Is My Desk Posture Causing My Neck and Shoulder Pain?

Is My Desk Posture Causing My Neck and Shoulder Pain? A Physical Therapist Answers

By Nova Physical Therapy | North Hollywood, CA

Patient Question

“I spend most of my day working on a computer or laptop, and by the afternoon my neck and shoulders feel tight, stiff, or painful. Is my posture causing this? Do I need to sit perfectly straight all day, and can physical therapy help?”

The Short Answer

Your workstation, prolonged sitting, computer use, movement habits, sleep, physical capacity, and other individual factors may all influence neck and shoulder symptoms—but there is rarely one single posture that explains everyone's pain.

A 2026 study involving 1,777 frequent computer users found associations between neck pain and factors including working from home, sitting with the trunk somewhat forward, and sleep quality. Because the study was observational, however, it does not prove that any one posture directly caused the participants' pain. 

This distinction matters.

You do not necessarily need to hold your spine in one “perfect” position for eight hours.

Instead, an individualized approach may include:

• Changing positions periodically
• Adjusting the workstation when appropriate
• Building neck and shoulder muscle capacity
• Taking movement breaks
• Improving tolerance to desk work
• Addressing mobility limitations when present
• Gradually increasing physical activity

A major 2026 systematic review found that brief workplace exercises lasting approximately 2–20 minutes were associated with improvements in neck/shoulder pain and neck disability among sedentary workers, although researchers cautioned that the certainty of evidence was limited. 

The practical message is:

Your best posture may not be one perfect posture. It may be having several comfortable positions and the physical capacity to move between them.

Why Does My Neck Hurt After Working at a Computer?

Computer work often involves remaining relatively still for extended periods.

Your neck and shoulder muscles continuously perform low-level work while you:

• Look at the monitor
• Type
• Use a mouse
• Read
• Attend video meetings
• Look between multiple screens
• Use a phone

Even a position that initially feels comfortable can become uncomfortable after enough time.

This is one reason patients often tell us:

“I feel fine in the morning, but by 3:00 PM my neck is killing me.”

The issue may involve more than how the person looks while sitting.

Physical therapy may consider:

position + duration + movement + muscle performance + workload + recovery + individual factors.

Is “Tech Neck” a Medical Diagnosis?

“Tech neck” is a popular term used to describe neck discomfort associated with prolonged use of phones, tablets, computers, or other screens.

It is not a specific diagnosis that can be established simply by looking at someone's posture.

Someone who sits with their head forward may have no pain.

Someone with visually upright posture may have substantial neck pain.

Symptoms should therefore be evaluated individually rather than assuming:

forward head = damaged neck.

Physical therapists can evaluate movement and functional impairments within their professional scope, but California law does not authorize physical therapists to diagnose disease. 

Is Poor Posture Really Causing My Neck Pain?

Posture can be relevant, but the relationship is more complicated than many social-media posts suggest.

A 2026 cross-sectional study examined workers aged 18–65 who spent at least 75% of their working hours using a computer.

Among the 1,777 participants, researchers found that neck pain was associated with several factors, including:

• Working from home
• A somewhat forward-bent sitting posture
• Sleep quality
• Other individual characteristics

But association is not the same as causation.

The study cannot establish that sitting in one particular posture directly produced someone's neck pain.

A better question may be:

“Does this position become uncomfortable when I stay in it too long?”

Do I Need Perfect Posture?

Probably not.

Trying to maintain one rigid position all day can itself become uncomfortable.

Consider standing.

Standing upright for several minutes is easy.

Standing completely still in the same position for eight hours would be much harder.

Sitting is similar.

Rather than constantly worrying about whether your shoulders are exactly aligned or whether your head moved slightly forward, it may be more useful to:

• Find comfortable working positions
• Change positions periodically
• Move regularly
• Adjust equipment when needed
• Build physical capacity

Ergonomics should help make work easier—not make people afraid of normal movement.

Why Does My Neck Feel Tight?

People commonly describe their symptoms as:

• Tight
• Stiff
• Knotted
• Tense
• Heavy

Those descriptions are meaningful, but they do not necessarily tell us exactly what tissue is causing the symptoms.

A sensation of tightness does not automatically mean a muscle is physically shortened.

