There have been
studies on standing desks and pain, but many more on sitting and pain.

 

$
Average cost for a convertible standing desk (EXTREMELY wide range though)

 

Step 1: Introducing the treatment

With increasing awareness of sitting dangers, standing desks have become more prevalent — especially at startups.

 

Even as you sit here and read this review, you already know that sitting too much is bad for you. In fact, those who sit for 10 hours a day have a roughly 34% greater risk of early death. Sitting for many hours uninterrupted is bad news.

standing desks - officeEnter standing desks! They’ve been all the rage in the past few years, but standing for long periods can actually be more painful than sitting. I live in San Francisco, one of the hubs of standup desk use. Startups often use standing desks, which is not surprising since they’re not constrained by beastly HR departments that require all sorts of paperwork to get a comfortable chair or desk. Bonus: as we’ve already covered, there can actually be decent calorie burn from standing a few hours.

One last bit of background info … just know that standing desks are not one monolithic thing: a well-designed sit-stand hybrid desk can be a boon for your health, whereas overusing a crappy standing desk can easily hurt you.

 

Step 2: Does the science make sense?

Staying in any one position for long periods can cause pain. Sitting is uniquely bad for certain body parts when it’s prolonged and/or you’re slumped.

 

Sometimes you get hurt while playing sports. Or getting in an accident. Or getting punched in the face. But much of the time, people accumulate injuries due to the repetitive (and soul-sucking) nature of modern life: sit in the car/train to go to work, sit at a desk, hopefully take a nice lunch break, then sit back down.

Our bodies weren’t made to sit in a chair all day. The more you sit, the more certain joints get tight and certain muscle get weak. Here are a few specific impacts:

microbreaksMicrobreaks
The most important thing to take from this article: even if you don’t stand when typing, take several short “microbreaks”. Just getting up to drink water, say hi to someone, or walk up and down the hall is enough. You could even take a couple flights of stairs (or if no one’s looking, do some simple bodyweight movements). Microbreaks can substantially reduce muscular discomfort, and you’re more likely to do them if you’re not glued to a chair all the time.

Ab/back muscle strength
Slumping is terrible for back pain, and part of the reason is because of its effect on stabilizing muscles. One study showed a substantial reduction in activity for a variety of stabilizer muscles when sitting slumped or standing in a swayed posture.

Low-back
Sitting at work often involved prolonged time at the same posture, and that posture is one of reduced lumbar lordosis (meaning: rounding the lower back and slumping your butt forward in the chair). Back pain patients may be more likely to have exaggerated slumpy-butt when sitting.

Perhaps most importantly, sitting for too long is bad for the transverse abdominus. This is the muscle under your six pack (you have a six pack, right??) that is a main protector of your lower back muscles and spine. One study showed that slouching while seated results in a less thick transverse abdominus, which is bad for spinal stability.

Shoulder
Sitting for long periods is associated with greater shoulder pain, with almost half of office workers typically reporting shoulder pain. And sitting erect instead of slouched may be beneficial for shoulder range of motion. Basically, sitting for long periods slumped over isn’t in line with the elegant ball-and-socket design of the shoulder, which has a wide range of motion and otherwise experiences regular motion when doing non-computer tasks.

Head/neck
The Jerry McGuire kid wants to tell you that the human head weighs eight pounds, which is pretty close the more typical 9-10 pounds. In any case, it’s heavy. And if you sit for long periods with no other muscles moving, the head is bound to start moving more and more forward. This can over-activate muscles in your neck, which could make you more predisposed to migraines.

 

Step 3: What do trial results show?

Most people stick with standing desks after starting. Pain conditions haven’t been studied, but even low levels of standing help discomfort.

 

Do workers actually stand at their standing desks?
Pretty much yes. One study showed that when given a choice, workers stand at height-adjustable workstations for between 20-30% of their day. Workers in another study chose a sitting:standing ratio of 3:1. Some studies show lower usage after a few months, which is to be expected. What does this mean for you? Don’t feel like you need to stand all day … variation is not only okay, but better than too much standing.

Do standing desks reduce pain/discomfort?
Again, pretty much yes. But they are much better at reducing discomfort if you get trained first. In a company setting, that would be like “see-do-practice”: you watch a demo, try it out, and get reminded to change postures. This also applies at home, but you just have to find legit advice yourself on the web.

How much do you have to stand to get benefits? Not much! Standing only around 8 minutes per hour has decreased musculoskeletal discomfort by around 27%. If you stand more, like equal parts standing and sitting, then legs and feet have been shown to hurt a bit more while the upper body hurts less. But the devil is in the details: what postures are used, and what your body is like. More important than an immediate pain reduction is the prevention of built-up pain over time from relying on static postures.

