updated 10/15/05

Back Pain and Other Hazards of Sitting In Chairs (Way) Too Much

Recent personal experience proves that a lot of sitting actually is as risky as I’ve been telling my clients all these years

by Paul Ingraham, Vancouver, Canada MORE
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Credentials and qualifications

I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.

For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.

This article is of interest for people with minor low back pain who could use some tips on how to cope with spending too much time in chairs. If you are having more serious back pain, please go directly to this article: Save Yourself from Low Back Pain!.

The original title of this article was “I Hate It When I’m Right”, which I still love to say out loud (who wouldn't?). Unfortunately, Google can’t index a non-title like that, and people just weren’t finding the article when they were searching for “back pain” or “what can I do about sitting way too much in chairs”.

In this article, I have the rare pleasure of talking about two of my favourite things in one place: writing and massage therapy, together at last, like peanut butter and chocolate. I’ve been sitting in a chair a lot recently, writing even more than usual. And I’ve rediscovered that chairs actually are torture devices — just like I’ve been telling my clients.

Over the years, I have described The Chair Problem to my clients in many ways. I call my excessively sitting clients “chair warriors” who come to me with “chair wounds.” I say things to them like, “Did you get in a fight with a chair?”

I tell them that sitting in a chair is practically like an Olympic event, and they are elite chair athletes — that they can only do it because they’ve been training for it since kindergarten.

“If you put a caveman in a chair for eight hours a day,” I sometimes tell them, “you’d probably kill him.”

Occasionally, I tell the young chair warriors stories about the crippled old ones. I see people at every stage of their chair-o-centric careers, and at every stage of chair-induced disability …

twentysomethings who are just beginning to feel a bit stiff
thirtysomethings who live with the constant annoyance of pain and stiffness
fortysomethings who suffer from an array of mildly debilitating chair-induced injuries
fiftysomethings who are driven from their jobs by serious chair-induced malfunction

With this perspective, it isn’t difficult to see what the relatively minor injuries are going to lead to. To the young chair warrior, the stiffness is just an irritation; to a physical therapist, it’s the beginning of the end, the thin edge of the wedge! Without preventative measures, many of these people will become casualities.

I tell my clients this, and then I say, “Sometimes ten minutes of advice is worth ten hours of massage.” And I start trying to convince them to protect themselves as early as possible.

Chair warrior evangelist, heal thyself!

When you repeat something often enough, it starts to lose its power. Like repeating a word over and over again until it sounds ridiculous, my own advice was starting to seem silly in my own ears. How appropriate, then, that I have recently suffered from some nasty chair-induced discomfort!

It’s not like I’ve never tangled with chairs before. I went to school. And years ago, I actually chose massage therapy as a career because I wanted work that kept me more physically active. (Ironically, the three-year education in massage therapy was largely spent in chairs, and uncomfortable ones at that.)

Unfortunately, even as a massage therapist, I can’t avoid chairs — because I’m also a writer. Massage therapy is a job that I love, but writing is my identity. I like almost everything about writing — I’m basically a curmudgeonly and cerebral loner — except the damned chairs. If only it wasn’t for all the sitting …

I’ve had much more opportunity to write in the last year, as my massage therapy practice has become more or less self-sustaining. And so I’ve had my tush in a sling more often. And I gotta say: “Yikes! Chairs are bad!” It’s one thing to know about it intellectually, and quite another to actually feel the pain.

I’ve long had a professional habit of trying to identify with my clients — I will often do the same exercises that I’ve prescribed, for instance — but this is ridiculous! I am now sharing their pain. My butt feels numb half the time. I creak and crackle almost continuously. My neck has a crick three days out of five. My shoulders are hunched forward like they’re being pulled on by teams of oxen. And ominous pains are flickering around my body like brush fires in the distance.

So my enthusiasm for the war against chairs is refreshed. For the rest of this article, I will review some basic chair lore in Q&A format.

What is the problem with sitting, exactly?

The problem is immobility. Biology is a use-it-or-lose-it business. Everything works on feedback. Nothing works without a stimulus. The first consequence of immobility is soft-tissue stagnancy, the worst manifestation of which is the “bed sore.” A bed sore is literally a rotting patch of tissue, starving to death, and is a real and serious problem for anyone who actually can’t move. This is how Christopher Reeve died in 2004: an infected bed sore.

When you actually can move, but don’t move much — like a lot of office workers — you are basically suffering from sub-clinical bed sores. Your muscles start to scream for the physical and neurological stimulation they need to survive and thrive, and you only move just enough and just in time to stop tissue from actually starting to become necrotic (dead). But they certainly get sick, especially in the shoulders, back and hips — which tend to remain relatively immobile even when we get up and go to the water cooler.

Is stretching the answer?

No. Although it’s better than nothing, getting out of the chair to stretch is simply the wrong tool for the job. A little static elongation of muscle tissue does not constitute adequate stimulation to be an antidote for four hours of sitting per day, let alone eight or twelve.

What you need is a concept I call “mobilizations”: repeated, rhythmic elongation and contraction of muscle tissue (see Mobilizing!). For instance, when most people get up from a long sit, they will instinctively stretch their arms backwards, opening up the chest, and a few will then close the chest as well, flexing the same muscles they just stretched.

