I’ve often been asked, “What is the best chair to use?” My response to that question is the best chair is the one you sit in as little as possible. There is a lot of research demonstrating the damaging effects of sitting. In fact, sitting has recently been referred to as the “new smoking”.

Sitting for prolonged periods of time can be a major cause of back and neck pain. Poor posture will cause increased load and damage in the inter-vertebral discs in the spine, deformation of the spinal ligaments and tension and fatigue in the muscles of the neck, jaw, upper and lower back, shoulders and hips.

If that’s not enough to scare you out of your chair, new studies also show that prolonged sitting can increase the risk of cardiovascular disease, diabetes, cancer and depression. This has been demonstrated in people who sit as little as four hours per day total. Even more alarming is that this increased risk of disease linked to sitting was still present in subjects who exercised. The body is designed to move consistently throughout the day. Movement allows proper circulation to occur. Lack of adequate circulation is what leads to these conditions. So if you have poor circulation all day except for a half hour to hour of exercise, damaging effects will still accumulate.

So what is the solution? Stand up!

Options for those who work at a desk are standing desks, or even better, adjustable height desks so that one can sit or stand depending on their condition. If sitting cannot be avoided, take short standing breaks every 20 to 30 minutes for at least one minute and walk, stretch or perform a simple exercise. More active chairs such as exercise balls and Swedish kneeling chairs can be helpful, but consult a professional to assure this is a suitable option, as they can also be a problem if injury is already present. Try to sit no more than a total of 3 hours per day, including work, commute and home on the couch.

Here are some basic postural guidelines to follow while sitting to minimize stress on the muscles, ligaments and discs:

• Sit as close as possible to your desk so that your upper arms are parallel to your spine.
• Maintain a 90-degree angle at the elbow while your hands are on the keyboard or mouse. Move your chair up or down accordingly. Armrests are helpful and should be set so that they very slightly lift your arms at the shoulders.
• Check that you can easily slide your fingers under your thigh at the leading edge of the chair. If it is too tight, prop your feet up with an adjustable footrest. If there is more than a finger width between your thigh and the chair, you need to raise the desk/work surface so that you can raise your chair.
• With your buttocks against the chair back, try to pass your clenched fist between the back of your calf and the front of your chair. If you can’t do that easily, the chair is too deep. You will need to adjust the backrest forward, insert a lumbar support or get a new chair.
• Your buttocks should be pressed against the back of your chair, and there should be a cushion that causes your lower back to arch slightly and prevent slumping forward. Never slump or slouch in your chair, as this places extra stress on your spine and lumbar discs.
• Your gaze should be aimed at the center of your computer screen. If your computer screen is higher or lower than your gaze, you need to either raise or lower it.

Dr. Robert Inesta