Where sitting is contributing to back pain or stiffness, a review of sitting posture and positioning is appropriate.

Optimal sitting (ergonomic) chair posture is an inexact science. There is, however, moderate consensus amongst ergonomic and Occupational Health and Safety trained physiotherapists with respect to the correct sitting posture.

Approximately 50% of physiotherapists prefer the chair seat to be tilted slightly forward with the backrest upright and both feet flat on the floor. With the chair height adjusted to achieve these guidelines, the client is instructed to sit on the chair with the lumbar spine relatively flat or curved mildly inwards or away from the seat back and the lower abdominal (transversus abdominus) muscles activated along with the deep neck flexors (chin slightly down and in) and the scapula (shoulder blade) mildly retracted (pulled back). This position is known as an active sitting posture.

Approximately 30% of physiotherapists recommend an alternative sitting posture. In their advice, the seat should be horizontal or tilted slightly back with the back rest similarly tilted back. This means the client sits back in the chair with the chair supporting your back.

Price Warren is of the opinion that most clients should try to sit ~50% of the time in the activated posture with the chair either horizontal or tilted slightly forward and ~30% of the time with the chair tilted slightly back as per the second position (you can choose the remaining 20% providing it is pain free). The optimal posture is where there is least aggravation of the back with no referred pain or back stiffness. He is also of the opinion that it is easier to sit for longer periods in a good quality ergonomic chair that has adjustable seat height, tilt and back support options, than one without these parameters. It is possible to sit on almost any chair well and in any chair poorly.

It is also possible the progression of arthritic or degenerative disease may well be influenced by the quality of one’s chair and your posture and period of time spent in that chair particularly given the disc and joint pressures in sitting postures (Ref; Nachemson, 1964, Journal of Bone and Joint Surgery).

For analysis and advice on chairs, sitting posture and back pain please consult your Richmond Physiotherapy Clinic physiotherapist. Please also refer to our website for advice on Workstation Assessment, Neck Pain, Pillows and Buying a Bed.