Plautus once said that sitting hurts the loins, and reading hurts the eyes. The relationship between back pain and sustained sitting has been described in narrative and notional terms from antiquity, and continues to persist into the common day, confounding the ergonomist's best efforts to mitigate the discomfort of the worker and continuing to give rise to all sorts of weird and wonderful measures to manage the discomfort that arises from spending a significant amount of time sitting down.
Before considering back pain, sedentarism itself is a point of consideration, being an understood antecedent to the development of chronic and noncommunicable ills such as cardiovascular disease, diabetes, the increased incidence of stroke, lung disease, and of the development of the obese phenotype. Sedentarism is the natural and unfortunate consequence of the stereotyping of occupational postures to be as minimally effortful and as maximally supported as are possible - to transition the human body from seated posture to seated posture, all the while allowing the brain, the eyes, and the ears to engage with information in as minimally frictional and maximally functional a manner as is possible. The drawback to this is that the support provided by upholstery and apparatus of sitting deprives the body of the necessary engagement of its own musculature that is needed to maintain its own strength. Anyone who's felt uncharacteristically stiff after having gotten off a long-haul flight or stood up after watching a Christopher Nolan movie has experienced this.
The human back is a series of thirty-three bones, twenty-four of which are stacked one on top of each other like Oreo cookies and the remainder of which are fused into units like Oreo cookies when they come out wrong. This arrangement of bones, within whose hollow and semicontinuous canal the spine proceeds from the base of the brain to provide power to and convey sensation from skin, muscles, and joints, is supported by networks of muscle which can be as short as the thickness of a fingernail or as long as to reach from the base of the hips to the bottom of the skull. This spinal scaffold of muscle is responsible for maintaining upright posture, of stabilising the trunk, and consequently of supporting the action of the limbs.
Back pain from seating may arise through three broad means. Firstly, discomfort may be felt when in a seated posture from inappropriate and awkward load of the spine in an otherwise supported position. Chairs, benches, and seating more generally are manufactured means by which passive postures may be supported to facilitate the frictionless engagement of the human brain with sources of information. Chairs are generally designed to standard manufacture and developed with consideration of stereotyped body anthropometries. People are not standardised and so may experience different strain and load when sitting on the same chairs. Secondly, discomfort may be felt as a consequence of the deconditioning or weakening of muscles and structures owing to prolonged sedentarism which deprives muscles of engagement. Supported postures such as those maintained by ergonomic chairs take the load off muscles and allow a person to sit comfortably and effortlessly, concentrating their efforts in other directions. This unloading results in a lack of stimulus for muscles, giving rise to weakness and predisposing those structures to deconditioning in the same manner as lying down on one's back. Finally, movement from a sedentary to active posture may cause discomfort when the engagement of muscles in the back and the core gives rise to discomfort similar to that which may be experienced when undertaking an exertional effort.
The management of back pain that may arise from sitting should be undertaken following consideration of and in line with those recommendations presented in the Hierarchy of Controls. It is impossible to separate a worker from their duties of work aside from where that work may otherwise be automated, and so it is impossible to eliminate the presence of sitting in the workplace unless you want your workers to be standing around all the time. Substitution of sitting for standing may be appropriate where the worker is inclined to participate in such a measure but may introduce difficulties for those workers whose concentrations are interrupted by changing posture. Engineering of appropriate seating solutions appears to be the regular remit of every ergonomist and design engineer, but flexibility and customisability does not account for individual factors such as age, gender, and body habitus or psychosocial factors such as stress, aggravation, or fear, all of which may cause discomfort to arise.
Each workplace is different, with different demands, methods of business, and is staffed by people whose capacities, needs, and risk profiles are different. Managing ergonomic, environmental, and occupational health and safety challenges requires a business to examine and engage with the ecosystem of factors that give rise to risk, and how that risk may affect people. Each workplace is different and so sometimes the same problem will require different solutions. This applies to workers as well - every person is different and so may require different support, supervision, or resources to perform comfortably and sustainably. Under Work Health and Safety law, consultation with the workforce, the control of risk as far as is reasonably practicable, and the provision of information, training, instruction and support to the worker by the workplace, is essential to meet obligations to provide workers with a workplace that is as free of risk as far is reasonably practicable.
In our capacity as consultants, Atlas Physio will explore and scope the business and its needs, examining how exposures, risks, and processes contribute to the hazard ecosystem, best inform the design and arrangement of procedural, policy-based, and practical risk controls. Our solutions are tailored to the needs of those with whom we work, implemented in a simple, sustainable, and supportive fashion, designed to be robust and resilient, and to support the ongoing life of the business as well as the sustainable wellbeing of the workers who undertake the day to day activities of work.
At Atlas Physio, we provide reporting, structured control, and ongoing management of risk onsite, on the road, and wherever work is done. We are open seven days a week, and are happy to offer a brief complimentary discussion to explore the needs of your business and your workers if you are an employer, and your needs if you are a worker. Reach out today to arrange a discussion and take the first step toward managing risk and working safely, supported by expertise that is practical, reliable, and designed to deliver lasting results.