David Borenstein, MD, FACR, MACP, and"America's Back Doctor," never gives up on a patient. The renowned rheumatologist and expert on arthritis and pain serves as Director and Professor of Medicine and Neurological Surgery at the George Washington (GW) University Spine Center. The views expressed herein are his and his alone. Stay in touch and share your questions with Dr. B on Facebook and Twitter @drbhealth.

blue chairs

America is getting fat and achy sitting on its behinds.

Given how much we sit day in and day out, it’s amazing that some of my patients can go a week without going to the emergency room. Never mind prescriptions for medications; these days, I’ve had to write prescriptions for the ergonomically challenged. It’s clear: Employees really do require a better setup at work.

Sitting leads to conditions like neck and low back strain. And it’s particularly problematic for those already suffering from back problems such as herniated discs and spondyloarthritis, a family of inflammatory diseases that lead to arthritis; the most common is ankylosing spondilitis, which affects the spine. If it worsens, spondyloarthritis can manifest in other parts of your body, e.g. psoriasis (skin), and inflammatory bowel disease (digestive system).

Medical conditions with tongue twister names aside, sitting and staying still simply hurts.

Sitting puts great pressure on the supporting structures that make up your spine. Even worse, you get shorter as you sit. Here’s a doc-approved tip: If you want to feel tall, measure yourself in the morning. In the morning, your discs are the plumpest between all the vertebrae in your spine. When you sit, gravity pulls down on your spine, pushing all the water out of your discs and compressing your tissues.

Tissues are happiest when they’re moving and getting oxygen flowing to them. This is why certain exercises that force you to hold your muscles in one place for long periods of time make people extremely tired. When you expand and contract your muscles, blood is better able to flow through your arteries to the muscles.

So here we are, sitting eight hours a day, getting shorter and achier. Until we can quit our jobs and live on a resort, here are some tips that can help:

red chair Photo by geoffbarrattgeoff
Exercises for the Back
  • Every hour, get up for just two minutes. You can still keep your eyes on the screen! Gently do a forward bend and a bend to each side, keeping in mind your own comfortable range of motion.
  • Try a pelvic lift. If you really are chained to your desk, here’s what you can do while sitting. My favorite exercise I recommend is called a “pelvic lift.” Raise your legs up, which rounds your back and stretches all the muscles in your spine. Back when telephone books existed, I’d recommend to my patients to stack a few under your chair as a footrest, which keeps you in the “pelvic lift” position. To give you a better idea of what we’re achieving, the most extreme version of this stretch would be the fetal position. This, by is the way, is why bars install a rail under your stool: It keeps you comfy so that you sit for longer and drink more…at least until you’re so tipsy that you can’t feel the pain any longer (not what this doctor recommends!).
Exercises for the Neck
  • Yoga for your neck. As we experience increased energy, stress, or anger, we tend to lift our shoulders up and around the earlobes and keep them there. If you can’t do yoga in your office, the next best thing is this series of stretches: Take your fingers and push your chin straight back. You can feel the muscles in your neck stretch out. Rotate your neck right and left and then bring your chin in.
Your Workspace

Some people have invested in standing desks. Others have even incorporated a treadmill (at extremely low speeds) under their desks to walk while working. Forget the fancy stuff for now. You wouldn’t believe the kind of contortions people put themselves through when so many fixes are simple and free!

Here are my top immediately actionable adjustments:

  1. Take a look around and check for proper alignment. Make sure that you are properly aligned with your keyboard and computer screen. For example, one fellow who came in to see me hadn’t realized that his office setup had him perpetually looking to the left, unaligned the entire day! Help your neck out by making sure that your computer is at the horizon and throughout the day, adjust your chair or workstation so that you vary your line of vision from slightly above to slightly below the horizon. Get the gist? Switch it up.
  2. Anything moveable or adjustable works wonders. For example, just having a chair that can go up or down a little bit that you can adjust one or two times during your workday is beneficial. It doesn’t have to be expensive equipment – any desk or chair or a stack of books that helps you to change an angle easily works. Don’t keep your head in one position all day.
  3. Consider your phone. If you’re on the phone for long calls, make sure that you don’t keep your phone at an angle that puts you at risk. One of my patients is a reporter; it turned out that he kept his phone in the crook of his neck for hours while conducting interviews. He sorely (pun intended) needed a headpiece to keep his neck in better alignment (and hands free while typing).
Choose Your Chair Wisely

It’s false that a "sofa chair" — you know, the kind where you sink in… ahhh — is comfortable. Actually, your back is working like crazy and your muscles are on red alert to constantly support you on a structure (those “comfy” cushions) that is sinking. You want support: You need a chair that has a good foundation, light cushioning, and supportive arms. So, give your cushy chairs to Goodwill!

Fortunately, you don’t need a special chair that costs a thousand bucks. A good seat can be a really basic chair with adjustable seat height, back, and arms. In fact, as sleek as some of the top-of-the-line chairs are — I’ll refrain from naming specific brands — they’re often built for a specific type of person (six feet tall in perfect musculoskeletal health). It’s likely not the “ideal” chair for you. In fact, for some, it may encourage hyperlordosis, an exaggerated curve in the lumbar region.

Better Habits, Better Spines

Let’s face it: We’re engineered to be walking. (Of course, I’m giving you this advice as I’m sitting here typing!) Sitting is a huge factor in the obesity epidemic and so much of why we ache. But it’s a problem that can be helped with some simple pieces of advice.

I’ll leave you with this thought: Cardiologists are increasingly interested in what we rheumatologists work on. We’ve learned that inflammatory disease anywhere in the body ages the cardiovascular system. Think about it: it makes sense that inflammation would cause the heart to have to work harder to pump blood through the system. A healthy spine, and better work habits aren’t just good for our skeletons, but a key to overall health. To help your body and help your spine, work right!

Do you like sitting all day? How have you managed to ease stress on your joints and spine? Let us know your tips in the comments below.

Photos by Pedro Moura Pinheiro, geoffbarrattgeoff