Because the mechanism of low back pain is so poorly understood, there is no obvious solution to the epidemic of back pain that has engulfed the Western chair centric world. But, if we think that having our individual anatomy distorted by decades of all day contact with inflexible chairs, one solution might simply be to stop sitting. Unfortunately, this solution isn’t available to most of us. Chairs are now designed into our lives: we sit while driving, at meals, at work, at play, at… well, you get the idea.
A more practical solution might be to change the way we sit: rather than sitting passively, adopting the posture imposed by our Western chairs, we could sit actively, constantly changing our posture to match our anatomic needs and the requirements of the task at hand. Chairs that promote active sitting have become available in the last decade, and are becoming more affordable.
Unfortunately, active sitting is such a recent innovation that little research is available to support the expectation that active sitting will improve back pain. But there are plausible mechanisms by which active sitting might help: active chairs not only improve posture but also contribute to core strength and balance. By improving overall “back hygiene” we might hope to reduce, and perhaps eliminate, back pain. Indeed, the idea of “back hygiene” underlies an initiative by the Frode Skretting and the Norwegian government to provide active chairs to grade schools, on the theory that children who develop good postural habits will develop lifetime protection against back pain.
Until peer-reviewed research is published, we must rely on anecdotal reports of the association of active sitting with improved back pain. Reports such as this one: “I love my active chair; I can’t wait to get to the office in the morning to sit on my chair, because it makes my back feel so good”.