Thursday, January 26, 2012

The Best Chairs for Lumbar Back Support - How to Prevent Back Pain at Work and Home

Your back is aching, and it’s no wonder! You spend three-quarters of your day either sitting at the office or on a couch watching TV. But you don’t have to just grimace and bear chronic lower back pain. Proper posture, a good office chair and some simple lifestyle changes can bring relief...

How much time do you spend sitting?

If you’re like most desk jockeys, it’s as much as 40 hours a week at work.

So if your office chair just isn’t right, your back health will suffer, leaving you with an achy spine, sore shoulders or stiff neck.

“When a chair doesn’t support your spine, your muscles have to work harder, and you’ll feel fatigued at the end of the day,” explains Paul Cooke, M.D., a physiatrist (rehabilitation specialist) at the Hospital for Special Surgery in New York City.

After a while, the vertebrae in your lower back, known as your lumbar, won’t be able to maintain spinal alignment.

That puts more stress on discs and joints, leading to more pain, he says.
Later, when you settle into your couch to watch TV, you may be worsening back pain.

That’s because soft cushions offer even less lumbar back support than office chairs do.

But your back health doesn’t have to suffer from long hours behind a desk and on spongy sofas.

We asked back doctors and physical therapists for tips to finding the best office chair, relieving pain and even preventing varicose veins.

Sit Right
Lumbar back support: “In an office, none of the other adjustments you make – to your keyboard, mouse or desk – is as important as your chair,” says Marc Turina, a Pittsburgh physical therapist and ergonomics specialist who helps businesses provide body-friendly workplaces.

“It sets the foundation for how you’re positioned at work," he says.

The most important function of an office chair is to maintain proper curvature of your lumbar spine, Cooke says.

For this to happen, your pelvis needs to tilt slightly forward, adds Mary Ann Wilmarth, a Boston ergonomics specialist, physical therapist and spokeswoman for the American Physical Therapy Association.

“If your lower back isn’t properly supported, it’s almost impossible to put your upper back in a good position,” Wilmarth says.
If your chair isn’t supportive, attach a small lumbar roll where the chair meets your lower back, she advises.

Posture perfect: While sitting in your chair, ask someone to observe your posture or take a cell phone picture so you can evaluate it yourself, Wilmarth says.

“Your ear, shoulder and hips should be in a vertical straight line.”

To avoid wrist and back problems, “elbows should be at 90°-100° angles, and wrists should be straight out,” Turina says.

You should be able to adjust the height of your chair to make that happen in relation to your desk.

Feel the floor: Feet should rest on the ground with hips and knees at a 90° angle, Turina says.

If your seat is so high that your feet can’t feel the floor, use a footrest or pillow.

No knee pressure: Make sure the seat doesn’t press against the back of your knees, says chiropractor Scott Bautch, D.C., an occupational health specialist and spokesman for the American Chiropractic Association.

“Pressure behind your legs will cause poor circulation, varicose veins and spider veins,” he explains.
If your knees press against the edge of the seat, prop a pillow behind your back so you’re sitting farther forward – but make sure it’s still supporting your lower back.

Better yet, buy a chair that fits your body better.

Go Chair Shopping
In the market for a new office chair?

Find one that’s easy to adjust, says Turina. “The best office chairs have just 2-3 levers you can reach with just your right hand.”

Luxury office chairs offer good support, says Cooke. Some also offer woven mesh seats for better air circulation, which helps keep the skin cool, he says.

But you don’t have to buy a top-of-the-line chair to get good lumbar back support.

“No research supports one specific chair over another,” Turina says. “It doesn’t matter how much money you spend. What’s important is that you’re comfortable in it.”

Look for the following features:

Lumbar back support: This slight cushioning in the back of the chair needs to rest in the proper place.

How to know?
“Put your hand behind your back at about waist level. That should be the apex of the curve,” Wilmarth says. “If it doesn’t hit you in the right place, it doesn’t help.”

Look for lumbar back support that can be adjusted up or down so you can move it into the proper location, she says.

Seat height: Look for a seat that you can adjust.

If it’s too low, you’ll tend to slouch, Wilmarth says. If it’s too high, you won’t have proper leg support.

Recline: When working at your computer, you probably sit upright. But if you’re reading, talking on the phone or conducting a meeting, you can lean back.

“A slightly reclined position relieves pressure on the spine,” Cooke says.

Armrests: These aren’t necessary in an office chair.

But if you prefer them, look for “half rests, so you can push your chair up to your desk,” Wilmarth says.

“If the rests are too long, you’ll need to push your chair too far out, forcing you to slouch or lean forward.”
Wheels: If your chair doesn’t have wheels, you’ll need to twist your back when you turn around, says Wilmarth.

You want to be able to move the chair instead of yourself.

Adjustable seatback: For upper-back support, the chair should be high and wide enough for your shoulder blades to rest on, Cooke says.

Keep Moving
Sitting in any one position too long strains your back and other muscles, Wilmarth says. So it’s important to move every half hour or so.

“Just stand up and stretch, then take a walk around the room – even if it’s just for 30 seconds,” she says.

Frequent stretching can also help, says chiropractor Steven Conway, D.C., another occupational health specialist and spokesman for the American Chiropractic Association.

He recommends taking “micro-breaks” every 15 minutes in which you stretch your hands, neck and back while sitting in your chair.

Bending forward over your desk also strains your shoulders and neck, notes Cooke.

To reset your upper body in a more neutral position, pinch your shoulder blades together, he says.
“Hold for five seconds and relax. This activates your upper back muscles to support your shoulders and neck.”

Protecting Your Back at Home
Avoid the sofa. It’s not the best choice for sitting for long periods of time, says Cooke.

“Most sofas don’t offer much lumbar back support, and there’s a tendency to slouch.”

Instead, use a recliner or an easy chair with back support.

Check your posture. Resist the urge to slump down in your chair during a “Real Housewives” TV marathon.

“Have your feet on the ground,” Cooke says. “And sit far enough back in the chair so your seat makes contact with your thigh muscles.

Recline. Yep, that La-Z-Boy is actually good for you.

There’s less strain on your lumbar discs when you’re in a reclined position, and having your legs slightly elevated can improve blood flow, Cooke says.

Expensive recliners, advertised as “stressless” or “back-friendly,” are fine, he says, but not necessary.

“Any comfortable recliner is good,” he says – just make sure it supplies some lumbar back support.
Use pillows as props. Since most easy chairs don’t have lumbar support for your lower back, “use a pillow or lumbar roll to maintain curvature,” Cooke says.

If you don’t have one handy, use a rolled-up towel, adds Wilmarth.

If your feet aren’t resting on the ground, use a pillow or footrest, so knees don’t dangle.

Bend your knees. If you like to relax with feet up on a coffee table or ottoman, keep a slight bend in knees and hips.

“If your legs are straight out, it strains your low back and sciatic nerve [the nerve fiber running from your lower back through your buttocks],” Wilmarth says.

For optimum support, place a small pillow under your knees to keep them in a slightly bent position.

Visit our Pain Health Center for more information.
How Bad Is Your Back Pain?
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