A physical therapist may assess:

• Cervical movement
• Shoulder movement
• Thoracic movement
• Muscle performance
• Functional tolerance
• Symptom response to movement

rather than assuming every sensation of tightness requires stretching.

Why Do My Upper Trapezius Muscles Feel Tight?

The upper trapezius helps control the shoulder girdle and contributes to movement of the neck and scapula.

During desk work, these muscles may perform prolonged low-level activity.

Some people respond by repeatedly stretching them.

Stretching may feel helpful for some patients, but if symptoms repeatedly return during prolonged work, the rehabilitation program may also need to consider:

• Strength
• Endurance
• Workstation demands
• Movement frequency
• Overall physical activity

Treating the sensation alone may not address all relevant contributors.

Can Looking Down at My Laptop Cause Neck Pain?

Laptop use can create practical ergonomic challenges because the screen and keyboard are physically connected.

If the keyboard is positioned comfortably for your hands, the screen may sit relatively low.

If the laptop is elevated to eye level, the keyboard may become uncomfortable to use.

For prolonged laptop work, some people may benefit from using:

• A laptop stand
• External keyboard
• External mouse
• External monitor

depending on the environment and individual needs.

Interestingly, a newly published 2026 analysis of U.S. Google search behavior found that public interest in workstation-related products—including adjustable desks, ergonomic chairs, monitor arms, desk risers, and footrests—increased during the work-from-home transition and frequently remained elevated afterward. 

This suggests that workstation ergonomics remains a significant public concern.

How High Should My Computer Monitor Be?

There is no single monitor position that perfectly fits every person's body, vision, prescription lenses, workstation, and job.

Generally, the goal is to allow comfortable viewing without repeatedly forcing the neck into an uncomfortable position.

Factors may include:

• Monitor height
• Viewing distance
• Screen size
• Multiple-monitor setup
• Eyewear
• Desk height
• Chair position

Someone using progressive lenses, for example, may position the head differently than someone who does not wear glasses.

Ergonomic recommendations should therefore be practical rather than rigid.

Should I Sit Completely Upright?

Not necessarily.

Your body can tolerate many sitting positions.

You may sit upright during one task, lean back during another, and move forward briefly while concentrating on something.

Variation is normal.

The problem is not necessarily that you ever move away from an idealized posture.

The more relevant issue may be whether one position is being maintained for too long or repeatedly provoking symptoms.

Should My Shoulders Always Be Pulled Back?

No.

Constantly squeezing the shoulder blades together is not a normal resting requirement.

Some patients become so concerned about posture that they spend the entire workday actively retracting their shoulders.

That creates continuous muscular effort.

Your shoulders should be allowed to move naturally.

Strengthening exercises may involve controlled scapular movement when clinically appropriate, but this is different from permanently holding the shoulders “back and down.”

Does Sitting Too Long Matter?

Prolonged sedentary behavior may matter for overall health and may also influence musculoskeletal comfort.

During desk work, the body experiences relatively little variation.

One practical strategy is to periodically change what you are doing.

For example:

sit → stand → walk briefly → return to sitting.

The goal is not to create another rigid rule such as:

“You must stand every 30 minutes exactly.”

The appropriate schedule depends on the person and job.

Are Standing Desks Better?

Standing desks can help some people vary their position.

But standing all day is not automatically superior to sitting all day.

A sit-to-stand workstation may be most useful when it gives the worker another position to choose from.

Think:

more options

rather than:

standing = good, sitting = bad.

What Are Micro-Exercises?

Micro-exercises are short periods of structured movement or exercise performed during the workday.

A major systematic review and meta-analysis published in Scientific Reports in June 2026 evaluated micro-exercise programs for sedentary workers.

The review included:

19 randomized controlled trials

and

2,732 participants.

Programs generally involved short exercise periods of approximately 2–20 minutes. 

The analysis found improvements favoring micro-exercise for:

• Combined neck/shoulder pain
• Neck pain
• Shoulder pain
• Neck-related disability
• Overall quality of life

However, the authors rated the certainty of most pain outcomes as low to very low because of issues including high heterogeneity, methodological limitations, and possible publication bias. 

That is important.

The research is promising, but it should not be marketed as proof that a two-minute exercise break will eliminate everyone's neck pain.

What Could a Desk Movement Break Look Like?

