Back pain from sitting: NHS, Arthritis UK and HSE advice on posture, breaks and warning signs

Can sitting cause back pain?

Often back pain does not have one simple cause. Arthritis UK lists lack of exercise, which stiffens the spine and weakens muscles, muscle strains or ligament sprains, poor posture and an inadequate work or home working set-up among the possible contributors.² The NHS says it is not always obvious what causes back pain and that it often gets better on its own.¹

Sitting itself is not named as a disease. What the sources point to is staying in one position for a long time and sitting badly. The Health and Safety Executive (HSE) lists being in one position for a long time and working with display screen equipment with poor posture among the tasks that can cause back pain or make existing pain worse.⁵ Arthritis UK says awkward positions, or staying in the same position, may increase pain or recovery time.²

Another point from the HSE is worth knowing. A major reason for developing back pain is having had a previous episode, particularly a recent one. How work is organised, for example high workloads, tight deadlines and lack of control over how you work, can also have an impact.⁵ So a desk chair is part of the picture, not the whole of it.

This page covers back pain you can notice at a desk, in the car or on the sofa. It is not a diagnosis, and a gadget cannot tell you the cause of your pain. If you are worried, see the section on warning signs first.

Warning signs: when not to wait

Most back pain is not serious. The NHS says that very rarely it can be a sign of a serious problem, such as a broken bone, cancer or an infection.¹ The NHS sorts the symptoms by how quickly to act.

None of these signs is caused by a chair, and none is a reason to keep sitting. If one applies to you, the page is no longer the right place. Call 111 or 999 as above.

Setting up your workstation: what the HSE says

The HSE explains what good posture looks like with display screen equipment (DSE), meaning computers, laptops, tablets and smartphones, at home or at work.³ Incorrect use of DSE or a poorly designed workstation can lead to pain in the neck, shoulders, back, arms, wrists and hands, as well as fatigue and eye strain, and the causes may not always be obvious.⁶

Arthritis UK gives a matching checklist for people with back pain at work. Make sure the chair and desk are at the right height, the lower back is well supported and your feet reach the floor, with a footrest if they do not. Avoid stretching to reach the mouse, keyboard or phone.²

The HSE rules are an employer duty. They apply to workers who use DSE daily for continuous periods of an hour or more.⁶ If you are self-employed or work on the sofa, the same posture guidance is still a sensible checklist. The legal duty is not the same.

Breaks and movement: how often, how long

The law says employers must plan DSE work so there are breaks or changes of activity.⁴ The HSE says there is no legal guidance on exactly how long or how often. It depends on the work. It does recommend short, frequent breaks: for example, 5 to 10 minutes every hour is better than 20 minutes every 2 hours.⁴ Ideally you choose when to take them.⁴

A break should let you get up and move around, or at least stretch and change posture.⁴ Changes of activity count: going to a meeting or making a phone call can be that change, if it gets you off the chair.⁴ Arthritis UK suggests setting a timer on your phone or computer to remind you to stretch and walk around at least once an hour.²

Break-monitoring software can remind people to take breaks, but the HSE says employers remain responsible for planning work and making sure people take suitable breaks.⁴ If you are the one at the desk, the timer is your tool.

Staying active when your back hurts

The NHS advice for back pain you manage yourself is to stay active and carry on with daily activities. It says not to stay in bed for long periods.¹ Arthritis UK is more direct: in the past people were advised to rest in bed, and we now realise this does more harm than good.² Not moving can make the back stiffer and more painful.²

The NHS says activities such as walking, swimming, yoga and pilates may help ease back pain, and there are specific back exercises and stretches. It adds that you should stop if the pain gets worse and see a GP.¹ Arthritis UK lists swimming, walking, yoga, pilates and going to the gym, and says to choose something you enjoy and to start gently, building up a little each day.² Exercise may feel sore at first, which does not usually mean you are harming your back.²

For pain that is not settling, the NHS says other options may be offered after a few weeks, such as group exercise sessions and physiotherapy, manual therapy, or cognitive behavioural therapy to help you cope with the pain.¹ NICE has a guideline on assessing and managing low back pain and sciatica in people aged 16 and over, covering physical, psychological, pharmacological and surgical options.⁸

If you are unsure which painkiller suits you, the NHS advises checking with a pharmacist or GP.¹ Heat packs or ice packs wrapped in a tea towel are mentioned by the NHS and Arthritis UK.¹²

• Keep doing daily activities as far as pain allows.¹
• Do not stay in bed for long stretches.¹
• Choose gentle activity you like and build up slowly.²
• Stop an exercise if the pain gets worse, and see a GP.¹
• Go back to work, or stay at work, if you can. Arthritis UK says this often helps recovery.²

Work, weight and the long view

Arthritis UK says that getting back to work, or staying in work if you can, often helps people recover more quickly, and that you do not need to wait until the problem has gone completely. If you cannot get back to work after two weeks because of your back pain, it advises talking to your GP and employer about physiotherapy or other treatment.² An occupational health adviser, if your job has one, can advise on safe adjustments.²

On weight, Arthritis UK notes no special diet has been shown to help or prevent back pain, but if you are overweight, losing weight with a healthy diet and regular exercise can reduce the strain on your back. It suggests speaking to a doctor first if you plan to lose weight.² The NHS also lists joint and back pain among the day-to-day problems linked to obesity.⁹ For the numbers, see our guides to BMI and healthy weight and measuring your waist.

Lifting is a separate cause of back pain at work, according to the HSE, along with carrying loads awkwardly, pushing and pulling, repetitive tasks, bending and twisting.⁵ Arthritis UK suggests bending the knees, keeping the load close and using both hands.²

The HSE adds a reassuring point for employers and workers: people with back pain usually recover completely if the problem is recognised early and managed appropriately, and it encourages workers to report problems early.⁵

What a seat sensor can and cannot do

Some people want feedback on how they sit. A connected cushion is one wellness option. Dorsi has a 9-axis sensor that records tilt angles while you do guided movements on it, and the Chutex app uses them to build an indicative lumbar mobility assessment.¹⁰ That is information about how you move, in degrees.

It does not tell you why your back hurts. Dorsi does not diagnose, does not promise pain relief and does not replace a physiotherapist or a GP.¹⁰ Treat it like a timer with a bit more detail: a prompt to move and a record of what you did. The measures that the NHS, Arthritis UK and the HSE describe, such as breaks, activity and a well set up desk, do not depend on any device.

• A sensor can record tilt angles. It cannot tell you the cause of pain.¹⁰
• A cushion can add lower back support, as the HSE notes for a seat back,³ but it does not change the desk, the screen or the time you sit.
• If you have any warning sign from the table above, call 111 or 999 and do not use a device first.

Frequently asked questions