Transient perceived back pain induced by prolonged sitting in a backless office chair: are biomechanical factors involved?
PainSci notes on Greene 2019:
In this odd little study, people both with and without a history back pain were asked to sit for an hour in a position as they like.
27 of 61 people with no back pain history developed some back pain after sitting one — a fairly high number. If they'd had a history of back pain, I would have said that this was probably just a positional trigger — and largely irrelevant to the epidemiological puzzle of whether sitting causes back pain.
This is probably another rather quotidian phenomenon: being stuck in a chair for an hour can get uncomfortable even for perfectly healthy people, and that probably does not have much epidemiological significance, if any.
In other words, for people without the back pain history, this was a mainly test of how well people respond to the short term stress of being partially immobilized, which is a form of mild torture for many. 🙂 Some people find it particularly challenging, for a mixture of physical and psychological reasons. Others are much more practiced at coping with that particular stress. Some will have vulnerabilities. The result for an individual could depend on very transient factors that that week or that day.
I suspect that you’d see great variability even in the same people if they were re-tested at intervals over time. Probably some of them do poorly with it for reasons that do predict future cLBP. But I suspect they are in the minority.
And now, what about the people who did have a history of back pain? About 15% more of them struggled with the sitting, and that is actually a surprisingly small difference — I’d expect sitting to be a stronger trigger for people prone to back pain. That makes me wonder what kind of numbers we’d see in a replication of this trial.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
It is not currently known if biomechanical factors contribute to low back pain (LBP) during prolonged sitting. Thus, this study recruited 90 participants (61 with no history of LBP, and 29 with) to sit for 1 hour where back electromyography, spine posture, and perceived pain ratings (PPR) were collected. Participants were classified as Pain Developers (PD) or Non-Pain Developers (NPD) based on their maximum PPR. PDs had significantly higher PPR (p = 0.000) and lower number of spine fidgets (p = 0.004) than NPDs. There was a significant interaction between clinical health history and pain group (p = 0.037) for PPR. Besides fidget frequency, there were no biomechanical differences between pain groups. Therefore, sitting-induced back pain does not appear to be due to posture or muscle activity; however, it may be related to micro-movement strategies. Future work should explore fidgeting further and whether healthy PDs are at risk for clinical LBP in the future. Practitioner summary: We have replicated the differential transient sitting-induced pain response observed in previous studies. Pain developers do not sit differently than non-pain developers, although they do appear to move less. More research is warranted to better understand these groups and the relationship between pain developers and future cases of back pain. Abbreviations: LBP: low back pain; PG: pain group; PD: pain developer; NPD: non-pain developer; +veHx: positive clinical history for low back pain; -veHx: negative clinical history for low back pain; RTS: right thoracic erector spinae; LTS: left thoracic erector spine; RLM: right lumbar multifidus; LLM: left lumbar multifidus; MVC: maximum voluntary contraction; Pelvic N: normalized pelvic angle; ANOVA: analysis of variance; SD: standard deviation.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials. Wang 2025 BMJ.
- Gabapentinoids and Risk of Hip Fracture. Leung 2024 JAMA Netw Open.
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.