• Luke Nelson

Does sitting cause back pain

We sit to work, to eat, to travel, for entertainment, in fact, we spend a lot of our day sitting. So does all this sitting cause back pain? Are there better ways to sit?

Unfortunately as a society, we are increasingly becoming more sedentary, even more so in the last 18 months with COVID and the lockdowns it brought! Read our previous blog here.


Anecdotally, we see when our patients have back pain, sitting for prolonged periods of time will tend to aggravate their pain. We also tend to see that if someone has had a prolonged period of sitting or inactivity, it can trigger an acute attack of back pain. A lot of people think that back pain is triggered by overuse, but in reality, we see a lot of acute attacks bought on by UNDERUSE and lack of movement.


So what does the research say about sitting and back pain?

There have been a number of studies that have looked at the impact of sitting duration AND positions.

  • Sitting time more than 7 hours/day was significantly associated with low back pain, especially if combined with low levels of physical activity. (Park 2018)

  • A systematic review in 2018 showed that prolonged sitting does increase pain in those with back pain but it was unclear whether long periods of sitting were a trigger for episodes. (De Carvalho 2020)

  • Conversely, there have been a number of studies showing that sitting time is NOT associated with the development of low back pain (Korshøj 2018, Chen 2009, Hartvigsen 2000, Roffey 2010)

So what can we take for this? We know that back pain is a multifactorial condition, with many things contributing, so it really needs to be assessed on an individual basis. For some sitting time may influence their pain, whereas, for others, there are other more important factors at play.

What about our posture when sitting?

We do recommend people have their workstations set up ergonomically, but we have a favourite saying: “Your best posture is your NEXT posture”. What this means is a variety of postures and positions versus sitting in any one particular way are likely more important to avoid repetitive load. So if you’ve been sitting for a period of time (45-60mins), get up! If you’ve been standing up for a while, then sit down.


Our top tips for back pain and sitting:

  1. For those working at a desk most of the day, look at implementing a sit-stand desk. Alternate sitting for 30-45mins with standing for 10-15mins.

  2. If you have been sitting for 45mins, stand up and move around. You could get a glass of water, do a few air squats, just get some movement into your body.

  3. Mix it up: ensure that you are changing positions throughout the day

  4. Get regular short duration walks in during the day. Rather than walk 45mins all in one hit, split it up throughout the day: i.e 15mins in the morning, 15mins at lunch and 15mins in the evening. This ensures that there are no long blocks of sedentary time.

  5. If you are one to veg out on the couch in the evenings, again ensure that you get up after 45mins and move around.


References

  • Chen, S. M., et al. (2009). "Sedentary lifestyle as a risk factor for low back pain: a systematic review." Int Arch Occup Environ Health 82(7): 797-806.

  • De Carvalho, D. E., et al. (2020). "Association of Exposures to Seated Postures With Immediate Increases in Back Pain: A Systematic Review of Studies With Objectively Measured Sitting Time." J Manipulative Physiol Ther 43(1): 1-12.

  • Hartvigsen, J., et al. (2000). "Is sitting-while-at-work associated with low back pain? A systematic, critical literature review." Scand J Public Health 28(3): 230-239.

  • Korakakis, V., et al. (2019). "Physiotherapist perceptions of optimal sitting and standing posture." Musculoskelet Sci Pract 39: 24-31.

  • Korshøj, M., et al. (2018). "Is objectively measured sitting at work associated with low-back pain? A cross sectional study in the DPhacto cohort." Scand J Work Environ Health 44(1): 96-105.

  • Park, S. M., et al. (2018). "Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth Korea National Health and Nutrition Examination Survey." Spine J 18(11): 2051-2058.

  • Roffey, D. M., et al. (2010). "Causal assessment of occupational sitting and low back pain: results of a systematic review." Spine J 10(3): 252-261.

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