How did we transform from such an active past to such as inactive present?
Unfortunately, it is today’s modern workforce that is mostly to blame. To make matters worse, our society is faced with the terrible COVID-19 pandemic. People who previously went into the office are now working from home with badly improvised work stations. From sitting on the couch with a laptop to slouching at the kitchen table, we will undoubtedly observe an even greater increase in the amount of sitting and the negative consequences that come with it, including low back pain.
Epidemic proportions of sitting induced low back pain
Low back pain has become an epidemic in our modern society and is now the leading cause of work absence and activity limitations throughout the world.¹ Even if you recover from your first episode of low back pain, chances are, you are going to experience another episode at some point in your life.
Why is this happening? Sitting. As our society continues to sit more and more, the prevalence of low back pain directly increases.
Humans are constantly sitting. We sit to eat, drive, and work. We sit to relax and during other leisure activities. In fact, working age adults in England sit for an average of 9.5 hours per day.
As you go into the office on Monday morning and have a seat at your desk, you may start with relatively good posture. Throughout the day, your posture may worsen, and over the course of a few days, weeks, months, your body adapts to this posture. Areas of the body get tight, other areas become weak, bad habits develop, and pain arises.
Why can’t we simply keep that good posture all day long?
Our bodies intuitively look for ways to decrease energy usage. So, instead of relying on muscles to help maintain a strong posture, we begin to rely on other passive structures such as ligaments, joints, and intervertebral discs. These parts of our bodies were not made for prolonged load-bearing. Therefore, the more we rely on these structures, the more pain we experience, the weaker our back muscles become, and the cycle continues.²
What makes back pain even worse is static sitting. Static sitting refers to maintaining the same posture or position throughout an activity or task. A continuous load is placed through muscles, tendons, joints, discs, and other body parts. This static sitting behavior has been found to be associated with chronic low back pain and pain related disability.³
So much research has been done on sitting induced low back pain. There is no denying the direct relationship that sitting time, whether for work or leisure, has on low back pain intensity.³
While avoiding sitting may be helpful in decreasing pain, some people cannot avoid sitting at least for some portion of their work day. So, if you have to sit, you may as well sit in the best posture with the most optimal muscle activation patterns you can.
How active sitting helps to prevent and reduce sitting induced low back pain
The opposite of static sitting, discussed earlier, is active sitting. Active sitting refers to engaging muscles, especially of your core, while in a sitting position. One could achieve the effects of active sitting by constantly getting up and moving around, but this is not very efficient for the workplace. Instead, someone could work on actively sitting by using the Symbiotic chair, which is an ergonomically and environmentally friendly chair.
This active sitting chair does not allow you to just passively sit while at work. Preferably, it stimulates your postural and trunk muscles that help keep your body upright and stable. Chairs that allow active sitting are built to still provide support to your sitting bones and low back, while also challenging the user’s muscles by having a flexible seat, mounted on a balancing mechanism. Whether reaching forwards to grab something, turning to answer the phone, and everything in between, this mechanism allows the person to use their own muscles to move around and stay balanced in their chair while still receiving adequate support.
Chairs without this balancing mechanism do not engage the user’s core muscles. Without using these muscles, the body relies on non-contractile tissues for support. And as we learned earlier, this is what can create the vicious cycle of pain.
However, with the use of the balance mechanism, there is an increase in trunk motion, higher muscle activity, constant changes in pressure to the joints, discs, and other structures of the spine, and overall less low back pain.⁴ This postural variation aspect of active sitting is a key component in combating sitting induced low back pain epidemic.
What is postural variation
Postural variation is really the outcome of active sitting.
To better understand this concept, think of riding a horse. If you have ever ridden a horse, you may have noticed that it doesn’t take a significant amount of effort to stay upright and balanced. The horse is walking and moving around, while you stay balanced on top. This balanced poise while sitting for long horseback rides is the same thing that happens with active sitting. Your body is constantly shifting and moving to stay balanced, utilizing postural muscles, but without significant fatigue or realization that you are even doing this.
Now imagine sitting on the couch and watching a movie without any breaks. How do you feel when you stand up once the movie is over? Your back is probably stiff and it may take a few minutes to feel back to normal. This is because your couch or other chair does not have the ability to allow you to have postural variation.
Research has even found that in one hour of sitting, people that develop pain actually move much less than people that do not develop pain. This particular study found that it had nothing to do with the posture, but with the amount of movement. You can think of this as fidgeting for the spine.⁵
While it is unfortunate that so many people have to sit at work, we are lucky enough to have the resources available to create better sitting environments. The path to reducing low back pain, and avoiding it altogether starts with active sitting.
With active sitting, you will be able to have constant postural variation with the ability to use your own muscles to find balance, ending the sitting induced low back pain cycle.
Author: Adria Biasi
US based Doctor of Physical Therapy and Board Certified Orthopedic Specialist