Physiotherapy is often associated with ageing joints, sports injuries, accidents or post-surgery rehabilitation. But for a growing number of younger adults, the reason for seeing a physiotherapist can be much more ordinary: a stiff neck after a day at the laptop, persistent lower-back pain, shoulder discomfort or an injury after suddenly increasing workout intensity. For millennials and Gen Z, work and leisure increasingly revolve around screens. Long periods of computer use, mobile-phone use, commuting, sedentary entertainment and inconsistent exercise can mean that the body spends much of the day in relatively static positions.

At the same time, the other end of the spectrum can be equally problematic. People who are otherwise inactive during the week may suddenly undertake intense gym sessions, long runs or weekend sports without adequate conditioning or recovery.

"Physiotherapy is no longer just about older adults or major accidents. Many of my patients are younger and struggling with pain issues that are intimately related to the nature of their daily lives - how they work, how they exercise, how they use their technology," says Dr Dharam Pandey, Physiotherapy, ShardaCare - Healthcity.

The result is a generation discovering that being young does not necessarily mean being protected from musculoskeletal problems.

Why are young people experiencing more everyday aches and pains?

The modern working day can involve hours of uninterrupted computer use. Research has found associations between computer-related work, prolonged exposure and neck and upper-limb complaints, although the relationship is complex and cannot be reduced to one factor such as "bad posture".

A systematic review of office workers found that factors including low task variation, certain workstation characteristics and perceived muscular tension were associated with a higher risk of developing neck pain. 

Smartphones add another dimension. A recent systematic review and meta-analysis found an association between smartphone overuse and neck pain, although researchers noted that the relationship requires further study.

Dr Pandey says these lifestyle patterns can manifest as neck, back and shoulder pain, headaches, restricted movement and general stiffness. "Small aches may arise that, for being repeated and niggling, start impacting on productivity, sleep and leisure," he says.

India also has a substantial burden of musculoskeletal problems. Global Burden of Disease analyses have consistently identified low-back pain as a major contributor to disability. A 2021 analysis estimated that India had about 68.5 million prevalent low-back-pain cases among the working-age population, the highest absolute number reported among countries in that analysis. 

That does not mean all of these cases are caused by desk jobs or smartphones. But it underlines why preventing and managing musculoskeletal pain matters in India's working population.

It is not just sedentary young adults

There is another group increasingly seen with musculoskeletal complaints: the young, fitness-conscious adult who trains too hard, too quickly. "Other patients in this young age bracket are health and fitness conscious. The exercise regimens often involve rigorous training techniques, sudden intensification, new 'fads' or weekend warrior efforts that fail to adequately condition the body to the high levels of activity," Dr Pandey says.

Being young may allow the body to recover relatively quickly, but it does not eliminate the need for progressive training. "Although the individual is young, their musculoskeletal system still requires appropriate strength, endurance, flexibility and most importantly, recovery," he adds.

The problem is often the mismatch between what the body is conditioned to do and what it is suddenly being asked to do. Someone who spends five days largely inactive and then attempts an intense workout, long-distance run or competitive sport over the weekend may be placing considerably more stress on muscles, tendons and joints than they are prepared for.

What can physiotherapy actually do?

Physiotherapy is not simply about treating pain after an injury. "We look at faulty patterns of movement, assist in rectifying poor posture, build capacity through strength programs, help people to move more effectively," says Dr Pandey.

For younger adults, this can mean assessing how they move, identifying weaknesses or mobility limitations, improving strength and gradually building tolerance for work, exercise or sport.

Importantly, physiotherapy should not be viewed as a replacement for physical activity. The World Health Organization (WHO) recommends that adults aged 18-64 get at least 150-300 minutes of moderate-intensity aerobic physical activity a week, or 75-150 minutes of vigorous activity, along with muscle-strengthening activity involving major muscle groups on at least two days a week. WHO also recommends limiting sedentary time and replacing it with physical activity of any intensity where possible.

For office workers already experiencing neck pain, evidence also suggests that strengthening interventions can help. A systematic review and meta-analysis of 29 trials found that neck strengthening was among the workplace interventions associated with reductions in neck-pain scores.

When should you see a physiotherapist?

Not every ache requires professional treatment. Occasional stiffness after an unusually long day or workout may settle with movement, rest and recovery. But recurring pain that interferes with work, sleep, exercise or everyday activities should not simply be dismissed because of age.

Dr Pandey also cautions against self-treatment when symptoms are significant. "If an injury or pain is significant or has resulted in other debilitating symptoms (weakness, numbness, significant movement loss) it's important to seek medical advice and establish what has occurred before embarking on a program of physiotherapy or specific exercises," he says.

Young adults should particularly seek medical assessment after significant trauma or when pain is accompanied by neurological symptoms such as new weakness or numbness.

The idea that physiotherapy is something to consider only after an accident, surgery or with advancing age is increasingly outdated. For India's younger working population, the goal may be less about treating an already established disability and more about restoring movement, building physical capacity and preventing recurring pain from becoming a constant part of everyday life.

"The notion that 'youth confers some immunity against musculoskeletal issues' must be dispelled," says Dr Pandey. "Prolonged sitting, poorly aligned postures, lack of exercise or excessive workout levels take their toll on all of us, irrespective of age and physiology."

For millennials and Gen Z, physiotherapy may therefore be less about being "too young" for treatment and more about learning how to keep a modern, increasingly sedentary, and sometimes excessively active, lifestyle from taking a toll on the body.



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