Depending on the individual, a brief movement break might simply involve:

• Standing up
• Walking
• Changing position
• Gentle neck movement
• Shoulder movement
• A few appropriately selected exercises

The point is not to perform a complicated rehabilitation routine every hour.

It may simply be to interrupt prolonged static work.

For someone already experiencing significant neck symptoms, a physical therapist can determine whether more specific exercise is appropriate.

Should I Stretch My Neck Every Day?

Stretching may be appropriate when clinically relevant mobility limitations are present.

But more stretching is not automatically better.

Someone with normal or excessive mobility may not need aggressive stretching.

Another patient may benefit more from:

• Strengthening
• Endurance exercise
• Movement breaks
• Workstation changes
• General exercise

An examination helps determine the appropriate emphasis.

Does Strengthening Help Desk-Related Neck Pain?

It may.

Exercise research in office workers has repeatedly supported strengthening and endurance approaches for symptomatic neck pain.

A systematic review of workplace interventions found moderate-quality evidence supporting neck/shoulder strengthening and general fitness exercise for symptomatic office workers, with larger effects reported for targeted strengthening. 

A separate systematic review and meta-analysis of office workers with chronic neck pain found reductions in pain and disability following strengthening programs in several included randomized trials. 

Strengthening might involve muscles associated with:

• Neck control
• Shoulder girdle function
• Upper back
• Upper extremities

depending on examination findings.

Why Would Strengthening Help If My Muscles Already Feel Tight?

A muscle can feel tight and still have limited endurance or capacity.

This surprises many patients.

Feeling tight does not necessarily mean the solution is to make the muscle longer.

Imagine holding a light grocery bag for a long time.

Eventually your arm may feel:

• Tired
• Tight
• Achy
• Heavy

That does not necessarily mean the arm requires stretching.

It may simply have been working for longer than it comfortably tolerates.

Desk work can similarly involve long periods of low-level muscular activity.

Should I Buy a Posture Corrector?

A posture corrector is not automatically necessary for neck pain.

The growing popularity of ergonomic and self-management products is noteworthy. The August 2026 Google Trends analysis found persistent public interest in workstation equipment and recovery products, while interest in posture correctors actually declined compared with some other ergonomic searches. 

An external device cannot replace:

• Movement
• Physical capacity
• Appropriate exercise
• Workstation adjustment when needed
• Individual assessment

Some people may find temporary external cues useful, but patients should be cautious about products claiming to permanently “fix posture.”

What About Massage Guns?

Massage guns have become increasingly popular.

The 2026 Google Trends study specifically identified increasing public search interest in massage guns as a self-management product. 

Temporary symptom relief does not necessarily mean the underlying functional limitation has been addressed.

Passive tools may sometimes complement care, but rehabilitation should generally emphasize the patient's ability to move, exercise, and function independently.

Can Stress Affect Neck Pain?

Pain is influenced by more than biomechanics.

Stress can affect:

• Muscle tension
• Sleep
• Activity
• Recovery
• Pain perception

This does not mean neck pain is “just stress.”

It means that persistent pain is often influenced by several interacting factors.

Physical therapy can address appropriate movement and functional limitations while other health concerns are managed by the appropriate professionals.

Can Poor Sleep Affect Neck Pain?

Potentially.

The 2026 study of 1,777 frequent computer users found an association between sleep quality and neck pain. 

Again, this does not prove that poor sleep directly causes neck pain.

But sleep may be one relevant factor in the broader clinical picture.

Physical therapists should remain within scope when discussing sleep and refer patients appropriately when significant sleep-related health concerns require further evaluation.

Why Does My Neck Pain Cause Headaches?

Some headache presentations can involve the cervical region, but a headache should not automatically be labeled as coming from the neck.

Headaches have many potential causes.

A condition known as cervicogenic headache is associated with the cervical region, but proper clinical and medical assessment is important.

A 2026 systematic review and network meta-analysis of randomized controlled trials found that multimodal non-pharmacological approaches involving manual therapy and exercise showed benefits for adults diagnosed with cervicogenic headache. 

However, a new or unusual headache—especially one accompanied by neurological or other concerning symptoms—requires appropriate medical evaluation.

Can Physical Therapy Help?

Yes, when neck and shoulder symptoms and associated movement or functional limitations are appropriate for physical therapy.

