Why sitting down can kill you – and how to stop your back pain for good


Sitting has been dubbed “the new smoking”. Not only can sitting too much lead to back pain (which afflicts 2.5 million people in the UK every day), it is also associated with a host of other health risks.

Adults of working age in the UK spend around nine and a half hours a day sitting, according to the NHS. It’s a habit already ingrained in our lifestyles – at desks, in cars, on sofas – but poor posture habits and sedentary behavior have been exacerbated over the past two years amid the on-off work from home guidance.

Even if you’re physically active outside of your sitting time, you’re not immune to the so-called “posture pandemic”. “The poor health effects from too much sitting are separate from whether you are physically active or not,” explains Stuart Biddle, professor of physical activity and health at the University of Southern Queensland (previously of Loughborough University in the UK). “They are separate behaviors in the same way that smoking is different from diet.”

According to the British Heart Foundation, prolonged sitting is linked to diabetes, cardiovascular disease and death from all causes – even if you’re not overweight. Meanwhile, a study has highlighted the link between prolonged sitting and increased depression and anxiety. “Sitting is a sneaky behavior,” said Jacob Meyer, assistant professor of kinesiology at Iowa State University, the lead author of the study. “It’s something we do all the time without thinking about it.” Put simply, sitting too much is a health risk in plain sight.

Since the start of the pandemic, sitting has sneaked up on me. I’ve ignored my posture, crouching over a laptop without taking regular breaks or care over ergonomics, my neck and eyes straining, my hands like claws. It wasn’t until I spent Christmas lying on the floor resting my lumbar vertebrae on a hot water bottle, spiraling into a bad temperature when we ran out of paracetamol, that I performed an intervention was required.

I booked an appointment with a physiotherapist, adjusted my screen height so that the top of the screen is at eye level, and rested my forearms on the desk with elbows at a 90-degree angle. The new set-up was an improvement, but the lower back pain continued to come and go. I gingerly took up gentle exercise again. Friends recommended posture braces, stand-up desks, expensive appointments with osteopaths, gadgets and gizmos. But when I listened to my body, instinct told me that movement was the key.

How to cure back pain for good

The power of movement for back pain and better posture

I signed up to an online Pilates for back pain course with physiotherapist and Pilates teacher Helen O’Leary (complete-pilates.co.uk), who confirmed my suspicions. “Sitting at a desk and inactivity is bad for your posture and causes lower back pain because it reduces blood flow to connective tissues, like discs and ligaments. Increased pressure on the discs in the lumbar spine contributes to pain and inflammation,” she explains. Movement is an antidote. “Any kind of movement is good, and variety is better. We need to move more and sit less. We need good muscle strength, and a full range of movement with good endurance.”

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According to O’Leary, a lack of movement also explained my general grumpiness. “Posture is affected by mood, and vice versa. If you’re feeling low, your posture is likely to be worse. Movement and exercise, getting outside and socializing with others helps to reduce pain. Sitting for long periods at a desk is the opposite of this.” Psychological stress, explains O’Leary, is also linked to back pain and poor posture.

According to sports scientist Professor Greg Whyte OBE, non-specific lower back pain can be down to a complex combination of biological, psychological and socio-environmental factors, and needs to be treated holistically (Whyte makes an important distinction between non-specific back pain with no obvious cause, like mine, and specific back pain, where there’s an underlying issue which needs to be identified and treated, like a slipped disc). The NHS also states that non-specific back pain is “associated with feeling stressed or run down”. With this in mind, says Whyte, all components of your life need to be addressed before lower back pain becomes chronic.

“Psychological support can be as important as physical support. But as well as that, and your position at your desk, think about life outside work. How do you spend your free time? Do you also sit in a car or on soft furnishings for long periods? Is your mattress supportive? What position do you sleep in? Do you hunch over your phone? Figure out how you move in every aspect of your life, and consider what changes you can make,” he recommends.

“One of the big problems for those who sit at desks is simply the absence of movement. When we’re inactive, we set like concrete. It’s hard to reverse.” If a doctor or physio has ruled out a specific cause of back pain, there’s no need to be afraid of movement, he says.

Posture is not a static pose. It’s how you move. “Think of the body as a kinetic, moving chain. The chain is only as strong as the links. Strength, endurance, stability and mobility training all play a role, but it doesn’t need to be complicated. Most simple aerobic activities inherently require strength and stability. Whatever it is, physical activity is number one on the list.

