Study: Standing at Work is Associated with Less Neck and Back Pain and More Optimal BMI

Updated: January 7, 2019 by RJ Burr DC, Cert. MDT

Does standing more and sitting less lead to healthier outcomes for office workers? Our Office Lifestyle Study was designed to help us understand how standing more throughout the work day and sitting less has an impact on back pain, neck pain, and BMI.

Methodology

Many studies have highlighted the impact standing desks can have on weight loss and productivity but few have evaluated the potential benefits of standing periodically at work and in the office and how it relates to back and neck pain.

We reached out to nearly 800 office workers who typically sit and/or stand at a desk while working. We asked those who responded how much they typically sit and/or stand at their desks during a typical workday. We then asked the respondents to report on their back and neck pain levels, weight, height, and gender in hopes of revealing contrasting data between groups that tend to stand vs groups that tend to sit or combinations of both standing and sitting.

In evaluating the data we found it important to break out respondents into buckets based on their standing or sitting habits. We will be referencing these groups in our findings below.

Defining groups that mostly stand or mostly sit
  • “Standers” define the group of respondents that reported they stand at their desk 20% or more of the time during a typical workday.
  • “Sitters” define the group of respondents that reported they stand at their desks less than 20% of the time during a typical workday.

  • Defining groups based on the duration of their standing
  • “Power Standers” define the group of respondents that reported standing 50% or more of the time spent at their desk.
  • “Moderate Standers” define the group of respondents that stand 20% to 49% of the time spent at their desk.
  • “Light Standers” define the group of respondents that stand 1% to 19% of the time spent at their desk.
  • “Non-Standers” define the group of respondents that reported they do not spend any time at their desk standing.
  • Findings

    1. Standers experience 31% less back pain than sitters

    We asked all respondents to rate their level of back pain on a scale from 1 to 10 with 1 meaning no pain and 10 meaning intense pain. The overall average value was 2.92 but when broken down by those who sit (sitters) and those who stand (standers) we found that standers reported 31% less back pain reporting an average back pain level of 2.39 while sitters reported an average of 3.47. A study done by Ognibene et al. and published in the Journal of Occupational and Environmental Medicine in 2016 gave participants suffering from lower back pain standing desks. They observed a "a significant reduction in current in lower back pain over time." This suggests that standing at work can not only avoid pain but help reduce it for those that are already suffering. Visit the JOEM site for more information on the study.

    Level of reported back pain (1-10 scale):
    Group Average Pain Level
    Standers 2.39
    Sitters 3.47
    Overall 2.92
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    2. Standing duration is correlated with less back pain

    We took the same back pain level data and broke it down into groups by standing duration and found indicators that the more you stand the less back pain you’re likely to have. Power Standers, the group that spends 50% or more of their time at their desk standing reported the lowest back pain level at an average of 1.31. There are a number of studies that support that even a nominal time allocation to standing can lead to many positive outcomes. A great example is the Take-a-Stand Project conducted in 2011 which observed in their participants (after introducing the option of standing desks) a "reduction in upper back and neck pain by 54%, and improved mood states." Read further about the insightful study by Pronk et al. on the CDC.gov site.

    3. Standers experience 28% less neck pain than sitters

    Like our back pain evaluation, we also asked all respondents to rate their level of neck pain on a scale from 1 to 10. The overall neck pain value was 3.1. Again, we broke this metric down into those who stand and those who do not and found that standers reported having less neck pain with an average pain level of 2.6 or 28% less than the 3.6 reported by sitters. A study conducted by Ariens et al. on the relationship between sitting and neck pain observed similar results concluding that "Sitting at work for more than 95% of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain." Review the full study published in the Journal of Occupational and Environmental Medicine.

    Level of reported neck pain (1-10 scale):
    Group Average Pain Level
    Standers 2.61
    Sitters 3.61
    Overall 3.09
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    4. Standers have an 8% lower BMI (body mass index) compared to sitters

    During our evaluation, we also gathered data on each respondent that would allow us to calculate their actual body mass index as well as their ideal BMI. While the overall average for the study was 25.9, standers averaged a 24.9 while sitters averaged 27.1 a difference of 8%.

    Calculated BMI using age, height, weight, and gender
    Group Calculated BMI
    Standers 24.9
    Sitters 27.1
    Overall 25.9
    5. Standing duration has a positive impact on BMI

    Using the same BMI metrics we broke down the respondents by their standing duration. found that respondents that stood the most had lower BMIs. Power Standers reported the lowest BMI calculation while decreasing standing time lead to higher BMI, with non-standers having the highest of the 4 groups.

    Calculated BMI using age, height, weight, and gender
    Group Calculated BMI
    Power Standers 24.3
    Moderate Standers 25.2
    Light Standers 25.8
    Non-Standers 28.1
    Overall 25.9

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    Conclusion

    The first major finding is that “standers” (respondents who stand 20% or more of the time) experience 31% less back pain than “sitters” (respondents who stand less than 20% of the time), on average. The study also found that “standers” experience 28% less neck pain than their “sitters” counterparts. The final major finding was that “standers” report having an average BMI of 24.9 while “sitters” reported and average BMI of 27.1 – a difference of 8%. Thus, standing more at work is associated with less neck and back pain and a more optimal BMI for office workers.

    Is the difference maker of the statistics really standing versus sitting, or maybe people who stand at work already tend to be health conscious, practicing other health-conscious habits like walking, exercise, and diet/nutrition?... I believe, at very least, standing at work imparts active behaviors and a healthy mindset, which leads to overall wellness. Dr. Simmons of the Cincinnati Children’s Hospital had this to say about the results:
    ‘A healthy lifestyle, including minimizing musculoskeletal pain and maintaining a healthy BMI, is the cumulative effect of dozens of dietary and physical behaviors. Standing at work is a relatively easily modified behavior that can have a profound impact on quality of life, especially when we consider the close relationship between BMI and musculoskeletal pain.’

    References and Continued Reading

    • G Ariens, P Bongers, M Douwes, M Miedema, W Hoogendoorn, G van der Wal, L Bouter, and W van Mechelen. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Journal of Occupational and Environmental Medicine, 2001 March; 58(3): 200–207.
    • Nicolaas P. Pronk, PhD; Abigail S. Katz, PhD; Marcia Lowry, MS; Jane Rodmyre Payfer. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011.
    • Ognibene, Grant T. BA; Torres, Wilson BS; von Eyben, Rie MS; Horst, Kathleen C. MD. Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of Occupational and Environmental Medicine, 2016 March; 58(3): 287-293.

    What You Can Do Next

    Below are our recommended next steps that can help guide you to live a healthier lifestyle based on this study's results and external findings.
    • Make time to get up from a seated position at least once every hour of every day.
    • If you have access to a standing desk take our 30-day challenge to start standing at work. This lays out a realistic blueprint for standing at work and offers tips to turn this into a sustainable habit.
    • If you're researching standing desk options, read our buying guide to find things to look out for or jump to our latest research on the best standing desks.
    • If you work at a desk, standing or sitting, take the time to ensure you're using proper workplace ergonomics.
    • Continue researching on the risks of excessive sitting.
    • Learn how sitting can cause back pain and how to avoid it.
    • Set achievable standing goals and remember that even a small amount of time invested in standing can lead to improved pain and health outcomes as evidenced in our findings.

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