Standing Desks and Back Pain

By Paulina Wegrzyn.
Paulina Wegrzyn is a physiotherapist residing and practicing in British Columbia, Canada. She completed her Master’s in Physical Therapy at the University of Toronto, in Ontario, Canada. She currently treats a large persistent pain population. Paulina is a certified pelvic floor physiotherapist, and takes a biopsychosocial approach to treatment. She uses a combination of education, manual therapy, soft tissue release, and exercise prescription with her clients. She is interested in educating others regarding the benefits of physiotherapy in order for them to feel empowered to take control of their health. She enjoys writing content related to this field of study as she believes that physiotherapy should be accessible to all.
Pauline - Masters Qualified Physiotherapist

In this article, our resident physiotherapist Paulina discusses how many people with lower back pain have seen significant improvements as the result of using a standing desk.

Contents

Benefits of Standing Desks for People with Back Pain
 - Reduction of Lower Back Pain
 - Improvement of Posture
 - Increases Mood and Energy Levels
 How People with Back Pain should use a Standing Desk
 - Specific Ways to Stand
 - Standing vs. Sitting Time
 - Standing Surface
 Medical Considerations
 References

Benefits of Sit-Stand Desks for People with Back Pain

Reduction of Lower Back Pain

Standing desks have been shown to be beneficial to people who experience persistent pain. In fact, a 2018 study https://pubmed.ncbi.nlm.nih.gov/29330230/ showed that using a standing desk decreased persistent low back pain in participants by 50%.

This does not mean that standing desks are the solution to your back pain, but it certainly can help you manage your symptoms. When used appropriately, standing desks have the ability to help you manage your symptoms of low back pain, and may decrease your symptoms of pain while working.

Improvement of Posture

Using a standing desk can help you improve your posture. Standing for a few hours of your work day will increase the endurance of your small, stabilizing muscles in your low back, hips, glutes, and thighs. Being better able to recruit these muscles for longer periods of time can also help you improve your sitting posture while you take breaks from standing at your sit-stand desk.

Increases Mood and Energy Levels

A standing desk has been an effective way to improve worker’s moods and energy levels. A 2012 study https://pubmed.ncbi.nlm.nih.gov/23057991/ demonstrated that an improvement in mood and increase in energy levels remained so long as employees continued to use standing desks while at work, and that these positive effects were reversed once they stopped using a standing desk.

 Mood and energy levels are highly correlated with pain; in fact, about 25-50% of individuals with persistent pain report at least a moderate level of depression and/or anxiety according to a study conducted in 2012. https://www.jospt.org/doi/full/10.2519/jospt.2012.4182 Improving energy and mood levels can have a significant impact on the severity of your musculoskeletal pain. In fact, depressive symptoms in individuals who underwent physical therapy treatments decreased by around 40%. This study showcases how a reduction in pain can increase one’s mood, and vice versa.

How People with Back Pain should use a Standing Desk

Specific Ways to Stand

In order to optimise the benefits of a standing desk, one must consider their standing posture. Standing in a neutral spine position is ideal.

In order to find your neutral spine, widen your collarbones and drop your shoulders. Elongate your neck and do a small nod yes to keep your neck in a neutral position. Next, tilt your pelvis forwards and backwards, from one extreme to the other. After doing this tilt a few times in each direction, stop in the middle of the two extremes. This is a neutral low back/pelvis position.

When working at your standing desk, do a check in every fifteen to twenty minutes to see if you have shifted from this ideal neutral position. Frequent checks throughout the day will help you increase the amount of time you spend standing in a better position during your work day.

Standing vs. Sitting Time

Standing desks are a fantastic strategy for those with persistent pain. A 2019 study showed that individuals with higher levels of persistent low back pain move less during their work day, which includes less shifting and micro changes in position while sitting at their desks.

 While a sit stand desk is a remarkable tool for modifying our behaviour at work, we should not aim to stand for the entire day. Rather, aim to stand for ⅓ to ½ of your work day. If you currently spend your entire work day sitting, start with standing for a combined total of one hour during your work day and progress up to three to four.

 In addition to the combination of sitting and standing throughout your work day, you should also try your best to walk throughout your work day. Two to three minutes of walking every hour is ideal. Consider taking a quick walk to the kitchen or bathroom, or up and down your stairs at home.

 This combination of sitting, standing, and walking has been shown to be the most effective way to improve and manage low back pain and problems during the work day.

Standing Surface

Optimising comfort is another important consideration when working at a standing desk. An ergonomic standing mat, which is meant to provide extra cushioning to stand on, can help mitigate low back pain. These mats should be 2-3 cm thick.
Good footwear with adequate support is another consideration if you have low back pain with prolonged standing. A running shoe or sandal with arch support can help when standing throughout your work day. Consider switching your house slippers out for footwear with slightly more support while working.

Medical Considerations

For the majority of the population, sit stand desks are wonderful tools for decreasing sedentary behaviours and improving low back pain. However, standing desks will likely not help improve pain from more serious low back problems such as scoliosis or bulging discs.

If you suffer from any cardiovascular problems, standing for a prolonged period of time can actually increase your chances of developing a deep vein thrombosis or varicose veins. You may develop swelling or pain in the legs or feet. Prolonged standing is not recommended for individuals with vascular or heart conditions, especially intermittent claudication.

If you are currently experiencing problems with your heart or have a vascular condition, or have had one in the past, consult a medical professional before purchasing a standing desk.

References

Bontrup, C., Taylor, W. R., Fliesser, M., Visscher, R., Green, T., Wippert, P., & Zemp, R. (2019). Low back pain and its relationship with sitting behaviour among sedentary office workers. Applied Ergonomics, 81, 102894. doi:10.1016/j.apergo.2019.102894
Gibbs, B. B., Hergenroeder, A. L., Perdomo, S. J., Kowalsky, R. J., Delitto, A., & Jakicic, J. M. (2018). Reducing sedentary behaviour to decrease chronic low back pain: The stand back randomised trial. Occupational and Environmental Medicine, 75(5), 321-327. doi:10.1136/oemed-2017-104732
Pronk, N. P., Katz, A. S., Lowry, M., & Payfer, J. R. (2012). Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Preventing Chronic Disease, 9. doi:10.5888/pcd9.110323
Wideman, T. H., Scott, W., Martel, M. O., & Sullivan, M. J. (2012). Recovery From Depressive Symptoms Over the Course of Physical Therapy: A Prospective Cohort Study of Individuals With Work-Related Orthopaedic Injuries and Symptoms of Depression. Journal of Orthopaedic & Sports Physical Therapy, 42(11), 957-967. doi:10.2519/jospt.2012.4182