Treatment may include:

• Therapeutic exercise
• Progressive strengthening
• Endurance exercise
• Mobility exercise when indicated
• Movement breaks
• Ergonomic education
• Workstation modification
• Functional training
• Manual therapy when appropriate
• Home exercise
• Education about activity and symptom management

The goal is not to force everyone into the same posture.

A better goal may be to help the patient develop:

more movement options + greater physical capacity + improved work tolerance.

For someone who works eight hours per day on a computer, rehabilitation should eventually prepare the body for the actual demands of that work.

What Does Research Say?

Several 2026 publications make this an especially useful topic right now.

June 2026 Micro-Exercise Meta-Analysis

Yaghoubitajani and colleagues published a systematic review and meta-analysis in Scientific Reports examining micro-exercise interventions for sedentary workers.

The researchers included:

19 randomized controlled trials

2,732 participants

and brief exercise programs generally lasting 2–20 minutes.

Micro-exercises were associated with improvements in neck/shoulder pain, neck pain, shoulder pain, neck disability, and quality of life. 

Importantly, the authors explicitly cautioned that certainty for most pain outcomes was low or very low.

That means the results are encouraging but should not be exaggerated.

August 2026 Computer-Worker Study

Snodgrass and colleagues studied 1,777 workers aged 18–65 who frequently used computers.

Neck pain was associated with working from home, certain reported sitting positions, and sleep quality, among other variables. 

Because the study was cross-sectional, these findings identify relationships rather than proving direct cause and effect.

August 2026 Google Trends Study

A newly published study analyzed U.S. Google search activity from March 2018 through March 2025 for 23 ergonomics and recovery-related terms.

Search interest increased for products such as:

• Standing desks
• Adjustable desks
• Ergonomic chairs
• Monitor arms
• Desk risers
• Footrests

and much of that increased interest persisted after the initial pandemic-related transition to remote work. 

This is particularly relevant for SEO because it demonstrates sustained public interest in workstation ergonomics and musculoskeletal self-management rather than relying on anecdotal assumptions about search behavior.

2026 Ergonomic Intervention Study

A March 2026 study of 66 office workers with mild-to-moderate neck disability used ergonomic risk assessment to guide targeted interventions involving ergonomic counseling, practical workstation modification, and postural exercises.

Participants demonstrated improvements over four weeks in pain, disability, and ergonomic-risk measures. 

Because this was a relatively small study, it should complement rather than replace the larger evidence base.

Established Exercise Evidence

Previous systematic reviews have also supported strengthening and endurance exercise for symptomatic office workers with neck pain. 

Taken together, current evidence supports a practical message:

Neck pain during desk work is probably better addressed through movement, appropriate exercise, work-tolerance strategies, and individualized ergonomics than through fear of imperfect posture.

Why Is This Topic Especially Relevant Right Now?

This topic is particularly timely because of a study published online August 21, 2026 specifically examining Google Trends data for ergonomics and musculoskeletal self-management.

The researchers found that search interest in workstation-related ergonomic products increased substantially during the shift toward remote and hybrid work and often remained elevated afterward. 

At the same time, multiple 2026 studies have specifically examined:

• Neck pain in computer workers
• Working from home
• Sitting posture
• Ergonomic interventions
• Micro-exercises
• Exercise for sedentary workers

That makes questions such as:

“Is my posture causing my neck pain?”

“How should I sit if my neck hurts?”

“Are standing desks better for neck pain?”

“Do I need a posture corrector?”

and

“What exercises help neck pain from computer work?”

particularly useful for patients in North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, Van Nuys, Sherman Oaks, and greater Los Angeles.

What Happens During a Physical Therapy Evaluation?

At Nova Physical Therapy, an evaluation for neck and shoulder symptoms associated with desk or computer work may include, when appropriate:

• Symptom history
• Medical history
• Work demands
• Computer-use duration
• Home versus office workstation
• Activities that increase or decrease symptoms
• Cervical movement
• Shoulder movement
• Thoracic movement
• Muscle performance
• Neurological screening when appropriate
• Functional movement
• Work tolerance
• Patient goals

The physical therapist may also discuss the patient's workstation and typical workday.

The goal is not simply to take a photograph of someone's sitting posture and declare it “bad.”

