At the age of 24, I found myself lying on the radiology unit floor after spending nearly a year in excruciating pain, bedbound, and dosed to my eyeballs in painkillers.
I was waiting for my MRI scan, unsure why I spent so long avoiding getting one.
The results clearly showed a massive herniation on my L4/L5 vertebrae. The disc was fully dehydrated, and its contents were pushing into my spinal nerve, causing excessive pain relative to its size.
Being somewhat young, I was advised to avoid surgery and embark on a more natural recovery to avoid unnecessary risks. I continued using painkillers and begin an intense physiotherapy regime.
It took two years before I could jog, and I still can’t play sport.
I slipped my disc after quickly bending over to reach for something in an awkward position.
At the time, it felt so innocuous. It was hurting, but I kept thinking it would get better and heal like a pulled muscle. It didn’t.
I was baffled how a healthy 24-year old who’s been active throughout his life could have a severely herniated disc from bending over quickly.
The MRI provided a clue. Aside from the herniated disc, my L5/S1 (lower back) had a slight disc bulge.
Disc bulges are often precursors to herniated discs. It’s a sign the disc is compromised.
Here are some risk factors for developing disc bulges:
- Smoking and obesity
- Continuous strain on the disc from injury or heavy lifting
- Acute trauma (high contact sports, etc.)
- Sedentary lifestyle
- Bad posture during sleep, sitting, standing, and or exercise
I don’t smoke, and I’m not obese. I’m not continuously straining, nor have I had acute trauma.
This leaves a sedentary lifestyle and poor posture, of which I have in abundance.
You see, I am a software developer, and before that, I was a teenager who spent most of his time in front of a computer.
Although I am active outside of programming, I spend the majority of my day sat down.
And herein lies the problem, sitting.
The more I learn about sitting and, in general, a sedentary lifestyle, the more I realize how immense the problem is.
A study from the UK found office workers are sedentary for 82% of their work hours (1). More alarmingly, the US Bureau of Labor Statistics found that software developers spent 90% of their time sitting (nearly the highest of any profession) (2).
Including weekends, the average office worker spends 10.6 hours per day sitting (1). Plus, 7 to 8 hours for sleeping, which only leaves 5-6 hours per day for standing, walking, or running.
Ergotron, a global manufacturer of sit-stand desks, found nearly 70% of full-time American workers hate sitting, yet 86% percent do it daily (3).
Ironically, they also found that more than half of workers (56%) use getting food as an excuse when they do get up.
As bipedal apes, our physiology is designed to move and walk, not for extended periods of inactivity and sitting.
We’ve known since the 1950s that there’s a strong link between sitting and health when researchers found double-decker bus drivers were twice as likely to have heart attacks than their conductor counter-parts.
Since then, evidence continues to emerge, showing that excessive sitting is dreadful for our overall health in a myriad of ways.
Alarmingly, it appears short bursts of activity or exercise can’t remedy the detrimental effects caused by long periods of sitting. Just because you go for a run or hit the gym after work does not mean you are immune.
A study of nearly 8,000 adults found a direct relationship between time spent sitting and your risk of early mortality of any cause (4), even with exercise.
The most significant risk was for people who spent more than 12.5 hours a day being sedentary — and also people sitting for longer than 10 minutes at a time (4).
Even the most physically active amongst us who run or swim for an hour every day or are active for 300+ minutes per week still may face an increased risk of all-cause mortality when sitting for six or more hours per day (5, 6).
“The association between sitting and all-cause mortality appeared consistent across the sexes, age groups, body mass index categories, and physical activity levels and across healthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus,” the researchers wrote.
“Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity.” (5)
Studies have linked sitting duration and periods of inactivity to heart disease (7), type 2 diabetes (8), and certain forms of cancer (9).
Sitting for long periods is thought to affect your body’s ability to regulate blood sugar (insulin resistance), blood pressure, and fat breakdown by slowing your metabolism.
A well-studied side effect or sitting is endothelial dysfunction (the inability of our blood vessels’ inner lining to relax arteries). If you don’t use it, you lose it. Interestingly the cell lining of our arteries can sense the force of blood flowing past. Maintaining regular blood flow is crucial for a healthy endothelium. Without this, we set ourselves up for heart disease (10)
As mentioned above, your metabolism slows down while sitting. Enzymes that break down fat drop by 90% (11), and you burn fewer calories compared to standing or walking (depending on your current weight).
