An interesting dichotomy has arisen in the ergonomic world due to the research demonstrating that increasing incidental activity in the day is beneficial to long term health, particularly for those that have a sedentary job (see Working from a stand-up desk). For decades ergonomists have advised office workers to “eliminate muscle activity where you can”. This new maxim “use muscle activity where you can” requires a new approach to office ergonomics in order that increasing activity can be adhered to without increasing bodily pain. One method of increasing incidental activity currently being espoused in the media is to stand to work. But this advice requires qualification if you are to avoid painful ramifications.
In order to help you decide whether you should sit/stand/perch this post, and the one on Standing desks need a standing support, aims to address some of the arguments that are being left out of the current “Standing versus Sitting” debate.
Stationary standing can cause back pain
- Occupations that require standing for periods of more than 30 minutes in the hour show high incidence of back pain.
- In a recent study 23 people were required to perform light tasks for 2 hours from a stationary standing position. In these 2 hours, 15 of the 23 participants developed low back pain. The important point to note here is that these people had never previously had back pain.
- It is possible to predict who is at risk of developing low back pain from standing. It is also possible to prescribe simple exercises to treat this dysfunction effectively.Your physical therapist should be able to help with this and with a routine of trunk stabilizing exercises, if they are required.
- Although more women work from fixed standing postures than men, low back pain occurs in either sex if people work from a fixed standing position.
- People who have the freedom to sit at will have less low back pain than those who stand in fixed postures or walk.
Stationary standing can cause circulatory insufficiency in the legs
- Prolonged standing causes pooling of the blood in the legs with sluggish return of blood to the heart, swelling of the legs and the possibility of blood clot in both men and women. In females prolonged standing can cause preterm birth and spontaneous abortion.
- People working in a fixed standing posture are at a significantly greater risk of cardiovascular disease than those working in a fixed sitting posture.
- People with occupations requiring prolonged standing have increased incidence of varicose veins and nocturnal cramps.
Are there any benefits, then, of standing to work as opposed to sitting?
- Standing requires activation of muscles which uses 10kcal/hour more than sitting and in the long term, along with other measures, is useful in addressing abdominal fat.  (see Working from a stand-up desk?)
- “Activity energy expenditure is low during most types of sitting compared with even light-intensity movements when standing”. .(However, dynamic seating such as the Move Stool uses the legs to create movement, thus increasing circulation, decreasing leg swelling and improving spinal motion).
- Standing reduces loads acting on the back compared with loads accrued when sitting. Therefore “standing, used alternatively as a rest from sitting, could form a basis for injury prevention when designing work.”
- There is little agreement in the research literature as to whether standing reduces musculoskeletal pain, or whether it increases the ability to concentrate.
- It has long been thought that standing decreases the pressure in the discs and therefore reduces the risk of disc degeneration. It has recently been shown that disc pressure is similar in sitting and standing when some degree of the natural curve of the low back maintained.
Standing to work may be good for your health in the long term because it uses more calories, particularly if you move, and it decreases loads on the spine. However, in the short term prolonged standing can cause low back pain and circulation problems in the legs leading to blood clots in the lungs. And if you are standing stationary then there is constant loading through the same joints and tissues in the spine and lower limbs and little provision for rest or change in levels of muscular activity. On the other hand, sitting for long periods is also detrimental to health in that the reduced muscle activity uses less calories, there are increased loads through the spinal structures particularly in slouched postures (see Your ergonomic chair may not be the cause of your back pain), and sustained sitting can also lead to blood clots.
Therefore you need to be able to vary your posture between sitting and standing. And you need to move while in each posture.
One method of working from both sitting and standing postures is to use a sit/stand desk. But what do you sit on? Using a sit/stand desk requires a special seat. You have choices for such support in the Variér range. Starting with the Variér Move Standing Stool
Pedersen 2009 p.5559-60 states “It is well-established that physical inactivity increases
the risk of type 2 diabetes …, cardiovascular diseases (CVD), … colon cancer … and postmenopausal breast cancer. … In addition, physical inactivity may also play a role in the development of dementia … and even depression”.
 Andersen JH. et al. (2007). “Risk Factors for More Severe Regional Musculoskeletal Symptoms. A Two-Year Prospective Study of a General Working Population.” Arthritis and Rheumatism, 56, (4): 1355–1364.
Nelson-Wong E. et al. (2008). “Gluteus medius muscle activation patterns as a predictor of low back pain during standing”. Clinl Biomechs, 23, 545–553.
 Nelson-Wong & colleagues (2008) have shown that people who develop low back pain while standing compensate for weak abdominal and back muscles (trunk stabilizers) by overusing the hip muscles.
 Nelson-Wong E and Callaghan JP. (2010). “Changes in muscle activation patterns and subjective low back pain ratings during prolonged standing in response to an exercise intervention.” J. Electromyogr Kinesiol, 20(6):1125-33.
 However more men work in stationary sitting positions than women. Tissot F. et al. (2009). “Studying the relationship between low back pain and working postures among those who stand and those who sit most of the working day”. Ergonomics, 52(11):1402-18.
 McCulloch J. (2002). “Health risks associated with prolonged standing.” Work; 19(2):201-5; Shai A. et al. (2007). “Possible ramifications of prolonged standing at the workplace and its association with the development of chronic venous insufficiency”. Harefuah, 146(9):677-85, p. 734
 Sudol-Szopinska I. et al. (2011). “Prevalence of chronic venous disorders among employees working in prolonged sitting and standing postures.” Int J Occup Saf Ergon, 17(2):165-73.
 Bahk JW. Et al. (2011). “Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men.” Ergonomics E pub Aug 17, in press.
 Levine JA and Miller JM. (2007). “The energy expenditure of using a ‘‘walk-and-work’’ desk for office workers with obesity”. Br J Sports Med, 41:558–561.
 Hamilton MT. et al. (2007). “Role of Low Energy Expenditure and Sitting in Obesity,
Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease”. Diabetes, 56:2655–2667, p.2568.
 O’Sullivan, P., et al. (2006). “Lumbopelvic kinematics and trunk muscle activity during sitting on stable and unstable surfaces”. Journal of Orthopaedic Sports Physical Therapy, 36 (1), 19–25; Stranden, E. (2000). Dynamic leg volume changes when sitting in a locked and free-floating tilt office chair. Ergonomics, 43 (3), 421–433.
 Callaghan JP., McGill SM. (2001) “Low back joint loading and kinematics during standing and unsupported sitting”. Ergonomics, 44(3):280-94.
 Ebara et al. report that there is increased concentration and musculoskeletal pain. Husemann et al. state there was decreased concentration and musculoskeletal pain.
Ebara T et al. (2008). “Effects of adjustable sit-stand VDT workstations on workers’ musculoskeletal discomfort, alertness and performance”. Ind Health, 46(5):497-505; Husemann B. et al. (2009). “Comparisons of musculoskeletal complaints and data entry between a sitting and a sit-stand workstation paradigm.” Hum Factors, 51(3):310-20.
 Claus A. et al. (2008). “Sitting versus standing: does the intradiscal pressure cause disc degeneration or low back pain?” J. Electromyogr Kinesiol, Aug;18(4):550-8.
 “Standing/walking for > 5 hours/day without rest breaks, as well as frequent working in static postures and sitting during work were each significantly related to a high prevalence of experiencing lower back symptoms”. Pensri P. et al. (2010). “Biopsychosocial risk factors for musculoskeletal symptoms of the spine in salespeople.” Int J Occup Environ Health, 16(3):303-11.