Are you sitting comfortably?
A common cause of back or neck pain seen in clinic is an individuals prolonged poor posture. I am often amazed at patients who appear surprised that their back or neck has started to hurt following years of sitting in front of a computer for 6-7 hours a day. Do they think this is what the body was designed to do? Interestingly, with time it appears an individuals body will try to ‘re-design’ itself to carry out these types of activities, however at the cost of upsetting various structures which are not capable of functioning in the new design.
A 20-year office worker will often develop a forward head posture, or ‘poking chin’, due to years of sustained slumped sitting in front of a screen that was too low. Though this new posture allows the worker to see the screen more effectively, it also places increased stress through the supportive structures of the head and neck, leading to overload, which will often result in pain. The following picture illustrates the scenario perfectly.
Lets take a look at the science a bit more to help understand what is happening within the body during prolonged postures.
The Anatomy and Physiology bit.
Your spine is made up of three different components to help keep it aligned and stable. A passive element, which includes your ligaments, discs and joint capsules, an Active element involving your spinal muscles, and a Neural element (nerves) that ensures communication between the active and passive systems.
During static postures (i.e. sitting and standing), your ligaments are the main stabilizers / protectors of your spine and its natural curve. When ligaments are put under stress (i.e. sitting in a slumped position at your desk, bending down to put a sock on) they will stretch to allow movement but still maintain tension to protect your spine. Some stretch is acceptable, however if held for around 20 minutes or longer, the ligaments are unable to tolerate the constant force, and will start to lengthen (a process known as ‘creep’). This may trigger a painful sensation which helps you to move and prevent further damage. This pain can be felt during, or even after sitting for long periods, and is why you change positions regularly without even knowing.
A similar process is happening in your intervertebral discs which are designed to withstand compressive loads. Research has shown that slumped sitting loads your discs by almost twice your body weight, whereas upright sitting is significantly less. Therefore like your ligaments, it is important that you do not maintain poor sitting positions, and try to hold an upright posture or move regularly.
Why is it important to manage your back pain?
As discussed previously, prolonged static loading of the passive structures in your spine can cause pain in your back and neck. Forward leaning postures increase the pressure in your spine, especially the discs and ligaments. Poorly managed back pain often persists for weeks to months, with the longer you have it the harder it is to recover. Frequent episodes of back pain also make you more sensitive to stress on your back, causing you to have pain with shorter periods of poor postures.
What should I be doing then?
When you do sit at your desk, think about your posture. One of the best things you can do for your back is to keep it in a ‘neutral’ position. This is best achieved by using a pillow or rolled up towel in your lower back (see picture below). This keeps all your muscles and ligaments in a rested and supported position. Also think about your computer or laptop set up at your desk, the picture below is an ‘ideal’ sitting position (courtesy of ergonomics-info.com).
Another great trick is to keep getting up regularly so that you don’t place prolonged, sustained stress through your back or neck. Try placing a Post-it note on your computer screen that says ‘Move now’, or set an alarm on your phone to vibrate every 20-30 minutes. Just find something that will encourage you to move regularly. Better still, at lunch time go for a 20 minute walk and stretch with some of your colleges.
Finally, I hope you found this post interesting and I really hope it helps you to prevent any posture related back or neck pain. Remember however, the information presented has been written to give you some advice about how to manage your
posture and help protect your back during long periods of sitting. If you have sustained an acute injury to your back, or have a specific pathology (diagnosis) that is causing difficulty with your spine, then it is recommended that you get specific advice about how to manage your symptoms from a medical professional.
Good luck and thanks again,
Adam Eustace BSc, MSc, MCSP