Ask HN: Posture – what do you do during work to avoid back pain?

40 points by Donmario 9 years ago | 69 comments

Do you use any apps, products that help you stay healthy? Do you work out during work or take a lot of breaks?

redsymbol 9 years ago |

Doing these two things has worked extremely well for me:

1) Doing deadlifts. This is a strength-training exercise: https://www.youtube.com/watch?v=4AObAU-EcYE

2) Seeing a good chiropractor about twice a month. (You might need to shop around - I can elaborate on how to select a quality one if people want)

You asked about an app. I actually corrected my earlier posture and lower-back problems using the above and not any kind of app to remind myself to get up and move around; the above helped even though I routinely sat 1-2 hours at a time, in a deep coding trance, without moving around. Recently, though, I started using BreakTime (a macOS app) to remind me to look away from the screen, mainly because I believe it's healthier for my eyes. This is a $5 app I've been quite happy with.

All the above is in the anecdotal "works for me" category. Good luck in your effort to find what works best for you!

Edit: The video link above gives a rough sense of the exercise, but the fine details matter greatly, so if you decide to do it I highly recommend studying the relevant chapter of this book: https://www.amazon.com/dp/0982522738/

Edit 2: More about chiropractors: Few are MDs; the ones I've worked with all went through a 4-year, post-bachelors program. In my experience, chiropractors fit on a spectrum, going from ambulance-chasing quacks to gifted, remarkably effective healers. You want the latter. Only way to find out is to pay for about 3 visits; if you and your body are consistently feeling better physically and emotionally by then, you've found a good one. If not, stop, and go find another. So far, the best I've found lean towards alternative medicine (which was really surprising at first... I'm trained as a physicist, and was REALLY skeptical.) Can't say that's a general rule though. Again, all this is my experience; better to get your own experience and evaluate based on that, instead of blindly deciding based on something you read online.

v64 9 years ago | |

Is your chiropractor an MD? I've been skeptical about chiropractors after reading the Wikipedia entry on the practice [1]. As someone with back problems, I've taken chiropractor recommendations from colleagues, and looking into them, they were too alternative medicine for my taste.

[1] https://en.wikipedia.org/wiki/Chiropractic

dhimes 9 years ago | | |

At the very least, never let them touch your neck. A friend of mine had a stroke and died after having a neck manipulation. http://chiropracticstroke.com/victims.johnhoffman.php

jerelunruh 9 years ago | | |

There seem to be plenty that lean toward non-mainstream practices. However the one I go to was fully planning to have a career as an MD but converted to chiropractic after it helped him with his own health. He tells me that building core muscle strength is the long term solution, not constant adjustments.

mherrmann 9 years ago |

What helped me most was to get an ergonomic chair and an external monitor/keyboard/mouse. To avoid wrist pain, I recommend a split keyboard [1], a vertical mouse [2] and an alternative keyboard layout [3].

[1]: https://www.microsoft.com/accessories/en-us/products/keyboar...

[2]: https://evoluent.com/

[3]: http://mkweb.bcgsc.ca/carpalx/?full_optimization

nadezhda18 9 years ago | |

stretching your wrists and forearms (their inner sides) can also be a good help in fighting this kind of pain (speaking from experience)

mherrmann 9 years ago | | |

Yes. And Thera-Band exercises.

kejaed 9 years ago |

I go lift heavy barbells in the gym. A strong back is a healthy back.

762236 9 years ago | |

The squat and deadlift are great for the back, as long as you use proper technique. See Starting Strength by Rippetoe. You should be able to sit on any chair without back pain. An ergonomic chair is no answer --- it is a crutch that helps the problem grow.

whalesalad 9 years ago | |

Working out and weightlifting helps me too. You can't really lift in an olympic sense with bad mobility.

I try to do a combination of sitting and standing to keep my hips from getting too tight, which can end up creating an anterior pelvic tilt that will cause back pain. I'll do couch stretches[1] to open my hip flexors and banded pull-aparts[2] to alleviate some of the rounded shoulder issues that we all get from sitting and typing all day.

1. http://www.bodybuilding.com/images/2016/june/flex-those-flex...

2. http://www.bodybuilding.com/exercises/detail/view/name/band-...

timonv 9 years ago | |

I can vouch for this. Keeps the mind strong as well. Never have backpain and completely fixed my (mild) kyphosis.

Additionally:

* Try to keep about 20% tension in your abs/core all the time. Even when sitting. Punch your SO in the belly, that always works two ways!

* Don't sit all the time. Walk, stand, etc.

