This article is the first in a series on the relationship between sitting and lower back pain. I’d like to put it on record that my own personal experience is not entirely consistent with the research i.e. the periods in my life when I’ve had the most lower back pain is when I’ve been doing more sitting.
Essentially, if your lower back pain or sciatica is worse after sitting for 20 minutes than it is after sitting for 2 minutes, you can safely say that sitting is aggravating your lower back pain.
Why? Well, as usual, I turned to the scientific research to answer the question… BIG MISTAKE! After hours of reading, this is what I’ve gleaned from the latest research evidence.
There’s no association between sitting and risk of lower back pain
In their review of the scientific literature Hartvigsen et al (2000) concluded that there is no evidence that sitting at work increases the risk of lower back pain compared with “diverse workplace postures” – that threw a cat amongst the pigeons!!!
So I looked for a more up-to-date review… However, Roffey et al (2010) also concluded that “it is unlikely that occupational sitting is independently causative of lower back pain in the populations studied”. You might say “They looked at the wrong populations!”, but this review found 2766 “citations”, and whittled it down to 24 good quality studies worth including in their review; that’s a lot of people. One thing this study didn’t mention is how much sitting went on away from work; perhaps the people who sat more at work sat less outside of work? I don’t know.
So I cast the net a bit wider and found that “Cumulative low back load” is a “significant” risk factor for lower back pain (Coenen et al, 2013). The authors were looking at lifting and prolonged postures (including sitting) to calculate cumulative low back load.
So, we know that sitting for long periods increases cumulative load (which is a risk factor for lower back pain), but that sitting doesn’t appear to be a risk factor for lower back pain. What is going on here? Straight answer… I don’t know.
In research you have to ask very specific questions. What I’d really like to know (and couldn’t find research that answered the question) is – “Do people who sit for more than 8 hours per day 5 days per week suffer more lower back pain than people who sit for less than 4 hours per day?”
What I do know is that the vast majority of the thousands of lower back pain sufferers I’ve seen over the last 20+ years in practice find that sitting aggravates their lower back pain (and sciatica). And this was backed up (excuse the pun) by Biering-Sorensen’s (1983) research which looked specifically at what aggravates pre-existing lower back pain.
In summary…
- Sitting on its own is not a risk factor for the development of lower back pain.
- Sitting when combined with other factors is a risk factor for the development of lower back pain. (research not cited but available on request)
- Sitting is a significant aggravating factor for a great many lower back pain sufferers.
My next article will answer the question “Is there an ideal way to sit?”
Biering-Sørensen, F., 1983. A prospective study of low back pain in a general population. II. Location, character, aggravating and relieving factors. Scandinavian Journal Of Rehabilitation Medicine 15, 81–88.
Coenen, P., Kingma, I., Boot, C.R.L., Twisk, J.W.R., Bongers, P.M., DieA<, 2013. Cumulative Low Back Load at Work as a Risk Factor of Low Back Pain: A Prospective Cohort Study. Journal of Occupational Rehabilitation 11.
Hartvigsen, J., Leboeuf-Yde, C., Lings, S., Corder, E.H., 2000. Is sitting-while-at-work associated with low back pain? A systematic, critical literature review. Scand J Public Health 28, 230–239.
Roffey, D.M., Wai, E.K., Bishop, P., Kwon, B.K., Dagenais, S., 2010. Causal assessment of occupational sitting and low back pain: results of a systematic review. The Spine Journal 10, 252–261.