The evaluation considers how the person:

moves, works, tolerates activity, responds to loading, and functions.

California Business and Professions Code §2620 defines physical therapy to include physical or corrective rehabilitation, physical therapy evaluation, treatment planning, instruction, consultative services, exercise, and promotion and maintenance of movement-related health and wellness. 

Physical therapists remain within their professional scope and refer patients for additional medical evaluation when the presentation indicates that it is appropriate.

When Should You Seek Medical Attention?

Most desk-related neck discomfort is not an emergency, but neck pain can have many causes.

Seek appropriate medical evaluation for symptoms such as:

• Significant recent trauma
• New or progressive arm or hand weakness
• Significant or progressive numbness
• New difficulty walking
• New significant loss of coordination
• Sudden severe headache
• New facial weakness
• New difficulty speaking
• Significant unexplained dizziness
• Fever associated with severe neck symptoms
• Loss of consciousness
• Chest pain
• Severe shortness of breath
• Severe or rapidly worsening unexplained symptoms

Medical evaluation may also be appropriate when symptoms are persistent, progressively worsening, or not behaving as expected.

Do not assume that every case of neck pain occurring during computer work is simply caused by posture.

Why Patients Choose Nova Physical Therapy

At Nova Physical Therapy, our mission is simple:

We Care.

Neck pain can affect much more than the ability to turn your head.

It can make it difficult to:

• Work
• Concentrate
• Drive
• Exercise
• Sleep comfortably
• Use a computer
• Participate in everyday activities

Our goal is not to make patients afraid of sitting, phones, laptops, or normal posture variation.

We want to understand:

What does your neck need to tolerate during your real day?

Our rehabilitation philosophy emphasizes:

• Evidence-based care
• Individualized treatment
• Progressive strengthening
• Mobility when indicated
• Functional movement
• Work-specific rehabilitation
• Practical ergonomic education
• Appropriate movement breaks
• Patient education
• Building long-term physical capacity

Instead of chasing a single “perfect posture,” we focus on helping patients develop the movement options and physical capacity needed for everyday life.

Frequently Asked Questions

Is poor posture causing my neck pain?

Posture may be one relevant factor, but neck pain is multifactorial. A 2026 study found associations between neck pain, working from home, certain sitting positions, sleep, and other factors, but it did not establish that posture alone causes neck pain. 

What is tech neck?

“Tech neck” is an informal term commonly used for neck discomfort associated with prolonged screen or device use. It is not a diagnosis that can be established simply from posture.

Do I need perfect posture?

No single posture must be maintained continuously throughout the day. Comfortable position changes and movement can be useful.

Is forward-head posture bad?

A forward-head position does not automatically mean someone has an injury or will develop pain. Symptoms and functional limitations should be assessed individually.

Should I keep my shoulders pulled back all day?

No. Constantly squeezing the shoulder blades together creates continuous muscular effort and is not necessary for normal sitting.

Can working from home contribute to neck pain?

A 2026 study found an association between working from home and neck pain among frequent computer users, although this does not prove direct causation. 

Are standing desks better for neck pain?

A standing desk may help some people vary position, but standing all day is not automatically better than sitting all day.

Should I raise my laptop?

It may be useful for some people, particularly during prolonged laptop work. If the laptop is raised, an external keyboard and mouse may help maintain comfortable upper-extremity positioning.

Do ergonomic chairs prevent neck pain?

An ergonomic chair may improve comfort and provide more adjustment options, but no chair can guarantee prevention or elimination of neck pain.

Do posture correctors work?

They may provide a temporary positional cue for some people, but they should not be viewed as a substitute for movement, exercise, or individualized rehabilitation.

Do movement breaks help?

A 2026 systematic review found that brief workplace exercise programs were associated with improvements in neck/shoulder symptoms and neck disability, although certainty for many outcomes was low. 

How long should a movement break be?

There is no universal duration. Programs included in the 2026 review generally used short exercise periods ranging from approximately 2–20 minutes. 

Should I stretch my neck every day?

Stretching may be appropriate when clinically indicated, but not every patient needs the same stretching program.

Does strengthening help neck pain?

Research supports strengthening and endurance exercise for many symptomatic office workers with neck pain. 

Why do my muscles feel tight if they need strengthening?