“It doesn’t have to be for very long, you don’t need specialist equipment or Lycra, and you don’t need to take a shower afterwards – but you do need to take short breaks to move, often. Think of them as movement “snacks” – 30 minutes of movement can be broken down into five-minute portions. Good posture isn’t about straightening up and rolling your shoulders back once. It’s about training yourself to move better naturally and consistently. The accumulation of lots of little changes will make an overall dramatic change which you can sustain long-term.”

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making a move

At the start of January 2022, I set out to follow Whyte and O’Leary’s advice, and build better regular movement habits. A study published in the peer-reviewed journal Disability and Rehabilitation in 2019 concluded that going walking can help relieve back pain if done regularly – so initially, I began to weave more walks into my week, at least every two days for 30 to 60 minutes .

Then, I found Kerrie-Anne Bradley, the founder of Pilates At Your Desk, who shares simple, energizing Pilates-inspired ways to move more and better and improve posture during a desk-bound day (@pilatesatyourdesk; pilatesatyourdesk.com). I soon found I’d discovered a way to move even more throughout the day that was achievable and sustainable even while working. These movement “snacks” even seemed to improve my ability to concentrate on tasks and be productive in bursts between movement. During her virtual classes and tutorials, Bradley shares tips, tricks and reminders to improve sitting posture, to strengthen and stretch – wiggles, bends, turns, squats, lunges, rotations, planks, tricep dips, balances, wrist stretches – delivered with energetic enthusiasm . Her seated “little ball, big star” mini-routine in particular decompresses her body but also lifts the spirits. “It’s a great way to stretch both the front and back body,” she says. “Imagine a tug of war between your sit bones and the top of your head when you do it. It’s like power posing, so a good one before a meeting. It’s amazing how it makes you feel.” While there’s no single magic wand for lower back pain, moving more in the ways she suggests helps me to loosen up. The benefits both psychological and physical seem to be reducing the intensity and persistence of the dreaded lower back pain. For now, the hot water bottle and supine position is optional, not a necessity – and I’m even starting to feel like dancing again.

Move more at your desk

Previously an economist, Bradley trained with Sarah Woodhouse of the prestigious Fletcher Pilates school (Ron Fletcher, the founder, trained directly with Joseph Pilates himself; sarahwoodhousepilates.com) seven years ago. “I found Pilates myself because of a whole list of issues like sciatica, a stiff neck, a bad shoulder and a dodgy knee. Ten years as an economist and becoming a mum had taken its toll on my body,” Bradley says. “When teaching, I noticed that people would come for their class, leave feeling great, then return the next week with the same aches they’d had the week before.

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“I realized that it would be more effective if they moved more regularly and consistently during the week in between classes, incorporating short routines into their day – rather than trying to fix pain in a single one-hour session.” Her motive for her is to address the root cause of non-specific pain, rather than to “put a plaster” on it. She has been teaching her method for four years. It’s struck a chord: she has 12k followers on Instagram and works with corporate clients as well as individuals. In 2021, she moved from London to Castle Cary in Somerset with her ella husband Tim, their 10-year-old daughter Ivy and their toy poodle Astrid, running her business from their home. Her de ella online membership platform offers monthly live postural clinics, desk-pain related workshops and mat work classes.

You might not want to be the only person in an open plan office doing a seated chair lunge, but Kerrie wants to “normalise” having a wiggle and a stretch, so it becomes culturally acceptable to move in the workplace as well as when working from home.

“We’re conditioned to be still when we’re concentrating. At school, you’re told off if you fidget. If you normalize moving more, you find that it releases happy hormones, and that you can in fact fit it into your schedule – so you do more. It’s a virtuous cycle.

“Pilates is great because it gives you a greater awareness of where your body is in space (proprioception) and of the muscles you need to activate to hold better postures. It helps you to find a neutral and aligned position, so you’re not putting too much pressure on certain areas of the body and causing imbalances over time. If you can move every 20 to 30 minutes for a couple of minutes that’s amazing, but if that seems unmanageable, don’t let it be a deterrent. Every extra minute you move is a positive.

“The whole point is to find balance, and counter whatever movements and positions you find yourself mostly stuck in. Otherwise, eventually, you lose your range of movement and it leads to pain. I think of movement and fitness as a foot chart. There’s strength, mobility and flexibility, and cardio, and you need to try and manage that foot chart and work on all those areas.”

Greg Whyte joined forces with fitness app Her Spirit to launch Couch2Kilos, a six-week program helping women get stronger for life

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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