is working from home causing your back pain?

by David Harvey, DC MChiro - November 25th 2020

Under normal circumstances, adults in the UK spend around 9 hours sitting per day on average. This includes time spent at your work desk, as well as while commuting and at home. Now, to prevent the spread of Covid-19, there has been a sudden and dramatic shift in the location of work, with almost half of workers in the UK now working from home -- in London this figure is actually significantly higher.

Earlier in the year, it seemed like this shift may be short-lived and temporary, however, this situation has encompassed the majority of the year so far, and there is still no indication that we will go back to ‘normal’ any time soon, if at all. Many companies have been able to adapt to the current situation by going digital, thus allowing more opportunity for employees to work from home. As companies learn that many jobs aren’t required to be done in-office, working from home may become the new norm, so it's up to us to look for more permanent solutions.

There are many benefits to working from home for those who are able to. For many it will avoid the stress of commuting and allow more time with your family. You may also be able to roll out of bed, wear your pyjamas, have a constant supply of snacks to hand, and potentially lay on your couch or bed with your laptop while getting paid for it. However, the consequence of this could be poor posture, leading to musculoskeletal problems, such as back pain, neck pain, shoulder pain or cervicogenic headaches.

If you are new to working from home you may be noticing new aches and pains and wondering why. According to a recent survey by the Institute of Employment Studies, there has been a 'significant increase in musculoskeletal complaints' during lockdown. More than half of those surveyed reported new aches and pains: 58% in the neck, 56% in the shoulder, and 55% in the back. As many as 7 in 10 Brits currently working from home say they’re experiencing more aches and pains.

For many of us, working from home is something completely new. According to Marc Holl, Professional head of Physiotherapy at Nuffield Health, lockdown happened so suddenly that many people weren't ready or properly equipped to work from home. In the office, you may have had some kind of occupational health assessment at your workstation, to ensure that your desk, chair, screen and keyboard were all positioned properly, to optimise your posture. This may have also included an ergonomic office chair. However, the statistics show that these important pieces of furniture have not been transferred from the office into the home. Instead, a quarter (24%) of workers in Britain have moved to the sofa with their laptop, and one in five (17%) are sitting on their bed or living room floor.

How does poor posture while sitting cause pain?

Poor sitting positions exacerbate the damage to your body, by pushing and pulling unstable segments of the spine into misalignments. The best way to fix a problem is to first identify it. By understanding what goes wrong in the body when sitting, it becomes much simpler to try to fix. Let's start from the ground and work our way up:

When you are standing, your body is able to use its legs to support your body weight. However, when sitting, the weight of your entire upper body is being supported by the lower back and pelvis. The mechanical configuration of the bones in your lower back gives it a natural curve, called a lordosis. In between the bones there are squidgy, gel-filled sacs called intervertebral discs (IVD’s) which provide shock absorption.

When sitting in a slumped position, the curve in the lower back is reduced, or even completely reversed. This causes the forces of your bodyweight to go through the lower back in a way it was not designed to, meaning muscles, joints, ligaments, tendons and IVD’s are working harder than they are supposed to. The fatigue associated with this makes the tissues achy, stiff, and more susceptible to injury.

The neck also has a natural lordotic curve to support the weight of the head. The head is a heavier part of your body than you might think. The average head is around 10% of your overall body weight -- that's roughly the weight of a bowling ball!

Similarly, if you are sitting with your head in a forward position, your neck and shoulders will be forced to work much harder than they were designed to. To give a rough estimate, for every inch that your head moves forwards, you have to work around 10 times as hard to keep it up! The extra work that your body is doing while slouching is exhausting for the muscles, ligaments, and joints of the neck and shoulders, which may also send referred pain up into the head or down into the arms.

What’s wrong with sitting on my sofa or bed?

When you are sitting on a soft surface, you will naturally sink into it, with the heaviest parts of you sinking in the most. This means that when you are sitting on a soft surface like your sofa or bed, your pelvis will sink in more than your legs.

This creates a posterior (backwards) tilt of the pelvis, which will influence the curve in your lower back. The lower back curve will be reduced and you will be forced into a slumped position if you let your body relax.

It may be possible for you to force yourself into a more upright position, but one of two things will inevitably happen: you will either (1) forget about sitting upright and begin to slouch, or (2) get tired, achy and stiff from forcing yourself to stay upright and end up slouching to be more comfortable.

How do you sit properly?

Now that we have an idea of what not to do, I will summarise what to do in order to keep good posture while sitting. Here are my five top tips for sitting while working from home:

1. Make sure the top of your knees are slightly lower than mid-point of your hips⁣

If you are ever sitting with your knees higher than your hips, you will be creating a posterior (backwards) tilt of your pelvis. This will cause you to slump and slouch, forcing your body into a position it doesn't want to be in.

To achieve the knees being lower than the hips, you may need to:

• Raise the height of your chair, or
• Sit on a taller chair

2. Make sure that your pelvis is in a slight anterior (forwards) tilt

When you create a slight anterior (forwards) tilt of your pelvis while sitting, you allow your lower back to maintain its normal curve and your body will maintain an upright position with less effort.

To do this, you will need to lift the back of your seat--the part you are actually sitting on, not the backrest-- relative to the front⁣. This can be done in a few different ways:

• Use a seat wedge
• Fold a towel to create a wedge shape
• Some chairs may have an adjustable seat pad, which you can tilt forwards

3. Make sure the top of your screen is at or slightly below eye level

Even if your pelvis is in the perfect position, you will end up slouching if you're looking down at a screen which is too low.

To get your screen to be the right height, you may need to:

• Put your laptop/monitor on a stand or box
• Get yourself a monitor and keyboard if you are predominantly using a laptop

4. Get up and move often

As perfect as a sitting position may be, there is no substitute for movement. Try to get up every hour or so to move, whether it's to stretch or walk around. Taking some time to move will aid blood flow around your body and will help refresh your brain to stay sharp and focused.

5. Get some fresh air

As your lungs take in more fresh air, the oxygen levels in your blood will go up. Higher oxygen levels mean more of it can circulate towards your brain, helping you to feel energised and improving your ability to concentrate and remember information.

And finally, don't forget to get adjusted regularly!



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