Even though sitting for long periods might have negative effects on our overall health, it does not appear to be a major cause of getting low back pain (LBP). Nevertheless, sitting for prolonged periods is a common aggravating factor for people with LBP, and as such methods to reduce sitting discomfort are often sought. One of the ways people do this is investing (often large sums of money) in a new chair.
Many investigations have looked at the role of several different chair designs in the management of LBP. We have previously shown that sitting on dynamic (wobbly) chairs and stools does not prevent or reduce LBP.
The use of a backrest, or a sloping seat (like a kneeler chair), have also been looked at to see if they have an effect of LBP. Overall, while using a backrest appears to help reduce back muscle tension to some extent, there is no clear evidence that using a backrest affects the development of LBP. The use of a sloping chair did not help reduce LBP (in fact, if anything they were slightly provocative on average).
We believe there are two possible reasons why reviews of chair design generally suggest that changing chair design does not have a meaningful positive effect on LBP.
1. LBP, like most chronic painful conditions, involves much more than physical factors like the way we sit, bend and lift. We know that treatment approaches which adopt a pretty narrow “physical” approach to chronic painful conditions such as LBP have limited effectiveness. Therefore, it is hardly surprising that changing a single thing in a persons life (e.g. the chair) without addressing any other potentially relevant factors (e.g. their job satisfaction, their activity levels, their sleep, their thoughts, fears and mood) are ineffective.
2. The studies offer the same chair to all subjects, rather than trying to match the right chair for the right person. For example, we have previously shown that changing chair design might help some people with LBP sit more comfortably, yet similar changes in chair design might make other people with LBP more uncomfortable.
In conclusion, LBP is usually not just about the chair (or indeed any other uni-dimensional factor). If interested in examining whether a change in chair design is worth considering, as one part of an overall treatment plan, then try to make sure the proposed changes reflect the individual presentation
