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To sit or not to sit: that is the question


‘Sitting is the new smoking’ – most of us would’ve seen this image circling recently

However, what is it about sitting for prolonged periods in sustained postures that increases your chance of developing back or neck pain?

Previously the consensus was that back pain – specifically lower back pain – was a product of poor sitting posture and that in order to relieve pain we need to be sitting upright in a more ‘neutral spine’ posture. Sitting in a slumped posture with shoulders rolled forward and neck held in extension increases loading on the spinal structures such as the facet joints and discs which can lead to pain. We were told in order to have good posture you need to maintain the “neutral” or natural curves of the spine with the 3 basic rules:

1.      Chin Gently tucked in

2.      Shoulders relaxed, gently held down and back

3.      Maintain a slight, natural arch in the lower back

More recently, increasing evidence is showing that the amount of time spent in a specific spinal posture may actually be the main contributor to back pain, independently of the specific position itself1. This suggests that frequent repositioning and weight redistribution may be important in the prevention of work and study related back pain. This is relevant for all sustained static positions, i.e. sitting, standing, lying.

So, is posture irrelevant then? Definitely not, it always needs to be considered and as physios it will always be the first thing assessed. Maintaining a good position of your spine is important in everyday activities, loading of the joints and structures, and important for cardiovascular health.

However, there is some good news…we can reduce that neck, shoulder and back pain!

  • Ensure correct set up of your work area – for seated desks, ensure the desk/chair/screen heights are correctly aligned and implement simple supports such as a lumbar roll for your chair and a foot rest
  • Sit-stand desks have been shown to assist in reducing back and neck pain as well as mood, increasing productivity and overall well-being. Although this is a relatively new area of research, to date the evidence looks promising. It is however important that we do not overcompensate and just rely on standing at the desk in the same position all day. Find a sit-stand desk which is easily adjustable so you can change it every 2-3 hours.
  • Whether sitting or standing – regular repositioning from static postures is important. This may include incorporating a few simple back or neck exercises every 30-60 minutes or walking to the printer in another room. Find something that works for you and is easily adopted.
  • Exercise – a regular strengthening and fitness program (e.g. Pilates and yoga) can help with your postural awareness, core stability, muscle flexibility and overall health and wellness.

If back or neck pain affects you, now is the perfect time to make a change. If you want more information on how to improve your posture at work or to start a strengthening program, we are happy to assist the treatment of symptoms as well as to support you in the long term self-management of your back pain.


Further reading:

1. Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323.


Vatche Douzmanian


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