About 80% of the population in the UK and USA have sedentary jobs, meaning they’re often spending the majority of a 7-9 hour work day sitting down. With the significant toll that back pain takes on society this is an area that needs to be improved for the health of our lower back and body in general. For some professions it is simply a necessity, you have to be somewhat glued to the desk for your profession, for others there are degrees of freedom when it comes to sedentary work life.
Since 2020 the working environment has changed dramatically and the acceptance of working from home, at least in part, has become more widely adopted by employers and welcomed by employees. At a first glance this could seem like it would be a favourable option for those struggling with lower back pain or sciatica, however as we’ll explore, working from home also has its pitfalls.
Today we’ll begin by covering why lower back pain is so prevalent and how these sedentary workplaces can be a breeding ground for lower back pain. We’ll consider working from home and its role in helping or reinforcing lower back weakness and vulnerability. Finally we’ll cover some helpful modifications that you can make at home and at work to improve your back health and reduce the daily strain on the lower lumbar spine.
How work is making your lower back pain worse
In a recent episode of the podcast we quoted the british heart foundation who stated the average working age adult spends approximately 9.5 hours a day sitting. Perhaps like yourself, a huge amount of the average worker’s day is spent sitting down, often for extended periods. There are some important factors to be aware of that facilitate this straining of the lower back, understanding these will help you know what to avoid and why. It will also make the suggestions at the end of today’s article more easy to understand and implement.
Sustained loading and stretching: the perfect combination for back pain
One of the major issues that contributes to flare ups or the onset of lower back issues comes from the unique combination of forces in your lower back when sitting for extended periods. Firstly almost no-one in your office will be sitting on their sitting bones, instead they will be slumped into the office chair, bum forwards rounding into the back of the chair. The upper body is often then upright, or more likely peering forwards at a computer screen. This position is maintained often for extended periods.
When in this position the natural arching (backward bend) of the spine is significantly reduced, a position of flexion (forward bending) is adopted. This has the effect of compressing the front part of the spinal discs particularly those at the L4 L5 and L5 S1, the last two mobile joints of the spine. The discs are like little doughnuts and just like if you bite down on the front of a doughnut, the jam will be pushed towards the back of the donut, sometimes so much so that it leaks out the back as it breaks through the dough encasing.
As this compression is happening, there is a stretch being put through the muscles of your back as well as the ligaments of the spine. This chronic stretch for sometimes 30 minutes, 45 minutes or even hours at a time has the effect of weakening the ligaments, and creating vulnerability. It also creates a degree of stiffness and tightness in the muscles as they get tired of holding on. A common mistake people make is assuming these tight muscles need further stretching. Hopefully the understanding of the reality that they’ve been stretched significantly, which is why they are so tight, trying to hold on, will dispel the false belief that further stretching is required!
The big issue with this combination of forces is that it essentially weakens the structure of your lower back, particularly in the minutes following a bout of extended sitting. This instability is then exploited when you suddenly go to get out of the chair, a common mode of onset for those with back pain or sciatica.
A sudden, but normal movement after a period of extended sitting (badly).
For others it will be this sustained pattern over the weeks, months and years that gradually degrades the structure of the lower lumbar spine, gradually the discomfort in the lower back turns into an ache, then a mild pain then it starts to become a throbbing. Before you know it, 5-10 years have gone by and nothing much has been done to deal with it. The back pain at work was an inconvenience, now it’s not just at work and now it’s much more difficult to ignore.
If this sounds familiar, that is because it is probably the most common general theme for those suffering from lower back pain.
Gradual deconditioning of your body
In addition to the above, a gradual deconditioning of the muscular development that’s taken place in your younger years takes hold. Unless you make specific effort to continue a strengthening and fitness regimen, the muscle strength that protects your back, and helps compensate for low grade injuries to allow a quick recovery is gradually decreasing as the forces mentioned previously erode the integrity of your lower back. A dual effect.
