A question people with back pain often ask is this: “How should I be sitting to help with my condition?” In this piece I talk briefly about kneeling, and whether it can be beneficial for back pain.

A question people with back pain often ask is this: “How should I be sitting to help with my condition?” 

In this post I’ll talk a bit about an alternate form of sitting that is kneeling, and whether it carries any merit for alleviating back pain.

Conventional 90-Degree Sitting and its Effects on the Back

These days most chairs are shaped like an “L” to encourage us to sit in a way where the angle at the hips, knees and ankles are all at 90 degrees. The emphasis is on the chair supporting all the major components of our body for a long time to accommodate the modern lifestyle.

The issue with 90-degree sitting is the uneven pressure it places on certain parts of the body, especially the lower back. With the hips at 90 degrees relative to the thighs, the normal curvature in the lumbar region is lost, resulting in spinal compression as the weight of the upper body is forced straight down.

Compared to standing for example, upright sitting can exert up to 40% more pressure on the back. That’s the last thing you want over a long period if you suffer from back pain.

Is Kneeling Better?

Kneeling is a form of sitting where the knees are bent and positioned lower than the hips.

In unaided kneeling, your shins rest on the floor as your bottom rests on the feet. There are many variations, such as the vertical kneel where you are essentially standing up on your knees.

In aided kneeling, the use of a specialized chair called a kneeling chair is used.

In both forms of kneeling, the pelvis is tilted forward to various degrees. This naturally helps shift the spine into better alignment where pressure is better distributed across the entire spine.

Having said that, for back pain relief specifically, a kneeling chair does offer specific benefits over unaided kneeling.

Kneeling chairs come with a sloping seat that exaggerates both the forward tilting of the trunk and downward angle of the thighs compared to unaided kneeling. Most people find it easiest to maintain a neutral spine in this position.

According to a 2008 research, the ideal seat inclination to maintain natural lumbar curvature when seated is a forward tilting 20° or more. This is only possible using a kneeling chair.

Kneeling: Not the Perfect Solution

While there is sufficient evidence in my opinion that kneeling can be conducive for back pain, there are obvious shortcomings.

Since your leg movements are restricted in any kneeling position, it can restrict blood circulation to your legs after a while. With your shins bearing some of your body weight, it can lead to shin pain over time.

It can be hard to get up and sit down on a kneeling chair as well. As a back pain patient, you have to be extra careful when you do these.

Unlike chairs which come in all sorts of sizes and adjustments, tall people will have a hard time finding a suitable kneeling chair. In this case, a height-adjustable desk is necessary.

And finally, as anyone will tell you, kneeling for a long time just isn’t very comfortable.

Kneeling vs Other Forms of Sitting: Variety Wins!

At the end of the day, kneeling should best be viewed as just one piece of the puzzle to alleviating back pain. No singular working position is good for the body when sustained for a long time.

This means that variety is the real winner when comparing sitting positions. Throughout the day, alternate between various forms of neutral sitting to activate different muscle groups and promote blood circulation. This includes upright sitting, reclined sitting, standing, kneeling, and even squatting.


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