Low back and neck pain are among the highest disability rates and cause of individuals seeking medical attention. Low back is the 3rd leading cause of self-perceived disability and is responsible for 40% of all claims in U.S., while neck pain has an annual prevalence of 86%. [1,2,3]
Sitting does not directly lead to low back or neck pain but can be an associated risk factor and contributing element to chronic neck and low back pain. The average occupational desk worker sits for over 8 hours a day. The sustained static and awkward seated postures contribute to increased spinal load and shear forces at both the cervical (neck) and lumbar (back) spine. It has been reported that 21-51% off office workers that sit for an extended period of time suffer low back pain. 
In this blog post I will be discussing the effects of a slumped seated posture has on the cervical and lumbar spine, standing desk set up and exercises that can help support your spine and posture to improve your endurance with sitting and standing postures.
“When we sit, there is an increase in the forces that travel to the disc and place greater stress on these and other lumbar spine structures. By focusing on trunk stability, active exercise, and time under tension we can create a natural brace that helps to decrease the forces that can cause injury. These tips and exercises should not only be thought of as treatment for an injury, but also as prevention for problems that may arise due to prolonged sitting. I applaud Dr. Megan O’Linn and MOTI for the recommendations and instructions to help prevent problems before they arise.”Dr. Gene Tekmyster
Slumped Seated Posture effects on the Cervical and Lumbar Spine
The anterior to posterior reaction force at the lower neck and back was highest in the slumped position while sitting. Sitting with a forward head position and rounded low back places more demand on the extensor muscles to hold up the head and maintain an upright posture. It also impacts the joint space and creates more pressure on the disc which can lead to pain and inflammation from joint pain and muscle fatigue. 
Standing Desk Set Up
In the below video I will walk you through step by step standing desk set up, monitor and keyboard position and work cycle settings for standing and sitting work periods.
Key take aways:
Monitor: Eye level or slightly below
Keyboard: wrists neutral, elbows slightly extended past 90 degrees and arms in line with your body; use a detachable key board if you are working on a laptop to allow for proper screen height
Lower body set up: standing- feet hip width apart, standing about a foot away from the computer. Sitting– hips higher than knees, knees at 90-degree bend and feet slightly wider than hip width apart.
Work Cycle: Change positions every 30 minutes, take a 10-15 minute work break after 3-4 work cycles
Exercises to help improve postural strength and endurance for the work day
1. Chin tuck for deep neck flexor endurance
Perform: 3×10, with 10 second hold each repetition
Form: lay on back, pillow under head and knees bent. Nod your head downward by gazing your eyes over your knees and hold, then return head to midline looking at ceiling. Head should remain on pillow at all times and shoulders relaxed on ground.
2. Trunk Stabilization and breathing
Integrated spinal stabilization is the coactivation of the deep cervical flexors, diaphragm, pelvic floor, all sections of the abdominals and deep spinal stabilizers to provide spinal elongation and postural stabilization
Perform: 4 rounds of 10 repetitions [1 second inhale: 2 second exhale]
Form: same set up as exercise 1, lightly draw rib cage in towards abdomen, belly button drawn down and lower abdominals engaging outward into pelvic bones. Bring legs up into table top position – knees over hips, slight external rotation of hips with heels inward but not touching and toes pointing upwards towards your nose. Do not let low back or head arch. Abdomen should feel flat without doming. Breathing is in/out through the nose.
3. Standing T
Form: Hold the band in each hand, maintain abdominal activation and chin tuck from exercises 1 and 2, thumbs pointing back and arms in a 120-degree angle. Pull band back slightly, then return to midline while keeping shoulders out of ears. Do not let head drop or back arch when pulling band. Should feel muscles at center and lower shoulder blades.
4. Standing Y
Form: Hold the band in each hand, maintain abdominal activation and chin tuck from exercises 1 and 2, thumbs pointing back and arms in a 90 angle out to side. Pull band back slightly, then return to midline while keeping shoulders out of ears. Do not let head drop or back arch when pulling band. Should feel muscles at center and lower shoulder blades.
Perform each exercise 2x/day. Adherence to a 6-week program can lead to improved strength and endurance to maintain upright posture and reduce incidence of low back and neck pain. [5,6,7,8]
If you have any further questions or have been struggling with neck or low back pain, please contact MOTI Physiotherapy at either our Los Feliz, (323) 912-9166, or Highland Park, (323) 503-1414, locations. We would love to get you scheduled for a personalized evaluation with one of Doctors of Physical therapy that are movement experts and will help you achieve your goals!
By: Dr. Megan O’Linn, PT, DPT, OCS, CSCS
Clinic Director MOTI Physiotherapy Los Feliz
- Bontrup, C., Taylor, W., Fliesser, M., et al. 2019. Low back pain and its relationship with sitting behavior among sedentary office workers. Institute of Biomehcanics. Applied Ergonomics. 81.
- Lis, AM., Black, KM., Korn, H. 2007. Association between sitting and occupational LBP. Eur Spine J. 16:283-298.
- Mahmoud, NF., Hassan, KA., Abdelmajeed, SF., et al. 2019. The Relationship between forward head posture and neck pain: a systematic review and meta-analysis. Current Reviews in Musculoskeletal Medicine. 12:562-577.
- Kwon, Y., Kim, JW., Heo, JH., et al. 2018. The effect of sitting Posture on the loads at cervico-thoracic and lumbosacral joints. Technology and Health Care. 26:S409-S418.
- Falla, D., Jull, G., Russell, T., et al. 2007. Effect of Neck Exercises on sitting posture in patients with chronic neck pain. Physical Therapy Journal. 87:408-417.
- Ekstrom, RA., Donatelli, RA., Soderberg, GL. 2003. Surface Electromyographic Analysis of Exercises for the Trapezius and Serratus Anterior Muscles. Journal of Orthopedic Sports Physical Therapy. 33: 247-258.
- Rahimi, NM., Mahdavinejad, R. Hosseini, S., Negahban, H. 2019. Research Paper: Effect of Dynamic Neuromuscular stabilization breathing exercises on some spirometry indices of sedentary students with poor posture. Physical Treatments. Vol 9. Number3. 170-176.
- Frank, C., Kobesova, A., Kolar, P. 2013. Clinical Commentary Dynamic Neuromuscular Stabilization and Sports Rehabilitation. The International Journal of Sports Physical therapy. Vol 8, Number 1. 62-73.