All this makes losing weight increasingly tricky. Live Strong estimates the average sedentary worker burns 2,783 calories over 24 hours, in contrast to an active worker who burns 4,006 calories in the same period. (12)
That’s a difference of 1,223 calories per day!
It’s worth noting; I feel these estimates are a little exaggerated. That being said, even a 20% difference (currently 44%) between the two would be substantial.
Annually, 75% of office workers will experience lower back pain. Worryingly, the US is spending over $50 billion per year treating back pain. (13)
While it may be relaxing, sitting puts stress on the muscles and discs in your back and neck, causing pain.
Prolonged sitting often leads to slouching and shortened hip flexors which, causes the spinal ligaments to stretch beyond their limits, which leads to poor posture, which increases the strain on your spinal discs.
The result is increased pressure on the disc’s outer annulus, frequently leading to disc bulges, herniations, and back pain.
Additionally, working on a computer results in a forward head position and a rounded shoulder posture—aka “poor posture syndrome.”
Unexpectedly, the implications of sitting go beyond physical health. A study in 2014 found the risk of developing depression and anxiety increased inline with the amount of time spent sitting. The two worst offenders were travel-based sitting and sitting in front of a computer. (14)
Two commonly cited solutions for combating sitting at your desk are exercise before or after work and standing desks.
Both are severely flawed.
As mentioned above, exercising before or after work does not negate a sitting marathon’s harmful effects.
The adverse effects on your ligaments and muscles of sitting and lying for most of the day are unlikely to be reversible with 1 hour of exercise.
And, according to the estimates above, your exercise session would need to be an absolute sweat bath to catch up to an active worker (you’d need to run a half marathon).
Besides, prolonged sitting is a risk factor for all-cause mortality, independent of acute physical activity.
Standing desks appear like a considerable improvement; however, one study found standing only burned eight more calories per hour vs. sitting at your computer for the same period. (15)
What’s more, researchers in the Journal of Preventive Medicine carried out a systematic review in 2015 of sitting and standing desks in the workplace and found little evidence of positive health benefits or psychological well-being. (16)
Prolonged standing can lead to swelling & compression of the spine, just like sitting. Muscles and ligaments also tighten and stretch past their natural limits, leading to poor posture and chronic pain.
This chapter and article’s title mentions the phrase an “uncomfortable truth,” which is a light-hearted play on words, attempting to make fun of an otherwise lousy situation office-workers find themselves in.
The truth is, the only way to indeed be healthy at your desk is by leading an active day rather than a sedentary one.
You are a Homo sapien, built for walking, running, climbing, toolmaking, socializing, and generally moving around regularly, and this is what you must do every day.
The way we live in the 21st century is at odds with our evolution. If physical and mental health is important to us, we must reconcile both worlds to the best of our ability.
And is it possible to reserve many of the adverse side-effects from years of sitting?
Luckily it’s not all doom-and-gloom. Looking back at the research and personal experience, it’s clear we do have some weapons at our disposal in the war against sitting and our sedentary work lives.
Taking regular breaks is very important, especially if you use a chair or standing desk for most of the day.
Within just one hour of sitting, blood starts pooling, and blood flow stagnates. Early evidence from observational studies and interventional studies suggest regular breaks in sitting time can be beneficial (17).
More than 10 minutes of continuous sitting can be bad for us. However, getting up every 10 minutes is not practical. So it’s frequently recommended to get up at least every 30-60 minutes.
Once you’re up, physiotherapists advise performing a little backbend with your palms fixed on your lower back for support. The idea is to realign your spine and discs.
After which, go for a 5-minute walk. Grab a coffee, do a few squats. Whatever gets you moving.
Desk treadmills may be the ultimate weapon against sitting disease. They get your muscles working and oxygen pumping around the body.
Recent data now suggests that treadmill desks may improve office workers’ health without negatively affecting performance. Additionally, walking may be preferable to standing because of its ability to clear fat from our bloodstream (18).
Walking at your desk (3 mph) burns roughly 144 more calories per hour than sitting and 132 calories more than standing (15).
The result is a faster metabolism with better fat break down. Ligaments, especially around your hips, loosen, which reduces strain on your lower back, and your discs stay happy—providing a much-needed break from crunching your lower spine at a 90-degree angle.
Even at a relatively slow pace, our caveman DNA kicks in. Cognitive ability and concentration increases, while susceptibility to distraction decreases.
