Lower back aches from sitting at a desk. What can I do?

If your lower back aches after a day at a desk, the main things to look after are how your chair supports your lower back, where your screen and keyboard sit, and getting up often. The back pain page of the US National Institutes of Health (NIH) says a desk job may play a role in back pain, especially if you have poor posture or sit all day in an uncomfortable chair. Set the chair so your lower back is supported and your feet rest flat, keep the screen and keyboard straight in front of you, and take a short break to move every hour.

How common is lower back ache among office workers in Thailand?

One in three office workers in a Bangkok survey

A survey by Janwantanakul and colleagues at Chulalongkorn University sent questionnaires to 2,000 office workers in 54 workplaces in Bangkok. Of the 1,185 who were eligible, 63% said they had musculoskeletal symptoms in the past 12 months that they put down to work. The lower back was the second most common site.

The survey was published in 2008, and the figures are what people reported themselves, so they show how common the complaint is rather than how severe.

What went with it

A second analysis of the same 1,185 workers found that people who worked more than 8 hours a day reported lower back symptoms more often. A one-year study that followed 669 healthy office workers, also from Chulalongkorn University, found three factors linked to new lower back pain: having had it before, how often people took rest breaks, and how demanding the job felt. These are associations seen in one group of workers, not proof of cause. In the same cohort, 27% of the workers who developed new lower back pain went on to have ongoing pain for more than 3 months within a 6-month period.

Why does sitting at a desk make my lower back ache?

The same position for hours

A doctor at Ramathibodi Hospital explains that aches from desk work mostly come from sitting in the same position or not moving for a long time, and from habits of sitting or walking badly without noticing. The aches often affect the neck, shoulders and back.

Little support and a still body

Three things tend to happen together at a desk:

• Back support: OSHA, the US Occupational Safety and Health Administration, says poor back support and awkward postures can come from a backrest that is the wrong size, material or position, or that is not used.
• Posture: The NIH page lists poor posture and an uncomfortable chair as ways a desk job may play a role.
• Staying still: OSHA says that however good your working posture is, working in the same posture or sitting still for long periods is not healthy.

That is why the steps below focus on the chair, the desk layout and moving during the day.

How should I set up my chair and desk for my lower back?

The UK's Health and Safety Executive (HSE) sets out a standard desk set-up for good posture, and OSHA gives matching advice on chairs.

A doctor at Ramathibodi Hospital gives similar advice: sit fully back in the chair with your back against the backrest, bend your knees and hips to about 90 degrees, keep your feet on the floor, and place the keyboard and mouse so your elbows bend to about 90 degrees.

Sitting upright or leaning back a little

OSHA describes several good working postures. In upright sitting, your body and neck are roughly vertical and your thighs roughly horizontal. In reclined sitting, your body and neck are straight and lean back between 105 and 120 degrees from your thighs, supported by the backrest. Changing between these during the day is part of not staying still.

If you work on a laptop

The HSE advises using a separate keyboard and mouse with a laptop, so the screen can be raised on a stand. Bending over a laptop on a low table works against the set-up above.

How often should I get up from my desk?

Short and often is better than long and rare. The HSE says there is no fixed rule because it depends on the work, but recommends short, frequent breaks rather than longer, less frequent ones, for example 5 to 10 minutes every hour rather than 20 minutes every 2 hours.

What counts as a break

The HSE says breaks or changes of activity should let you get up from your desk and move around, or at least stretch and change posture. Break-reminder software can help, and a phone timer works too. If you sit most of the day and rarely exercise, see I sit at work all day and barely exercise. Where do I start?

What stretches can I do at my desk?

The NHS has short seated exercises that suit an office. It suggests a solid, stable chair without wheels or arms, where your feet rest flat with your knees at right angles. Move slowly and only as far as is comfortable.

The NHS suggests doing these at least twice a week. Its back pain page also mentions exercises and stretches for back pain, but says to stop if your pain gets worse and see a doctor for advice. For the neck and shoulders, see Neck and shoulders ache from desk work. What can I do?

My lower back aches now. What can I do?

Keep moving

The NHS says back pain, particularly lower back pain, is very common, and often gets better on its own, usually within a few weeks, though it can sometimes last longer or keep coming back. In the meantime, it advises:

• staying active and trying to continue with your daily activities
• not staying in bed for long periods of time
• using an ice pack (or a bag of frozen peas) wrapped in a tea towel
• using a heat pack (or a hot water bottle) wrapped in a tea towel

About medicine

Check with a pharmacist or doctor before using any medicine for the pain, and tell them about any other medicines you take.

When should I see a doctor about lower back ache?

The NHS advises seeing a doctor if you have back pain and:

• it does not improve after treating it at home for a few weeks
• it is stopping you doing your day-to-day activities
• you are worried about the pain or struggling to cope
• you have lost weight without trying to
• there is a lump or swelling in your back, or your back has changed shape
• it does not improve after resting, or is worse at night
• it is worse when sneezing, coughing or pooing
• it is coming from the top of your back, between your shoulders, rather than your lower back

A doctor at Ramathibodi Hospital also advises seeing a doctor promptly if the pain is bad enough to affect your rest and sleep, or if your back hurts while you are lying down.

Get help straight away

The NHS advises getting urgent help the same day if you feel hot, cold, shivery or generally unwell, or if severe pain starts suddenly or gets worse quickly. Go to an emergency department straight away if back pain comes with pain, tingling, weakness or numbness in both legs, loss of feeling around your genitals or bottom, changes in peeing or pooing, chest pain, or if it started after a serious accident. In Thailand, you can see a doctor at a hospital or clinic. In an emergency, go to the nearest hospital emergency department.