By Laird Harrison
January 12, 2018
The Case Against Sitting Desks
If anyone should know about the danger of being sedentary, it’s Bethany Barone Gibbs, PhD. A professor of health and physical activity at the University of Pittsburgh, Pennsylvania, she was writing grant proposals to study just that topic when her back began to hurt.
“I’m 30 years old,” she thought to herself. “How do I already have back pain?”
It didn’t seem to be a matter of getting more exercise. Dr Gibbs takes spinning classes twice a week; runs after her two kids, now aged 5 and 8 years; and traverses campus on foot rather than sending emails to her colleagues.
All that activity, she eventually realized, couldn’t compensate for the time she had to spend sitting still to write about the problem of sitting still. Fortunately, that same research provided the solution. After looking at the data on sit/stand desks, she got one for herself. Soon, the back pain ended.
In a pilot study, Dr Gibbs has now shown that she is not alone. Alternating positions between sitting and standing can go a long way toward alleviating back pain.
Most of the research into the problems of sitting has focused on damage to circulation and metabolism. Perhaps the most striking finding is that too much time sitting can increase the risk for death, even among people who meet standard exercise recommendations. To overcome the effects of sitting 8 hours a day, you’d have to exercise at least 1 hour, according to the authors of a 2016 meta-analysis.
This discovery has sparked interest in desks that allow the user to stand or even walk in place while working. Studies have shown that people burn more calories when standing than sitting at their desks and suggested that some people could lose weight that way or improve cholesterol levels.[3,4]
Of course, there’s a reason that people usually sit at desks. When researchers began looking at the benefits of standing at a desk, they immediately worried about muscle and skeletal pain. Previous research had shown that workers who spend more than one half their time standing up are more likely to experience this sort of discomfort. As a result, many of the early studies considered musculoskeletal pain as a possible side effect of standing at a desk. Whereas some studies found a slight increase in pain, most found no effect or a slight benefit.
Why might standing hurt less than sitting? Both postures can exert compressive forces on the intervertebral discs. But in a sitting position, the lumbar muscles are minimally activated, shifting their burden to passive structures, such as ligaments and discs. In addition, says Dr Gibbs, while sitting long-term, hip flexors may shorten. Standing up after a long period of sitting puts stress on these muscles, forcing the low back compensates for their lack of flexibility. About 60% of office workers experience back pain, and prolonged sitting is thought to be a major reason.
A recent meta-analysis of studies on standing desks found that offering employees sit/stand desks reduced their back pain by 0.30-0.50 on a scale of 0-10 points, where 0 is no pain and 10 is the worst pain imaginable. That may not sound like much, but in some studies, that meant a reduction in pain of about 50%.
For example, researchers at Stanford University, in Palo Alto, California, randomly divided 46 university employees into two groups. One group received work stations that could be adjusted to either a sitting or standing position and had access to them for 12 weeks. The others got nothing but a promise of such work stations at the end of the trial.
After 12 weeks, the people who got the sit-work desks reported a 55% improvement in back pain on their worst days, compared with a 15% change for the control group, a statistically significant difference. And importantly for employers, those who got the sit/stand desks reported a 60% improvement in their ability to concentrate, compared with 34% for the control group.
But few, if any, researchers believe that office workers would benefit simply by standing instead of sitting. One problem is that blood flowing to the legs while standing has more trouble returning to the heart. This pooling effect can result in clotting and varicose veins, says Jamie Burr, PhD, an assistant professor of human health and nutritional science at the University of Guelph in Canada. “Standing at your desk for hours and hours is probably not the answer.”
Dr Gibbs believes that office workers can get bigger benefits by combining sit/stand desks with reminders to get up and sit down in 15- to 30-minute intervals throughout the day. “We definitely did not want people to stand all day,” she says. “What we are saying is that we want you to change positions often.”
In a preliminary trial that she presented at the American College of Sports Medicine in 2017, coaches called the participants every month to remind them about the importance of changing postures, and to help them set goals for increasing their movement. In addition to sit/stand desks, the researchers provided participants with activity monitors that vibrated after 30 minutes of inactivity.
Latest Data on Treadmill Desks
If movement is key, wouldn’t treadmill desks work even better than sit/stand desks?
“If you have the ability to do your job and move at the same time, absolutely, it just makes sense,” says Dr Burr.
Walking at a desk appears to have greater cardiologic and metabolic effects than standing, including much more energy expenditure, more significant weight loss, reduced total cholesterol, reduced glycosylated hemoglobin (a measure of diabetes risk) and lowered blood pressure. In addition, walking engages calf muscles that pump blood back up to the heart, Dr Burr says.
Few researchers have examined the effects on back pain from walking at a desk. But because walking in other contexts is beneficial for back and joint pain, some researchers have assumed that walking at a desk would help, as well.
Treadmill desks come with their own downsides, though. On average, workers don’t type as fast when they’re walking as they do when sitting, and they don’t perform as well on tests of cognitive skills, although these measurements remain within the normal range.
These detriments are not a big drain on productivity, says Nicholas Gilson, PhD, an associate professor of physical activity and sedentary behavior who has studied sit/stand and treadmill desks at the University of Queensland in Brisbane, Australia. He cites other research suggesting that walking can enhance creativity.
But Dr Gilson sees another problem with walking while typing. “A treadmill desk is not as acceptable in workplace culture,” he says. “A lot of people when they see the treadmill desk their reaction may be, ‘Why is this here? Why is my office being turned into a gym?'”
In the end, no technology offers the complete solution to workplace immobility. Instead, he says, the best approach will probably vary among workplaces and individuals, with health-conscious workers looking for ways to keep changing their postures throughout the day.
Or, as Dr Burr puts it, “It comes back to moderation being the key. You don’t want to sit too much. You don’t want to stand too much. You don’t want to do anything too much.”
- Barone Gibbs B, Brach JS, Byard T, et al. Reducing sedentary behavior versus increasing moderate-to-vigorous intensity physical activity in older adults. J Aging Health. 2017;29:247-267. Abstract
- Ekelund U, Steene-Johannessen J, Brown WJ, et al; Lancet Physical Activity Series 2 Executive Committee; Lancet Sedentary Behaviour Working Group. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388:1302-1310. Abstract
- MacEwen BT, MacDonald DJ, Burr JF. A systematic review of standing and treadmill desks in the workplace. Prev Med. 2015;70:50-58. Abstract
- Graves LE, Murphy RC, Shepherd SO, Cabot J, Hopkins ND. Evaluation of sit-stand workstations in an office setting: a randomised controlled trial. BMC Public Health. 2015;15:1145.
- Agarwal S, Steinmaus C, Harris-Adamson C. Sit-stand workstations and impact on low back discomfort: a systematic review and meta-analysis. Ergonomics. 2017;4:1-15.
- Ognibene GT, Torres W, von Eyben R, Horst KC. Impact of a sit-stand workstation on chronic low back pain: results of a randomized trial. J Occup Environ Med. 2016;58:287-293. Abstract
- Barone Gibbs B, Kowalsky RJ, Perdomo SJ, Taormina JM, Balzer JR, Jakicic JM. Effect of alternating standing and sitting on blood pressure and pulse wave velocity during a simulated workday in adults with overweight/obesity. J Hypertens. 2017;35:2411-2418. Abstract
- Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanakul P. The effects of walking intervention in patients with chronic low back pain: a meta-analysis of randomized controlled trials. Musculoskelet Sci Pract. 2017;34:38-46.