I like to walk at a pace of 2mph for thinking tasks, 3mph for mind-numbing repetitive tasks, and 4mph for zoom meetings.
That being said, it’s not all sunshine and rainbows:
- Treadmills are expensive
- Treadmills are heavy and cumbersome.
- Treadmills still require a standing desk.
- Walking in a straight line is sometimes stiffening. We need different types of movement.
- Sometimes, treadmills give you static shocks.
- Treadmills use a lot of electricity.
- Treadmills can interfere with your electronics.
There is an abundance of little desk-based exercises we can perform throughout the day to combat some of the adverse effects of sitting.
Consistently performing specific active stretches and exercises can dramatically reduce chronic pain and correct our poor posture, developed from years of slouching.
Exercises and stretches which focus on your lower back, middle back, neck, hips & hip flexors, legs, shoulders, and chest can significantly improve:
- Chronic pain in your neck & back
- Rounded shoulders & tight check
- Nerd’s neck
- Hunch back
- Forward & backward hip tilt
- Strength in your back, legs, and core
- Endurance & cardiovascular health
Sitting for long periods is harmful to our health but a way of life for desk-workers.
To me, it’s clear from research and my personal experience that having a balance between sitting, regular breaks, walking, and desk-based exercises is the best way to fight this fight.
No single solution is enough by itself, so we need to change it up.
The biggest problem is our time and attention. The stress of work and life generally means we don’t prioritize our desk-health until it’s too late.
We don’t want another thing to stay on top of; therefore, we often ignore it and fail to put regular habits into practice, including me.
Thus, I have decided to direct my attention to solving this problem better.
Staying healthy at your desk shouldn’t be a drag; it should be seamless, fun, and rewarding.
I have a unique take on how to solve this issue and will spend the next six months of my life building it.
I have aptly named my upcoming product “Desk Warrior.”
If you are interested in following my progress, would like updates on the product and early access, please click the image below.
It’s worth mentioning there are limitations with the current research because most of the evidence is based on observational studies, which show an association between sitting and poor health, but not a direct cause.
- Occupational Physical Activity Habits of UK Office Workers: Cross-Sectional Data from the Active Buildings Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025535/
- Standing or walking versus sitting on the job in 2016 https://www.bls.gov/opub/ted/2017/standing-or-walking-versus-sitting-on-the-job-in-2016.htm
- Ergotron JustStand® Survey & Index Report https://www.juststand.org/wp-content/uploads/2017/05/SurveyIndexReport.pdf
- Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults https://www.acpjournals.org/doi/10.7326/M17-0212
- Sitting time and all-cause mortality risk in 222 497 Australian adults https://pubmed.ncbi.nlm.nih.gov/22450936/
- Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults https://pubmed.ncbi.nlm.nih.gov/20650954/
- Prolonged sitting: is it a distinct coronary heart disease risk factor? https://journals.lww.com/co-cardiology/Abstract/2011/09000/Prolonged\_sitting\_\_\_is\_it\_a\_distinct\_coronary.8.aspx
- Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis https://link.springer.com/article/10.1007/s00125-012-2677-z
- Sitting Time and Mortality from All Causes, Cardiovascular Disease, and Cancer https://www.flexchair.nl/wp-content/uploads/sites/12/2017/05/sitting\_time\_and\_mortality\_from\_all\_causes.pdf
- Sitting and endothelial dysfunction: the role of shear stress https://pubmed.ncbi.nlm.nih.gov/23197245/
- Energy expenditure of nonexercise activity https://academic.oup.com/ajcn/article/72/6/1451/4729468
- How Many Calories Are Burned Daily by Active and Sedentary People? https://www.livestrong.com/article/312510-how-many-calories-are-burned-daily-by-active-sedentary-people/
- Association between sitting and occupational LBP https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200681/
- Associations of overall sitting time and sitting time in different contexts with depression, anxiety, and stress symptoms https://www.sciencedirect.com/science/article/abs/pii/S1755296614000088
- Energy Expenditure During Acute Periods of Sitting, Standing, and Walking https://www.ncbi.nlm.nih.gov/pubmed/26693809
- A systematic review of standing and treadmill desks in the workplace https://www.sciencedirect.com/science/article/pii/S009174351400454X
- Breaks in sedentary time: beneficial associations with metabolic risk https://pubmed.ncbi.nlm.nih.gov/18252901/
- Treadmill desks: A 1-year prospective trial https://pubmed.ncbi.nlm.nih.gov/23417995/