The commute to work is far from ideal for your lower back
The sitting itself doesn’t begin at the office though, for many there is a prolonged drive at the start and end of each day, punctuated by a funny twisting and sitting motion as you get into and out of your vehicle. Those that commute by rail or other means are generally better off, however when suffering from particularly bad lower back pain, a journey on London’s Tube might be far from helpful, especially during rush hour.
Is working from home really that much better for your lower back?
When in the throes of particularly bad lower back pain or sciatica, it can be somewhat difficult to bring yourself to undergo the commute, let alone sit in the office for extended periods. It is understandable that in these acute stages staying at home to focus on getting out of the “episode” is going to be helpful. However, if we discount the severe and debilitating episode that renders you somewhat housebound, and focus instead on lower back health and the slightly less acute symptom picture, working from home has its own disadvantages too.
Workplace ergonomics compared to your home setup
Not all employers will have invested in such setups, however the trend of investing in expensive workplace ergonomic setups for staff wellbeing did seem to be a trend well before 2020. Chances are many of you struggling with lower back pain will be working from a setup in the office that was rather expensive, from the chair to the desk to the equipment around your work station. It is highly unlikely that you’ve gone to the same expense at home, or had the time to do so before your back pain became more difficult to ignore.
Many working from home will simply do so from the kitchen table, or have a rudimentary setup from Ikea. The chair is unlikely to be a good one, and you might even be working from your laptop on the sofa as some will do. This clearly is not an improvement and may even be something that you’re starting to realise as you read this, could be a factor for your lower back pain.
The commute to work as a form of exercise
For many the commute to work formed the only exercise that was routinely accomplished. The switch to working from home full time or even part time, eliminates a significant amount of this exercise, something that is often not replaced immediately. However, for those with longer commutes and those who really take a moment to consider their back health, as we’ll discuss later, this extra time can give us a unique opportunity to make time for our body and back health, before our lower back injury forces us to make time for it, often when we least want to.
More flexibility from home when your back pain is bad
One of the advantages of being at home when struggling with lower back pain is that you do have much more freedom to move around without distracting other members of your team. This can be quite helpful when you’re struggling, being able to do exercises like the towel stretch as well as go to the freezer to regularly ice the lower back or even undergo contrast bathing to help deal with excessive inflammation during a flare up is much easier when at home.
Reviewing the role of working from work or working from home with back pain
Ultimately there are advantages and disadvantages to working at work or from home when you have back pain. Both can be terrible, and with limitless funds, both can be good. It is about understanding the simple ways in which work can be bad for our lower back and investing some time and thought into working around these issues. If you or your employer can afford to do so, some money can be spent as well to make some impactful changes. In the rest of today’s article we’ll cover some helpful ideas to make life easier on your lower back at work and working from home.
Strategies to improve your back health working from work or at home.
Some of these strategies will be easy for you to implement and others more difficult. Some of them will involve purchasing equipment and others will require a little work and discipline on your part. Do the best you can based on your own personal circumstances and as always, there is a comment section at the end of the page so you can always post any questions down there too!
Be a fidget wherever you are, your back will love it
One of the biggest issues with the spine was mentioned earlier on, sustained compression and stretch. We see this process in extreme cases in bedsores in hospital patients. If not moved, the pressure on the skin creates damage and sores develop. So many of us sit still for extended periods when working, whether at home or in the office. This is no good for your lower back and in particular it allows the sustained stretch on the ligaments to deform them through a process called creep. The great thing is, creep doesn’t happen if you take the stretch off. So being fidgety disrupts the number one issue with long hours at a desk.
Most simply this is just repositioning yourself in your seat, but it could also be more significant too.
Where possible get up and walk around
An extension of the previous point, simply getting up, for example, if you need to proofread an email you’ve just written, do it standing. If you’ve got a phone call to take, that doesn’t require notes, stand up and go outside or pace up and down – with good posture preferably!
Investing in sit standing desks: go electric!