That’s the perfect thing, but you need to do more of it. Doing it once pulls your chest and upper back muscles away from the brink. Do it ten times in a row a few times a day is mobilizing, and effective preventative health care.

Should I get an expensive chair?

The importance of extremely comfy and ergonomically dazzling chairs is generally exaggerated. There is simply no such thing as a perfect chair: your body isn’t comfortable with any position for hours at a time. The problem isn’t the position that your body is in, but the lack of motion and variety of stimulation.

Therefore, the best chair is two or three quite different chairs used in rotation, including or used in conjunction with an destabilizing cushion, such as a Disc-O-Sit or Sissel Sit, or a fitness ball.

In my office, I have a standard office chair and a stool, both of which I use in combination with a Disc-O-Sit for plenty of variety. Because I have a home office, there are plenty of other places I can sit to work. All of this variety is more important than having one fancy chair.

What if I still want to get a good chair?

If you’ve got the cash, by all means — get yourself a fancy chair. If you’re going to do this, I recommend that you go “all out,” and get yourself a Herman Miller “Aeron” chair for about $1200CDN: they are unambiguously the best widely available ergonomic chair. (There are probably even better chairs out there, but they are even more expensive and I don’t think another several hundred clams gets you that much more.) The Herman Miller Aerons come in three sizes, which is a simple and effective solution to the most significant chair problem for many larger and smaller people: anyone large or small uses up the adjustability of their chair just getting it to fit.

What’s your famous “ergnomics schmergonomics” rant?

It’s not actually famous. I just made that up. But here it is anyway:

Ergonomics “professionals” all over the world are busily working on the wrong thing, trying to get people into good positions so that their workstations are as efficient as possible and require as little movement as possible. The goal of this kind of ergonomics is to turn people into cyborg-like extensions of their cubicles. The goal is also damage control: how to minimize the consequences of an insane amount of sitting, while still actually keeping people in their chairs.

The goal of this kind of ergonomics is to turn people into cyborg-like extensions of their cubicles.

And it’s all a sinister plot, obviously. Modern workplace ergonomics is a classic, Dilbert-esque piece of corporate manipulation. It fails to solve an obvious problem in an obvious way. The obvious problem is sitting, and obvious solution is getting up and moving around regularly — what more progressive ergonomics professionals call “micro-breaking.”

This is not to say that conventional ergonomics is useless or trivial — even if you get up fifty times a day, a bad mouse position is still going to torment you. But let’s get it in perspective!

This perfectly illustrates what I’m trying to say: that conventional ergonomics solutions may be missing the point, and often get out of hand.

Isn’t it good enough that I get up regularly for meetings, faxes, etc?

Yes and no. Any kind of getting up is so much better than being glued to your seat that I am always reluctant to criticize it. It really is better than nothing. But it really isn’t enough, either.

The key point that usually gets overlooked is that walking around the office does not — and I know this will come as a big shock — actually give your back muscles all that much to do. Photocopying isn’t really a big musculoskeletal challenge. Going the bathroom isn’t exercise.

How much mobilizing is enough?

Actually, it doesn’t take all that much. An adequate antidote for an hour of sitting is approximately five minutes of mobilizing.

How can that be enough? Simple: sitting wouldn’t be particularly stressful, except that we do so much of it. It’s not hard to counteract the effects of an hour of sitting with a few well-chosen exercises. If you make a point of flexing and using the muscles that are most needful, it really doesn’t take much to undo the damage.

Getting up and bending over to touch your toes thirty times every half hour may seem forced, contrived or arbitrary — but it’s the only cure for a forced, contrived and arbitrary amount of sitting.

What are the three most common office ergonomics disasters?

In my experience, the worst ergonomics offenses are: no micro-breaks, high monitors, and holding the phone to your ear. Always get on your feet for at least one minute in twenty, even if you don’t do any exercises, even if you just stand at your keyboard. Never look up at your monitor — it is a complete mystery to me why monitors have elevated stands at all. And never talk with a phone pinched between your head and shoulder, unless you just happen to enjoy stubborn headaches and neck cricks.

Should I consider standing on the job?

Standing on the job may be more of an option than I realized. According to business blog evolvingexcellence.com, several Japanese companies have ditched desks entirely. Everyone stands to do their office work!

Was it a tough change? Yes. The first month, or even two, is apparently quite difficult as the body adjusts. But then you begin to feel healthier, perhaps lose a few pounds due to the activity resulting from constant balancing, and you realize you are more productive.

I will look at this subject in more detail in the future. Meanwhile, if you’re interested, here’s the article: Lessons from Japan - Stand for Action

Anything else I should know about being a chair warrior?

Above all, take the risk seriously. True health and fitness are simply not compatible with serious chair warriorism. If you can’t avoid chairs, most people have to take preventative measures in order to survive their careers.

The best example I know of is a young man, mid-twenties, an extremely fit hockey player, roller blades everywhere — and a hardcore workaholic computer programmer, sixteen hours per day (no joke). His chair time is so physically punishing — and his athletic activities so demanding — that he has found that prevention is an absolute necessity. For him, the problem is unambiguous and the consequences of negligence are immediate: if he isn’t careful to protect his body from all that sitting, he starts to suffer right away.

The same thing is happening to you at eight-hours per day — just not as fast.