Seventy-nine medical secretaries with neck and shoulder pain were included in a study aimed at an in-depth description of the ergonomical work environment and the participant's symptom profile, as well as analysing relationships between ergonomical factors and symptoms. Data were collected by daily ratings, questionnaires, and direct observation. The symptom profile showed low mean daily ratings of perceived fatigue and pain, a low medicine consumption, and few stress symptoms. A mean number of 2.1 undesirable work postures was observed. The correlations between perceived fatigue, pain, and well-being with number of shifts from sitting to standing and time spent typing, were generally small. This study suggests that risk factors for neck and shoulder pain are individual and multifactorial.