Hills Blog

Posture and Pain – the science of Ergonomics

Posted December 13, 2019.

Physiotherapists have been telling people for years to sit up straight, don’t slouch or you’ll end up damaging your neck, or back or having headaches or something. This all seemed to make logical sense, because (anyone who has spend too long scrolling Facebook or reading a book knows) if you have your head down for ages your neck gets sore. The problem with logic is that it is prone to logical fallacy.

The post hoc fallacy, for instance (post hoc ergo propter hoc – latin for “after that therefore because of that”) is the logical error that because one thing happens after another, that the first thing caused the next thing. The famous example is that the rooster crows and then the sun comes up, so the sun must come up because the rooster crows! Confirmation bias is another big problem with logic, which is the human tendency to only seek out information that confirms what you already believe, and ignore other data that disconfirms it. These two “faults of thinking” have lead people to believe that because they got neck pain after sitting for too long at the computer, that the neck pain was because of the sitting.

Researchers have been more closely examining this situation over the last 10-20 years and have found some quite uncomfortable truths (for physios, who make a living out of telling people they’re sitting incorrectly);

• Prolonged sitting is NOT associated with back pain
• Sitting on a Fitball or an air cushion does NOT help back pain
• No particular posture is associated with increased chance of neck pain
• Experts can’t even agree on what ideal posture is
• Neck pain IS strongly associated with stress, poor support at work, high volume or high precision work, and being female
• Slouched postures don’t cause neck pain, but are highly correlated with depression. Upright posture is associated with regular exercise
• Frequent exercise reduces incidence of neck pain
• Office programs that involve strength exercise for the neck, or neck and shoulders 2-3 times per week significantly reduce incidence of neck pain
• Ergonomic interventions (setting up work station to “optimise posture”) don’t reduce the incidence of neck pain
• Alternative mouse use does not reduce the incidence of shoulder / arm pain
• Regular short breaks reduces both neck pain and incidence or Right
  shoulder / arm pain, without reducing productivity

*references for any of these claims available on request

What we can gain out of this body of research is that it is NOT helpful to assess someone’s workstation, correct their posture, or change their chair, but it IS helpful to throw a pair of dumbells at them and make them lift them at least a couple of times per week. It’s not even much exercise to get the positive effects, three lots of 20mins of weights per week is enough to significantly reduce the incidence and severity of work related neck pain, as well as conferring all sorts of other benefits.

So if sitting for hours is not causing neck pain, surely it is bad for us in other ways, we’ve all heard that “Sitting is the new smoking”. This suggests that our epidemic of sitting caused by increased reliance on computers, coupled with commuting and recreational sitting watching TV is resulting in significant health problems, as bad as smoking. Lets take a sec to examine that;

Smoking;

• is estimated to cost Australia nearly $137bil in health care costs, lost productivity etc.
• Leading preventable cause of Cancer (28.8% of Cancer related
  death compared with second highest – Obesity 6.5%)
• Causes lung disease, heart disease, arterial disease, peripheral
  vascular disease, increases risks of all major cancer, increases
  risk of tendon injury, increases pain of existing pain conditions

Sitting

• Sitting decreases activity levels, leading to increased weight which can lead to other health complications
• Reduces opportunity for healthy movement to reduce pain,
  weight and improve mood / mental health / stress management

In a study of nearly 3600 African-Americans (followed over 8years) compared occupational and recreational sitting, found sitting “often or
always” at work was NOT assoc with higher risk of heart disease,
but watching 4 or more hours of television per day increased risk
by 50%

So what is different about sitting at work or sitting at home?

At work, you tend to be busy working, discussing, changing position, engaging with others, compared with at home where you binge-watch Netflix on the couch – eating chips, drinking alcohol, etc.

There are also some Demographic factors – type of person who sits all day at work, compared with those who rarely sit (trades etc) are;

• More likely to exercise out of work (because they don’t move enough at work)
• Likely to have higher education (and understand negative health impacts of poor diet and exercise habits)
• Less likely to drink and smoke to excess (population data supports this)

So what are the solutions?

Work related neck, back or shoulder pain is really common – so
firstly, don’t panic (fear makes pain worse). In most cases it will settle down if you REDUCE the load on it (temporarily) – once your deadline is over, silly-season finishes, you get a new job . . .

Or INCREASE the load on it and make it adapt and get strong
and resilient due to exercise. No posture is more likely to cause you pain, but ANY posture held for too long can cause tissues to become acidic or a bit sensitive – which leads us to the new catch-cry

“Your best posture is your next posture!”

Consider using heat, cold or Paracetamol to reduce soreness
initially, then exercise – at least a couple of times per week, at high intensity
(uncomfortable, muscles sore next day). It doesn’t really matter what kind – “best exercise is the one that get’s done”, so if it’s something you enjoy you’ll do it as recreation instead of it being a chore. Consider implementing micro breaks during the day to reduce load and stress, and improve concentration and effectiveness when you are working. Since neck pain is more correlated with stress than posture, consider mindfulness practice, yoga, Pilates, Golf, Art Therapy – something to calm down your sensitive nervous system.

If that all fails contact Hills Physiotherapy on 13009HILLS or at https://hillsphysiotherapy.com.au/bookonline

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