* Certain exercises and stretches can work wonders if you have a _good_ PT who can point out where the problem is.

binarymax 9 years ago | |

I recommend that before going to the gym and picking up the heaviest thing you can lift - focus on your core for a good 3 months. Do crunches (properly) and plank every day. When your core is more stable, then do indeed go pick up some heavy stuff (with proper form and a spot of course!).

hmate9 9 years ago | |

As long as what you life is not too heavy. Than it becomes very unhealthy.

threepipeproblm 9 years ago |

As someone who has made huge progress on posture over a long period of time, my first recommended steps for you would be:

1. Watch the "Deskbound" Google Talk by Kelly Starett https://www.youtube.com/watch?v=kfg_e6YG37U

2. Read and do the exercises in Awareness Through Movement by Moshe Feldenkrais.

3. Get into the habit of wiggling and shifting your body throughout the day. And get into the habit of devoting regular time to being more conscious of where your muscles are and how you are using them.

4. Trigger Point Therapy is amazing for self-treating body pain, if you are willing to experience short bursts of pain during the treatment.

andrei_says_ 9 years ago | |

Ditto on the Feldenkrais method. Worked with a practitioner to resolve an RSI.

Rewrites how your body perceives itself and addresses the movement / freezing habits which cause injuries.

saturdaysaint 9 years ago |

I've had few/any complaints since strapping one of these to my cheapo office chair (at the recommendation of a spine/back specialist):

https://www.amazon.com/Original-McKenzie-Lumbar-Roll-OPTP/dp...

The extra lumbar support is really comfortable, and it sort of subtly nudges you to stay in a healthy position. Even when I'm completely unmindful of my posture, it keeps a healthy arch in my back.

I also take a 20 - 30 minute walk at lunch several days a week.

robbyt 9 years ago | |

I agree. Get a good chair.

Years ago, I had to sit in one of those leather OfficeMax chairs. I developed all sorts of back pain. I realized it was the chair when I changed jobs (and chairs) and the back pain went away.

People have a lot of opinions about chairs, but I really like the Aeron chair.

throwanem 9 years ago | | |

They're worth the price, even new. But if you poke around a little and don't mind being less able to customize than the Herman Miller site makes possible, you can probably find gently used castoffs for half retail price or less.

nadezhda18 9 years ago |

everyday stretching + yoga for 15-20 min in the end of the day has eliminated my backpain pretty much completely

I do not do anything special DURING the day except occasional (1-2 times a week) yoga sessions for 30-40 min at lunch

I was surprised to see that so little exercise had such a big impact on my well-being.

adamqureshi 9 years ago | |

Yes on the YOGA. I thought it was for girls. BUT THEN i took a yoga class, AND "WOW". 1-2 times a week at the very least. Yoga works for real.

nadezhda18 9 years ago | | |

the other good part is that after a while, your body gets used to it and you kinda get addicted. If I skip my yoga sessions, I start craving for them.

jerelunruh 9 years ago |

I added a function to my bash that forces me to do pushups every 30 minutes (by turning off my monitor and keyboard). https://gist.github.com/jerel/1fc7686263c9427522f945f755e0a7... An hour after I start work in the morning a cron job reminds me to start a terminal and run `work 8` (or however many pushups I want to do that day). I do the pushups on my knuckles to avoid aggravating my wrists.

I also have a Kinesis Advantage keyboard, go to a good chiropractor, and do cycling. All of which seems to contribute to a (nearly) pain free existence.

overcast 9 years ago |

Exercise, and if you had to limit to just one thing. Pushups. They work your whole body, especially core, and back. You can do them anywhere. I like to take random breaks throughout the day, and just get down and do ten pushups. Secondly, a good chair. Currently using the Herman Miller Embody, and love it. Third, a good mattress. Just picked up a Saatva, and for $1000 delivered, it's by FAR the best mattress I've ever had.

Pushups, and don't skimp on the two things you spend the majority of your day in. Chairs and Beds.

PaulHoule 9 years ago |

This book is the best one on the subject

https://www.amazon.com/Treat-Your-Back-Robin-McKenzie/dp/095...

The core idea is that most back pain is caused by the shortening of the muscles in your back. "Posture" is not a productive way to think about it because you don't have the flexibility to be in the correct posture. If you try to improve your posture without addressing flexibility you will feel more pain.

The exercises in that book will help, also try the "Cobra" position from yoga, and also this exercise

http://reichandlowentherapy.org/Content/Practices/Grounding/...

If you stand up and do the "bow" whenever you have back pain you will probably feel better pretty quickly (1 to 2 weeks)

If you are popping NSAIDs or tylenol, also consider the antidepressant Venlafaxine. It is often highly effective on chronic pain, particularly things like back pain that definitely have a stress-related component.

mccada 9 years ago |

I started getting chronic back pain last year after being in a desk position for quite some time. I even considered switching jobs as I was that uncomfortable sitting. Some things that have helped:

Movement. Try to get up and move around at least once every hour or so. Going for a couple of 15 minute walks on breaks helps as well. It is the lack of movement and tightening of muscles that causes most of the pain.

