Sit or Stand at Work?

This blog discusses some of the issues with the trend to use standing desks at work as a way of relieving lower back pain.

Some of my patients I see for lower back and pelvic conditions have been provided with standing desks by their employer. Although these patients have been using their standing desks before they start treatment, standing at work has not solved their back problem. In one case, my patient was using a standing desk to alleviate upper back pain, but then developed lower back pain. Her lower back and pelvic muscles were weak and she did not have the strength in the core muscles to tolerate a standing desk. It is not the constant sitting or standing that is the problem, but the underlying condition the patient has and how they are affected by sustained positions.

Clinically we know that sustained siting postures can produce lower back problems. Disc related injuries with sciatica are common when the lower back is flexed in the sitting position. When we assess these patients, we usually find there are a number of joint and muscle related problems that cause their pain. We see a common set of muscle imbalances that can cause lower back pain, and this is different in each person.

If we told one of our lower back patients to just stand at work, they could potentially get worse or develop additional problems. Standing requires different muscles to work compared to siting. Lower backs that are weak, together with weak core abdominal, will still be painful in either sitting or standing. Having a standing desk at work is going to be part of the solution but it won’t be a cure-all approach. Treating the lower back/pelvic muscles and joint imbalances are key to solving the underlying problems. Each patient should be rehabilitated to the point when they can sit or stand at work.

My advice to those who are already using a standing desk at work is to vary this with sitting, so that the body can adjust. Muscles that work more in standing will benefit from the rest when we alternate with sitting. Also, if you still have problems in standing, there may be some muscle imbalances that require correction. Common muscles that need strengthening include the deep back muscles, pelvic floor and deep abdominal. We also find the pelvic muscles, such as the gluteals and adductors are weak. The hip flexors tend to be short and over-active.

Things to avoid when using standing desks are leaning on one leg and hitching up the pelvis on one side. Locking the knees into a sway back position can be avoided by slightly relaxing the knees. Good shoes with adequate support go a long way to reduce the stress into the knees, hips and lower back. A proper assessment by a qualified ergonomist will also ensure the height of the desk and screen are customized to your body.

 

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