A theme amongst people with back pain is their posture, and more commonly, their seated posture. Has it caused their back pain? What can be done to alleviate their pain and prevent reoccurrence? The conversation invariably moves to ergonomics, and how best to sit.

We sit a lot nowadays. It's a social phenomenon. We send our children to school, and they're made to sit down and learn things. This is where it all starts.

A decade or two later, the majority of people are still sitting, but at least they're getting paid to sit and work. How they envy those who get paid to do a job that involves moving and being in nature...

Chairs

In other cultures and societies, chairs aren't so common. Perhaps they're unaffordable, so people squat right down on their haunches and remain there. The affluent Westerner remarks upon this when they see it as it seems unusual.

Hang on though - our children do this naturally and make it look easy.

Thanks to our sophisticated chairs, by adulthood we have typically lost the ability to sit like this, relying instead on always having access to chairs. Eventually, we point and remark about those who habitually sit on their haunches as it isn't the norm to us anymore.

Instead, we turn to ergonomic manuals for advice on how to stay comfortable when seated:

• A chair base that is parallel to the floor
• Knees and hips at 90 degrees
• Feet perhaps resting onto a footstool

Who's in charge here?

We pick apart these three bullet points in our therapy programmes, as they are each debatable. 

But more importantly, we should look at the sheer quantity of sitting we do.

Does sitting on its own actually cause back pain? Does sitting really damage our backs? The answer is no, it doesn't. Sitting can be sore for some people who have hurt their backs, but at the same time, it can be a great relief for others who have hurt their backs. Go figure.

If there is a problem with sitting, we won't solve our crisis by looking at the mechanical position of sitting and expecting to spot a flaw in the design.

While some people label "sitting the new smoking", it's not the sitting itself. It's the amount of time we spend there when we could be standing, walking, running, dancing, cycling, swimming, climbing... you get the idea.

We mustn't blame the chair, we should re-examine ourselves. Shine the spotlight on us. We are to blame.

Should we throw away ergonomics then?

Absolutely not! But instead, let's reconceptualise ergonomics as a guide to being comfortable. There's nothing wrong with that.

When we are comfortable we are more productive (hence the workplace incentive).

• If you must spend time sitting, sit in a position that is easy to maintain. Either be fully supported or actively upright.
• If sitting makes you hurt, find another place to be.

Please don't expect better ergonomics to cure back pain. Static positions don't cause injury, so how could they possible solve them?

What should we do then?

• If we are concerned about sitting, our concern should be with the duration.
• Our action plan should be to reduce that duration.

Can we condone investment in expensive chairs? Not after saying what we've just said. That would be awkward... Pick something comfortable, but ignore the gimmicks.

Can we support investment in adjustable desks so the user can split their time between sitting and standing? Absolutely, yes.

How about even having a variety of objects to sit on? Perhaps not realistic for many people, but why not spend some time sitting on a regular chair, followed by some time on the floor? How about a little time on a bouncy ball, and then the remaining time standing?

Moving our bodies through these positions is naturally beneficial. It's better than staying still. We should keep all the options available to us, and move freely between them.

Break out of the shackles of what you think you should do, and place yourself in your most comfortable positions. Your best posture is your next one.