Decreased fatigue
One study showed standing desks to reduce fatigue, but only after a week of adjustment. During the first week, fatigue in the lower back and legs/feet were common. This means you might have to hang in there for a bit. But fatigue is highly correlated with increased pain and worse perception of pain, so it may be worth it.

Not all bad when it comes to feet?
We’ll get to some possible lower-body drawbacks below, but a study has actually shown about 40% lower foot swelling with sit-stand adjustable desks. As always, the key is to switch up your positions.

Migraine
We’ve already seen that having a screwed up neck can predispose you to migraines. Trigger points are also common in the necks of migraine patients. That same study showed that migraine sufferers more often have forward head posture. So what’s one way to reduce forward head posture? Stand up! It’s much easier to ignore the alignment of your neck when you’re sitting in the same posture as you have for years.

 

Step 4: Potential drawbacks

Back pain patients have to be extra careful. A suboptimal standing desk setup can also cause pain.

 

Spine/back issues
While standing can help back issues, it can also make them worse in some cases. One study in nurses tested 20-minute standing breaks versus sitting breaks. Spinal shrinkage was predictably greater during standing breaks, and the higher spinal load of standing could be a particular issue for certain back issues. Be very careful and slow in adopting standing if you have back problems, especially if you already stand a lot at work (like nurses) or home (like moms with tons of kids). Jobs involving much standing have higher rates of back pain, so paying attention to time spent standing is crucial.

Yucky varicose veins
Research is clear on the relationship between standing too much and getting more varicose veins: it’s a major, major factor. If you stand or walk for more than 75% of the day, you have a 70-80% greater risk of varicose veins. Not to beat a dead horse, but standing desks don’t mean you have to stand literally the whole time. Also, if you have any circulation issues, you also need to be very careful when incorporating standing. 

Makeshift standing desks cons

If you stack some boxes for a makeshift standing desk, you may create some other ergonomic problems. Your keyboard and mouse should not be super high-up, near the monitor. Nor should they be super low-down, near the normal desk. Both are bad for certain upper joints, such as the wrist.

 

Step 5: PainDatabase's humble opinion

You probably spend most of the day at your desk, so this is going to be a major factor in pain. Standing for parts of the day is definitely worth consideration.

 

We gave this “treatment” a pretty high score of 7.9 out of 10. Why? If your joints can handle it, standing desks (or at least just standing or moving a bit more) could be the best lifestyle change you make this year. The main reason is that it encourages microbreaks and varied activity, and that is key to avoid repetitive stress injury. Many other treatments, whether supplements or medications, can’t have as broad nor reliable of an effect on the whole body.

If you stand then you might also want to get something softer to stand on, like an anti-fatigue mat, as well as maybe something to rest one of your feet one (like a bar on a chair). Don’t stand in uncomfortable shoes (especially not high heels!), and if you’re allowed to, consider standing barefoot at times.

And don’t ditch your desk and get an expensive desk right away, if you don’t have standing experience. You sometimes learn lessons from standing more over time, using a makeshift desk. Like how much table space do you really need? Should you start by getting a different keyboard or mouse? If standing ends up helping your pain or energy levels, then it’s time to invest.

If you’ve already used a standing desk for the purposes of pain management, rate your experience up there on the right sidebar, or even write a little review so that others can read about your personal experience with standing and pain.

 




6 Comments

  1. Great article and nice-looking site!

    Reply
  2. Hi – I just bought a desktop stand-up addition for my office desk. I drive 1 hour each way to work and can’t stand sitting. I do get up and move around a lot (I’m very fidgety) and also have a balance board to stand on so that I’m forced to change positions often. My health is overall good no joint or back issues. My concern is the varicose veins. (I’m 30 and already have plenty of spider veins, I know they’re not the same thing but….) Did your research show whether compression socks helped at all? I”m not planning on standing *all* day (3-4 hours) and I do walk around plenty and have good shoes. I’ll ask my Dr. too next time I’m there. Just curious what you found out.
    Thanks, m

    Reply
    • PS – I also have a high chair w/ foot-rest to use. I feel like I’m all set, but spider veins give me the heebie-jeebies and I don’t want to encourage their formation!

      Reply
    • Hey there Molly! Nice job with the standing desk setup, and being cognizant of standing issues.

      I’ve seen some decent but also mixed evidence for compression socks, such as this review paper. So it may be a good idea to check with your doctor, and also keep the standing sessions to shorter lengths and then build up over time (which you may be doing already).

      http://www.ncbi.nlm.nih.gov/pubmed/22071857

      Reply
  3. Hello,
    Your article is good, I want to know few more things
    So how can i reach you?
    any email?

    Reply

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