If you suffer from back pain, you may want to familiarize yourself with a concept in ergonomics called neutral sitting, and how it could help in both the prevention and exasperation of back and neck pain.

Awkward vs Neutral Sitting in the Prevention of Back Pain

For most of us, sitting is an invariable part of our daily lives, whether it’s during work or after coming home. Little thought is given to the effects of how we sit on our health, however.

If you suffer from back pain, you may want to familiarize yourself with a concept in ergonomics called neutral sitting, and how it could help in both the prevention and improving of back and neck pain.

Understanding Neutral Sitting

A neutral posture is a position wherein your joints, muscles, and bones are aligned and balanced. The stress on the musculoskeletal system is minimal. It requires little effort to maintain and gives your body biomechanical advantages to do tasks safely.

When it comes to sitting, a neutral sitting position refers to a sitting posture that exerts the least amount of stress in our lower back, shoulders and neck while still allowing us to be productive. If you operate a computer, observing the proper sitting posture can also help prevent other MSD such as carpal tunnel syndrome from developing.

A good starting point for people with back pain is to sit in a way where the load of the body is distributed equally across the major muscles of the body:

  1. The head is upright with the ears aligned with the shoulders.
  2. The shoulders are relaxed but pulled back, with the chest open.
  3. The spine is erect with the lower back cradled by a lumbar support. There should be no twisting of the spine.
  4. The elbows are held close to the body and bent at a 100° to 120° angle when operating a keyboard or mouse.
  5. The hips are slightly higher than the thighs at a 90° to 100° angle.
  6. A 1-2" gap exists between the edge of the seat and bottom of the thighs.
  7. The feet are flat on the floor. A footrest can be used if the desk and seat height aren’t adjustable.

If you’re unable to maintain such a posture for a long time due to the severity of your back pain, there are other neutral sitting positions for back pain to consider as well:

  1. Declined Sitting
  2. Reclined Sitting
  3. Supine Sitting

In declined sitting for example, the seat of the chair is angled downwards around 20° in a sloped position. A study by A.C. Mandal found that a declined sitting position makes maintaining the lumbar curve easier, minimizing lower back fatigue. It does this by shifting some of the body weight to the knees to lessen the burden on the spine. This is the reason why students often tilt their chairs forward when their back is tired.

Declined sitting is good for people with back, neck, or sciatic pain. However, very tall people will have a hard time finding a chair that allows them to assume a declined sitting position due to lack of legroom.

The easiest way to achieve declined sitting is by using a kneeling chair or saddle chair.

How Not to Sit - Awkward Sitting

In ergonomics, the opposite of a neutral posture is awkward posture. This occurs when the posture forces the body to deviate from its mid-range of motion. Since there is added stress to the bones, muscles, and joints, the risk of developing MSDs such as back pain or CTS greatly increases.

For example, if your desk is too low, you’ll have to flex your wrists to reach your mouse and keyboard. Meanwhile, if your desk is too high, the wrists will be extended when doing computer work. These awkward wrist postures can cause MSDs like carpal tunnel syndrome.

Another example is when you’re constantly flexing your back and twisting your waist to reach for things that you need to do your tasks. These put your spine at an unnatural position that elevates your risk of getting back pain.

At the same time, seemingly harmless habits like cradling a phone between the ear and shoulder and leaning forward to look closer at the computer screen are awkward postures as well.

When sitting, slouching is one of the worst enemies for your back. While it may feel comfortable at the time, this awkward position puts uneven pressure on your chest and spine while cutting off circulation to the rest of your body. Over time this is a recipe for a herniated disc or lower back pain.

Prolonged Sitting Not Ideal, No Matter How You Sit

It’s important to remember that regardless of how you sit, a long time in any stationary position is not going to be good for your body. A sedentary lifestyle has been linked to a big jump in everything from cancer, hypertension, to diabetes. Sitting in general also places more stress on your spinal discs compared to standing.

A good rule I tell clients to follow at the workplace is the 20-8-2 rule. Basically for every 20 minutes of sitting, work standing up for 8 minutes and walk around the office for 2 minutes. The breakdown doesn’t have to be exact, but the goal is to ensure you’re never sitting for long stretches of time.

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