Decent Office Chair. The one I have can lean back quite far, and I find this more comfortable. Try to change positions in your chair to keep your body posture and muscles moving.

Chiropractor. When my back starts acting up more than usual I'll see a chiropractor. This can help loosen up really tight joints and crack your spine or ribs back into proper position.

I've heard both swimming and yoga can both work wonders as well, but have yet to try these. Goodluck!

v64 9 years ago | |

Since you mention a chiropractor, can I ask you the same question as I did in this comment [1]? Is your chiropractor an MD?

[1] https://news.ycombinator.com/item?id=12653040

mccada 9 years ago | | |

I'm not sure if they use the same terminology in Canada, but the four chiropractors at the place I go to all use Dr. and DC as their title, so I'm guessing so.

woah 9 years ago |

My posture improved and my occasional back pain went away entirely after I added "roman chair"[1] to my exercise routine. This is a machine at the gym where you lie on a pad a few feet off the floor and your legs are held in place, and you raise your upper body by contracting your lower back. Reading online now that it can be dangerous if you're too gung ho about it, so do it without weights at first. There are also a lot of other lower back exercises like deadlifts, etc, but this one works best for me.

I like dealing with this stuff through exercise because it avoids the annoyance of having to remind myself to sit a certain way or buying special chairs or desks.

[1] https://en.wikipedia.org/wiki/Roman_chair

another_account 9 years ago | |

To add to this, the hyperextension you are describing can be done in reverse too. There is a proper machine for it, called, unsurprisingly, the 'reverse hyper' but they are rare.

Here are a couple of videos showing different ways to do it without the machine

https://www.youtube.com/watch?v=Ef4noCz83A4

https://www.youtube.com/watch?v=3d9_W--eUcI

As with the standard hyper. Start slow, good form without any weight.

Give it a try!

another_account 9 years ago |

Stretch hamstrings, piriformis, possibly quad lumborum for lower back. Get up every 15mins and give those poor hamstrings a break. Strengthen core, and not no, not just abs! Shoulder and scapula work is needed for upper. Good posture, no internal rotation. Shoulders back, pecs to the sky.

Myofascial release ball and or foam roll glutes, rhomboids and rotator cuffs a lot.

Lifting regularly has really fixed my posture. Bar the odd injury due to bad form and tight hamstrings. Work on core and mobility before starting to lift heavy.

Seeing a physio every so often is worth its weight in gold. There are lots of prehab things that can be done but its still worth seeing an expert. You only get one body and it is not meant to sit all day.

Tharkun 9 years ago | |

Don't have the relevant links handy on my phone, but stretching hamstrings and foam rolling glutes are frowned upon when you spend all day sitting. Strengthening the glutes+abs and gently stretching the lower back+hip flexors is a better idea. If you spend all day in a chair, your hamstrings might be a bit tight, but they'll also be weak as hell.

Foam rolling is a bit controversial, because the direction matters and the proper direction (to me) is non-intuitive.

A good physio is definitely a good idea. So is moving around as often as possible.

another_account 9 years ago | | |

Is that frowned upon possibly in people who have pelvic tilt from bad posture sitting down? I know it can exacerbate some existing conditions. And yes, very good point, un-trained hamstrings are going to be very weak.

Foam rollers and myofascial balls definitely have controversy around them! But, anecdotal as it is, they work wonders for me and have been recommended by every physio i have seen.

brendoncrawford 9 years ago |

I have been working at a standup desk for about the last 10 years. To combat fatigue, I add a walk around the room every 20 minutes. This system has mostly eliminated all aches and pains for me.

adamqureshi 9 years ago |

10 min PLANK. First thing in the AM. Then before Bed. On Elbows.

djkrudy 9 years ago | |

Ten minute static front plank? Video or it didn't happen. I've heard if you can do 3min front and 3 min each side (on elbows) without rest or movement, you'll never have back problems. I believe it, but I've never met or seen anybody capable.

adamqureshi 9 years ago | | |

I started with 1 min and worked my way upto 10 min. Elbows. It was TOUGH in the beginning. My WHOLE core ( abs , back side) area was sore, but then i just got used to it. Sometimes i'll add a weighted vest. You can do it. WR is 8 hours and change.

Tharkun 9 years ago | | |

The world record is eight HOURS. Ten minutes is well within the realm of the easily achievable.

Link: http://www.guinnessworldrecords.com/world-records/longest-ti...

debt 9 years ago |

I recently made a lil app that tracks how long you've been sitting at a computer using facial recognition. It's actually encouraged me to get up and off my computer when I've been sitting for too long; I can see I've been sitting in front the computer for like five hours. The time stops when you walk away. Super helpful.

http://overworked.io

tugberkk 9 years ago |

There is no "proper" sitting. The best thing you can do is to change your sitting position like every 30 minutes or so. Of course, standing up and doing some basic stretching would help too.