Sit standing desks are another great tool here, and you have to buy the electric ones, the manual ones don’t get used. It is worth the investment. This could be that you use a timer, and every 20-30 minutes you switch position. The regular switching, providing it doesn’t disrupt the task at hand too much, is another extension of the “fidget principle”. In combination with the two previous suggestions, this can really help keep stress moving around the lower back, spine and muscles instead of focusing on one specific area. If working from home is going to be a part of your working life for the foreseeable future, this really is an important investment to make and one which will pay dividends in the long term.
Get a good chair that will support you
When it comes to chairs there are many different opinions online, but here is our take on this. A good chair that is going to support your back is going to be best. The simple reason being that this should perhaps be a “main chair” and as we discuss in a moment, in combination with an electric sit-stand desk, and another “posture chair” this could work really well. The chair itself does not have to have a lumbar support, in fact these are often less good as they don’t support as well as a simple towel which we will discuss in a separate point.
Have a posture chair to switch to
This could be a kneeling chair, a perching chair, or a swiss ball as some like to use. The thing with these chairs is that they often allow you to work a good posture and also, like the kneeling and perching chairs or stools, they allow for a lower level of strain on your lower back from the hamstrings. When sitting with the hip at 90 degrees, your hamstrings, if tight, will pull on your lower back flattening the natural lordosis. This is unhelpful. In these two chairs, your thighs are slanted down and therefore there is less pull from the hamstrings on your lower back.
The reality of these chairs however, is that for the long days, you’re simply not going to sit upright all day. Your posture will fail and you’ll end up arguably worse off than a normal chair. Not to mention many will simply not have a good muscular system competent enough to hold good posture for any length of time without suffering fatigue and discomfort in the back muscles.
This is why, in combination with a sit-stand desk and a good chair, this could be considered a gold standard. You’re able to fidget in whichever chair you’re in, move from sitting to standing and then from a supported to posture chair, all in a matter of seconds.
The towel for your lower back support in the office.
If you’ve been following us for any length of time, you’re going to have heard about the towel exercise for lower back health. Now this is a great exercise to do during the day, much easier to do if you are working from home than in the office but helpful nonetheless. A smaller towel, perhaps the size of a tea towel or hand towel, rolled tightly and placed between your lower back and the seat can help support the natural arch in your lower back. This could be used in the office chair, home chair and in the car during your commute to help support good alignment of your lower back and prevent strain focussing disproportionately on the lower lumbar spine.
Drink more water during your day
A great strategy that has two benefits to your health and back health specifically is to focus on drinking more water during the day. Get a large bottle, say 500ml to 1 liter and be sure to drink this throughout the day aiming for 2 liters. Firstly, this is going to keep you more hydrated which is only going to be a positive for your health. Secondarily, you’ll be forced to get up more regularly to either fill up the bottle or visit the bathroom! This helps achieve that first strategy, be fidgety.
Prevent lower back pain from occurring in the first place
Ultimately the best strategy is always prevention. Preventing either the occurrence of back pain or if it does happen limiting the severity of episodes as well as creating an environment for optimal recovery is essential. If you’re already incorporating the strategies above, that’s a great first step. The next step is to devote a relatively small amount of time each week to engaging in resistance exercises that build both core and spinal strength. Although things like pilates and yoga are good for core strength and flexibility, these common choices miss the all important spinal strengthening part, not to mention unhelpful practices like pelvic tucks to flatten your low back during some of the exercises which are bad for your back health long term.
Commit to engage in some simple resistance based exercises for 30 to 45 minutes 3 to 5 times per week. It amounts to less than 3 hours out of the 168 hours we have every week. It will not only help your back health, but also your joint health, heart health offering so many secondary general wellbeing benefits it is difficult to overstate the benefits you can gain from this simple form of exercise accessible to us all.
What’s more, if you do have the flexibility with your working arrangement to work from home at least in part, the time you’re saving with the commute could easily accommodate such a workout practice and be a great boost to your general wellbeing both at home and while you’re working.
If you would like a little more help with a structured approach that you can take to get out of a back pain crisis, or just build up your core and back strength then check out membership to the Back In Shape Program. We’d love to welcome you to the community and help you work through the program to achieve your goals.