An estimated 4 million Australians suffer from some form of back pain. This can make your life more difficult than it needs to be, hurting your sleep patterns and your mood.
So are standing desks the lower back pain solution we’ve all been searching for?
The sudden interest in standing desks comes as no surprise. With remote work on the rise, we all want our home offices to be as comfortable as possible.
Adding aheight-adjustable desk to your office is one way to make work easier and less painful. Lots of people say that standing desks have helped them with back pain, but we wanted to look at what the data says.
We wanted to get to the bottom of whether standing desks are good for combatting back pain. Are they really better for you than sitting all day?
There are two main forms of back pain that physiotherapists see and treat. There is acute back pain that has a specific mechanism of injury, such as a lifting injury, or there is more chronic non-specific back pain, which typically presents as a general ache or discomfort and results from a gradual build-up of pain with no obvious mechanism of injury.
Excessive sitting can be linked to both of these types of back pain. The more common relationship is between sitting and the second type of back pain mentioned above, that of non-specific back pain.
Following are some reasons why prolonged sitting causes lower back pain.
When you sit, your lower back is placed in a flexed position. It is just the reverse of what you would usually associate with flexion - when you're standing and bend forward, you take your torso towards your thighs, whilst when you're sitting, you bring your thighs towards your torso. Nevertheless, the strain on the lumbar spine is similar.
When the lumbar spine is constantly flexed (as in sitting), there is a build-up of pressure on the lumbar discs. Over time, this pressure can wear away the integrity of the disc itself, and the surrounding ligaments, as well as simply irritating the intervertebral joints (the joints between each level of the spine) . This is likely to result in a sensation of pain.
More pressure is placed on the lumbar spine in sitting than in standing. If you sit with bad posture, the load that is transferred through your lumbar spine is 2.75 times greater than standing. Even sitting with perfect erect posture still transfers a load 1.5 times greater than when standing.
Over time, this increased pressure is likely to wear down the structures in the lumbar spine, causing pain and discomfort, not to mention increasing your chances of a more serious injury.
When you sit, the body's natural posture is to slightly round at the shoulders and slouch forwards. This automatically brings the whole upper body forward. Now, you can resist this posture, by making sure your chair is set up correctly and that you lean back into your backrest. However, most people who experience back pain do not do this - hence why they have back pain.
If the body is constantly leaning forward, even slightly, then gravity wants to pull you down even further - until your face hits the desk! To resist this, you have to activate your lower back muscles, to hold you upright. This constant contraction of the lower back muscles is likely to result in fatigue over the course of the day, as well as causing a sensation of pain.
Excessive sitting results in weight gain when compared with switching between sitting and standing throughout the day.See this blog post.
Weight gain around the midsection places much more stress on the lumbar spine. Think of your lumbar spine as a fulcrum or pivot point. The further away from the fulcrum that your stomach is, the longer the lever is, and the harder it is to produce the force required to support that weight.
I'm sure everyone has heard of the saying, "use it or lose it". Well, it applies in this instance. If you're sitting all day, then your postural muscles, or the muscles responsible for keeping you upright, don't have to do any work. Over time, these muscles will deteriorate.
If you lack strength through these muscles, your lumbar spine has less muscular support to protect it, making it more vulnerable to injury.
There have been recent debates on standing desks and back pain.
Standing desks are good for back pain if used correctly. If this sets your mind wandering, you aren’t the first. Aren’t you just standing? How could there be a wrong way to use them?
But standing too long has adverse effects too. It strains the leg joints, particularly in the knees and ankles. You can counter this by wearing orthopedic shoes and using an anti-fatigue mat.
The best approach is to alternate between sitting and standing. This promotes healthy circulation, increases alertness, and eases back pain. For this reason, sit-and-stand desks are particularly useful. You can adjust the height of your desk as you swap between sitting and standing, allowing you to change positions every couple of hours.
There’s also a positive correlation betweenstanding desks and blood pressure. Sitting for long periods increases blood pressure and a standing desk can help prevent this.
In this section, our resident physiotherapist Paulina discusses how many people with lower back pain have seen significant improvements as the result of using a standing desk.
Standing desks have been shown to be beneficial to people who experience persistent pain. In fact, a2018 study showed that using a standing desk decreased persistent lower back pain in participants by 50%.
This does not mean that a standing desk is 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.
Using a standing desk can help you improve your posture. Standing for a few hours of your workday will increase the endurance of your small, stabilizing muscles in your lower 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.
A standing desk has been an effective way to improve worker’s moods and energy levels. A2012 studydemonstrated 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 astudy conducted in 2012. 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.
To optimisethe 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 forward and backward, 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 desks are a fantastic strategy for those with persistent pain. A2019 study showed that individuals with higher levels of persistent low back pain move less during their workday, 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 workday sitting, start with standing for a combined total of one hour during your workday 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 workday.
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.
Adding some exercises to your routine may be helpful. This works even more movement into your day.Standing desk exercises can be anything from squats to lunges.
You can add in some light stretches or yoga too. This might be a great way to get through long, boring documents. Many people find that yoga, while relaxing, also helps to improve focus.
Getting your endorphins flowing might also help you figure out a tough problem. Not only is it great for circulation, but it relieves stress and improves problem-solving abilities.
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.
One of the main things people want to know is whether a standing desk is bad for your knees. If we stand for extended periods there is the risk of pain and discomfort in the legs.
Being on our feet too long can cause swelling. But instead of getting a simple standing desk, get a sit-stand desk that allows you to move around rather than being stuck in one position all day.