I am not recommending exercising for this specific reason, we should all be exercising regardless :)

henrik_w 9 years ago |

I am using MacBreakz [1] to remind me to take breaks and do some stretching throughout the day. I have not any back pains, but had severe RSI several years ago. A break program was the most important component to get better, along with an ergonomic mouse and keyboard.

[1] http://www.publicspace.net/MacBreakZ/

Donmario 9 years ago | |

What do you think of http://www.curie.me/?

jib 9 years ago |

Work out in the morning every day (strength stuff with dumbbells as the gym in the office doesnt have barbells).

I get up and walk around every couple of hours at least.

Slouch in the chair the rest of the time. Any time I've tried to sit according to "recommendations" (i.e. more straight up), my back hurts. Slouching at a 135 degree angle means no back pain for me.

Overtonwindow 9 years ago |

This may not work for everyone but I got one of those large rubber inflatable balls like you see in gyms and put it in my office. I lay on it and stretch my back. Also side note, check your shoes and chair. All of my back pain could be traced to either my shoes, or my chair. Consider buying your own chair if you have to.

clint 9 years ago |

My team takes a scheduled break (its completely optional tho) at 3pm and we get a conference room open up a google hangout for remotes and go around the circle. Each person present picks a stretch and everyone tries it out. You get about 5-10 good stretches over about 10-15 min and its a nice break from the day.

BooneJS 9 years ago |

My lower back pain all but vanished after we tried one of those foam mattress startups (we chose Leesa). We bought one for my father a few months later, and it worked for him as well.

It takes courage to throw away a 4 year old $3k mattress that required special-order extra-deep fitted sheets. ;)

andrei_says_ 9 years ago |

Standing + adjustable standing desk do I can sit or stand.

Moving my feet - "fidgeting" to avoid frozen body patterns. Taking frequent breaks and rigorous walks at the advise of my father who is a cardiovascular surgeon.

shiny 9 years ago |

I use a Humanscale Freedom chair w/ headrest.

http://www.humanscale.com/products/product.cfm?group=Freedom...

mwidell 9 years ago |

Try this exercise: https://www.youtube.com/watch?v=LT_dFRnmdGs

I've been doing it for a few days now and it is quick, easy and seems to help.

AlwaysRock 9 years ago |

I elevated my laptop with a 2ish inch folder holder. It's saved my neck from bending as much. The trade off is that my hands have to be elevated to type which might not work if you are typing extensively during the day.

polskibus 9 years ago |

At least 10 min daily exercise for the back. Push ups, rolling on the back, back and forth while keeping your knees close to your chest, etc. The essential bit here is _daily_ . Use alarm or sth to remember, never skip it.

e19293001 9 years ago |

I've read somewhere that Donald Knuth had suffered back pain. His doctor adviced him to swim three or four times a week and he eventually confirmed that swimming is an effective excercise to cure and avoid backpain.

cableshaft 9 years ago | |

Makes sense. When I had bad back pain I only really felt comfortable standing while in a pool, thanks to its buoyancy effect. I'd get out and almost immediately have back pain again. Thankfully I don't have that problem anymore.

Tharkun 9 years ago | |

It can be, or it can be really bad. Depends on how you're swimming. Especially when doing breast stroke, it's very important not to pull your neck back/up. Keep your head down.

1123581321 9 years ago |

Standing at work and losing weight have eliminated my back pain.

dereke 9 years ago | |

+1 for standing, it is hard work but does make you feel better. on the occasions I am in an office without a standing desk I find I have all sorts of aches and pains

demosthenex 9 years ago | | |

I'm considering a treadmill desk. Any thoughts?

dminor 9 years ago |

Sit/stand desk, stretching.

rubidium 9 years ago | |

Chiming in. Was having some back issues when I started a full-time "desk job".

Got a simple sit-stand dsek. Start the day standing at 8am, usually siting by about 11am. Lunch and a short walk. Sit or stand depending on how my legs are feeling after lunch. And then finish the last hour of the day standing. But it's really "try to stand unless focus/legs are asking for it".

That and a few short laps around the office every couple hours and my back pain is gone.

Tharkun 9 years ago | |

Got any tips on convincing my employer to OK a sit/stand desk? Not allowed to bring in my own desk, sadly:-(

dminor 9 years ago | | |

Get a better employer? :)

More seriously, having a note from your doctor might help. When I was having back pain I saw a physiatrist, who recommended a sit/stand desk and physical therapy (both effective), and I asked for a note for the desk which she happily supplied.