A sensation of tightness does not necessarily mean a muscle is physically shortened. Muscles can feel tight or fatigued after prolonged low-level activity.

Can neck pain cause headaches?

Some headache presentations may involve the cervical region, but headaches have many possible causes and should not automatically be attributed to the neck.

Can physical therapy help neck pain from computer work?

Yes, when symptoms and functional limitations are appropriate for physical therapy. Treatment may address exercise, muscle performance, mobility, work tolerance, movement habits, ergonomics, and education.

Schedule an Evaluation

If neck or shoulder discomfort is making it difficult to work, use a computer, drive, exercise, sleep comfortably, or participate in everyday activities, Nova Physical Therapy can help determine whether physical therapy is appropriate.

Our licensed physical therapists provide individualized evaluations and rehabilitation programs focused on:

• Mobility
• Muscle performance
• Functional movement
• Work tolerance
• Progressive exercise
• Ergonomic education
• Returning to meaningful activities

Contact Nova Physical Therapy today to schedule a comprehensive physical therapy evaluation in North Hollywood.

Disclaimer

This article is intended for educational and informational purposes only and does not constitute medical advice, medical diagnosis, ergonomic certification, or individualized physical therapy treatment.

Neck pain, shoulder pain, headaches, numbness, weakness, dizziness, and other symptoms can have many causes. Symptoms occurring during computer or desk work do not establish that posture, ergonomics, muscle weakness, or another specific factor is responsible.

Physical therapists evaluate and treat movement and functional impairments within their professional scope. California Business and Professions Code §2620 includes physical therapy evaluation, treatment planning, instruction, consultation, rehabilitation, exercise, and movement-related health and wellness within physical therapy practice. 

Exercise, workstation changes, standing desks, movement breaks, manual therapy, stretching, strengthening, and ergonomic equipment cannot guarantee pain elimination or prevention of future symptoms.

The research discussed in this article reports population-level findings and should not be interpreted as proof that a particular posture causes an individual's symptoms.

Seek appropriate medical evaluation for significant trauma, progressive neurological symptoms, sudden severe headache, new difficulty walking, significant coordination changes, fever associated with severe neck symptoms, chest pain, shortness of breath, or other severe or rapidly worsening symptoms.

Individual results vary.

References

1. Yaghoubitajani Z, Gheitasi M, Bayattork M, Seeberg KGV, Andersen LL. Effectiveness of Micro-Exercises for Managing Neck/Shoulder Pain in Sedentary Workers: A Systematic Review and Meta-Analysis. Scientific Reports. Published June 15, 2026. 
2. Snodgrass SJ, Salem T, Edwards S, Heneghan NR, Puentedura EJ, James C. Neck Pain Is Associated With Working From Home and Reported Postures in Workers Who Frequently Use Computers: A Cross-Sectional Survey. Journal of Occupational & Environmental Medicine. 2026;68(8):629–638. 
3. Lao HS, Telfer S. Ergonomic and Self-Care Strategies for Musculoskeletal Health in the Work-From-Home Era: Trends in Public Interest Across COVID-19. Published online August 21, 2026. 
4. Kumar P. Risk Stratification and Neck Pain Management in Office Workers Using Rapid Upper Limb Assessment.Musculoskeletal Care. 2026;24(1):e70208. 
5. Chen X, et al. The Influence of Exercise on Pain, Disability and Quality of Life in Office Workers With Chronic Neck Pain: A Systematic Review and Meta-Analysis.
6. Chen X, Coombes BK, Sjøgaard G, Jun D, O'Leary S, Johnston V. Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis. Physical Therapy. 2018;98(1):40–62. 
7. Koonalinthip N, Koonalintip P, Stonsaovapak C. The Comparative Efficacy of Treatments for Cervicogenic Headache: A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials. European Journal of Pain. 2026;30(2):e70219. 
8. American Physical Therapy Association. Clinical Practice Guidelines Library: Neck Pain and Associated Disorders. 
9. Physical Therapy Board of California. California Business and Professions Code §2620, Physical Therapy Scope of Practice. 

Current research resources: 2026 micro-exercise systematic review in Scientific Reports · 2026 computer-worker neck pain study on PubMed · August 2026 Google Trends ergonomics study · 2026 office-worker ergonomic intervention study· APTA Clinical Practice Guidelines Library