Does sitting cause Back Pain?

So it is exam season and many students will have to give up fun time in order to perform well in school.

Eventually they start developing neck pain or back pain.

So this week’s question is…does sitting cause back pain?

I remember when I started practicing Physio as a new graduate, I was absolutely convinced that sitting causes back pain.

I was telling all my patients to stop slouching their back: You have sit with a straight back sir. Your lazy lousy desk job is causing you back pain!!

What does the science say?

Well, there are literally hundreds of articles on posture and none of them can prove that back pain, or neck pain or shoulder pain is associated with poor posture. None.

Posture does NOT influence shoulder pain when it is protruded. Here is the link:

https://www.jshoulderelbow.org/article/S1058-2746(04)00247-2/abstract

Posture or sitting posture does NOT cause cervical pain. Here is an example:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213543/

Sitting posture is NOT associated with back pain: Click here:

https://www.ncbi.nlm.nih.gov/pubmed/11851181

There are so many articles that have completely debunked the myth about sitting posture causing back pain.

Now,

can posture be a problem?

Sometimes. Any posture can be a problem if there is NO movement involved. If you adopt a better posture and only use that one, it becomes a new bad posture. This basically means that there are no best postures, just postures that become problematic when maintained for too long.

Sitting with a slouched posture is not that bad, as long as you move!

So…sitting for too long CAN cause pain. but not because of posture. But more because of LACK OF MOVEMENT and/or also LACK OF EXERCISE.

Luckily, we have Acid Sensing Ion Channels (ASIC) in various areas of our body to detect Ph level. When Ph is too high, when you sit for too long, when a tissue is overstressed, the structure becomes more acidic. The ASIC senses this change and the brain translates the information into pain or discomfort. This is effectively what happens when you play video games for too long. You feel the need to stand up and move.

So.. is sitting bad?

NO. But not moving is bad. The reason why we have back pain at work is mainly due one factor: LACK OF EXERCISE.

It is not the sitting that’s causing the back pain. It’s the fact that all you do is lift your fingers at work. Your body is out of shape. Your muscles, ligaments, bones are “decomposing “. Your body is under stimulated.  

Adaptation is what causes progression in our body. But what happens if there’s nothing to adapt to? Maybe , your body is adapting to a less stimulating environment by degenerating or de-adapting? The brain may be thinking : Don’t need to use it, let’s lose it and save energy!

Bottom line is:

Desk jobs don’t necessarily cause Low Back Pain. But lack of physical activity does cause tissue breakdown. That’s why lying down in bed for too long causes bed sores and promotes osteopenia (reduction in bone density as per Wolff’s Law). Don’t use it and you might lose it!

It’s ok to have a desk job as long as you exercise at some point during the day. It’s ok to sit, as long as you move frequently! Simply doing a few sit to stands a few time can help with the pain!

So let’s move move move!

Physio Summum Brossard

Reference:

Does sitting cause back pain: https://www.ncbi.nlm.nih.gov/pubmed/11851181

Bakker EW, Verhagen AP, van Trijffel E, Lucas C, Koes BW. Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine (Phila Pa 1976). 2009 Apr;34(8):E281–93.

Blairs SN, Physical inactivity: the biggest public health problem of the 21st century.

BR sports med, 2009

Sedentary behaviour and cardiovascular disease: a review of prospective studies.

Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med sci sports exerc. 2009 may