect sizes exceeding minimal clinically important difference thresholds for pain. However, the certainty of evidence is moderate to very low due to high heterogeneity and potential publication bias. Evidence for work-related outcomes is mixed as work disability measured by Disabilities of the Arm, Shoulder and Hand (DASH) presented significant improvements in two of three intervention groups in one study, suggesting a possible benefit; however, work ability and absenteeism did not show significant results. Larger, well-designed trials are needed to strengthen the evidence for both clinical and occupational outcomes.