Most of us have probably heard in the last few years that we should generally be less sedentary and that most of us probably sit too much. From my point of view as a physiotherapist I am interested in sitting and/or the lack of activity from two points of view.
First of all I’m interested in the effects of sitting on the problems that my patients have. Both in terms of whether sitting causes or increases the likelihood of people having problems such as low back pain or neck pain in the first place and then whether sitting too much or too little makes things better or worse.
Second of all I’m interested in the effects of sitting or being sedentary on overall health, whether it’s for my patients or for myself and my family.
Does sitting affect low back pain or neck pain?
The first question posed above was does sitting cause problems such as low back or neck pain and/or does it influence the severity of the symptoms that you experience if you have low back or neck pain. From my point of view as a clinician the answer would be yes. In my experience sitting still for long periods, either at a desk or driving would seem to increase the risk of low back pain and neck pain.
With regard to the question of whether sitting would aggravate low back pain or neck pain, then in my opinion it would depend on the specific type of problem that the patient has. However in many cases sitting does aggravate the symptoms of people with low back pain or neck pain. Therefore if you have low back pain or neck pain that is worse when you sit for a while, then my advice would be to move more frequently. I would normally recommend moving even for just a few minutes every 45 minutes to an hour or so.
In terms of the scientific research it has mainly focused on the link if any between sitting and low back pain. As with research looking at many aspects of health the picture is mixed and somewhat confusing. Whilst there are some studies which suggest that there is a link between sitting, low back pain and other factors such as intra-discal pressure which would imply there is a link. There is little consensus and when we look at bigger, higher quality and more recent studies the influence of sitting appears to reduce.
However certainly from my viewpoint as a clinician there does seem to be a link, in that sitting for long periods often seems to occur in the run up to patients presenting to our clinic with low back pain. Patients who work in job roles where they are sitting for long periods of time, often present to our clinic with neck and low back pain.
There is also no doubt that if someone has got low back or neck pain, it is often aggravated by sitting for long periods. Therefore my take home message would be that whilst the research is mixed, sitting may be a factor in the onset of back or neck pain and certainly if you have either of these problems, sitting for too long may well aggravate your symptoms.
Does sitting affect your general health?
Unlike the question as to whether sitting affects spinal pain, the research regarding the effect of sitting on overall health is very clear. Sitting for too long is bad for you. Multiple studies have found that too much sitting results in an increase in problems such as diabetes, obesity, high blood pressure and various other problems including all cause mortality. i.e. dying for any reason.
A 2011 study which was widely reported found that those individuals who were the most sedentary had a 112% increase in diabetes, a 147% increase in cardiovascular evens, a 90% increase in death due to cardiovascular events and a 49% increase in death due to any cause. This was a meta analysis of 18 different studies looking at a total of 794,577 subjects. The interesting thing and the thing that has changed my own personal behaviour, as well as the advice I give my patients. Is that when the researchers adjusted for the overall amount of physical activity the subjects did the amount of time people were sedentary for was still linked with an increased risk of poor health outcomes. So while people who were sedentary and exercised regularly were better off than those who were sedentary and didn’t exercise, being sedentary seems to have a negative effect on our health that can’t be completely reversed by exercise done in discrete chunks. What I mean by this is someone who sits for long periods at work and then walks, runs or some other kind of exercise for a period of time outside of work.
Therefore what should we do to limit the negative effects of being sedentary. The advice from the NHS takes note of the fact that there are different kinds of exercise and activity and it would appear that for optimal results we probably need to both exercise and to avoid being sedentary.
So the advice mentioned in a previous blog regarding the NHS guidelines regarding physical activity and strengthening exercises is still relevant. The missing piece would be what an expert panel who reviewed the 2011 study mentioned above, termed all day movement. Their advice was that you should take a short break from sitting every 30 minutes or so. This may not necessary be feasible for everyone, however I would recommend trying to move every hour or so.
Can we help?
If you have problems with low back pain or neck pain or have any sort of musculoskeletal health problem which is affecting your quality of life. Please contact us to find out how we can help.