How to sit, stand, and sleep correctly and get rid of back pain
Most people spend eight or more hours a day sitting at work, then sit down in a car, settle onto the couch at home, and finally lie down in bed. The entire day is essentially a chain of positions the body passes through – and yet few people pay attention to how to properly sit, stand, and sleep. Yet it is precisely the quality of these basic positions that determines whether a person wakes up in the morning feeling refreshed or with stiff back pain that follows them throughout the day.
Posture isn't a topic just for physiotherapists and orthopedists. It's an everyday matter that concerns absolutely everyone – and especially those who work in an office. According to the World Health Organization, musculoskeletal conditions are among the most common causes of chronic pain and work disability in the world. And a large portion of them are rooted in habits that people aren't even aware of.
Imagine Petr, a man in his thirties working as an analyst at a Prague-based company. Petr was active in sports during university, accustomed to physical activity, but after starting his job, his daily routine changed dramatically. Eight hours in front of a monitor, lunch at his desk, then an hour in traffic and Netflix in the evening. After two years, he began experiencing a dull pain in his lower back, tension in his neck, and occasional tingling in his hands. His doctor told him there was no serious problem – just bad habits. Yet Petr's story is not exceptional. It's the story of hundreds of thousands of office workers who are slowly and imperceptibly destroying their musculoskeletal system through how they sit, stand, and sleep.
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How to sit properly: a guide for office workers
Sitting is a paradoxical matter. At first glance, it's a resting position, but for the body, prolonged sitting is actually an enormous strain. When a person sits, the pressure on the intervertebral discs in the lumbar spine is significantly higher than when standing – and if we add leaning forward, crossing legs, or hunched shoulders, we get a recipe for chronic problems.
Proper sitting starts with the chair but doesn't end there. The foundation is having your feet flat on the floor, knees at approximately a ninety-degree angle, and hips at the same height as the knees, or ideally slightly higher. The back should be supported against a backrest that maintains the natural lordosis of the lumbar spine – that gentle curve in the lower back that is natural for the human body. Many people lose this curve when sitting, their back rounds, and the entire spine ends up in a disadvantageous position.
Shoulders should be relaxed and drawn slightly back and down, not pulled up toward the ears, as we often see in people immersed in computer work. The head should be in line with the spine, ears approximately above the shoulders. The computer monitor should be positioned so that the top edge of the screen is approximately at eye level, and the distance from the face should correspond roughly to the length of an outstretched arm. The keyboard and mouse should be at a height where the forearms form a right angle with the upper arms and the wrists remain in a neutral position.
All of this sounds simple, but in practice, it's surprisingly difficult to maintain these principles. The human body simply wasn't designed to remain in one position for hours without a break. Even the most ergonomic chair in the world won't prevent problems if a person sits in it continuously all day. The key is regularly alternating positions and taking short breaks. Experts recommend standing up at least once every thirty to forty minutes, walking around, stretching, and changing position. Some companies therefore invest in height-adjustable desks that allow alternating between sitting and standing during the workday, and research published in journals such as Ergonomics suggests that this variability has a positive effect not only on the musculoskeletal system but also on productivity and concentration.
The choice of office chair itself is also important. It doesn't necessarily have to be the most expensive one on the market, but it should meet several basic parameters: adjustable seat height, adjustable armrests, quality lumbar support, and sufficient seat depth so that a gap of at least two fingers remains between its edge and the back of the knees. If someone works from home and doesn't have access to a professional office chair, they can help themselves with a simple lumbar cushion or a rolled-up towel placed between their back and the backrest.
Let's return to Petr for a moment. When he realized that his pain was related to sitting, he began making small changes. He adjusted his monitor to the correct height using a stackable stand, got a lumbar support, and set a reminder on his phone to stand up and stretch every thirty minutes. Within a few weeks, he noticed significant improvement. No magic, no expensive therapies – just a conscious change in habits.
Standing and sleeping: two positions that get overlooked
While office sitting ergonomics is discussed fairly often, proper standing posture and sleeping position receive little attention. Yet both of these positions have a fundamental impact on spinal health and overall well-being.
When standing properly, body weight should be evenly distributed across both feet. Knees should be slightly relaxed, not locked into extension, because excessive knee locking shifts the pelvis forward and increases lumbar lordosis, which can lead to lower back pain. The pelvis should be in a neutral position – neither excessively tilted forward nor tucked under. A good way to visualize this position is to think of the pelvis as a bowl full of water: the goal is for the water not to spill either forward or backward.
The chest should be slightly lifted, shoulders relaxed and drawn gently back. The head should again be in line with the spine, chin slightly tucked – not jutting forward, as we often see in people who stare at their phones all day. This so-called "forward head" posture is so widespread today that the English term "tech neck" has become commonplace, and it is becoming one of the most common postural problems of the modern era.
People who stand a lot at work – salespeople, teachers, chefs – should pay attention to quality footwear with adequate arch support and, if possible, stand on a softer surface or use an ergonomic mat. Just as with sitting, no static position is healthy if a person remains in it for too long. Alternating positions is key regardless of whether a person is sitting or standing.
And then there's sleep – a third of our lives spent in a horizontal position, yet one that most people completely ignore from a postural standpoint. Yet a poor sleeping position can be the cause of morning stiffness, back pain, neck pain, and even headaches. So what does a proper sleeping position look like?
Most experts in sleep medicine and physiotherapy agree that the most suitable position for the spine is sleeping on the back or on the side. When sleeping on the back, the pillow under the head should be of a height that keeps the cervical spine in a neutral position – the head should be neither raised too high nor tilted back. Some people also place a small pillow or bolster under the backs of their knees, which helps relieve the lumbar spine.
Side sleeping is also a very good choice, especially if a person places a pillow between the knees. This simple trick aligns the pelvis and reduces torsion of the lumbar spine. The pillow under the head should be higher when sleeping on the side than when sleeping on the back, to fill the space between the shoulder and head and keep the cervical spine aligned.
Sleeping on the stomach is generally considered the least suitable position for the spine. When sleeping on the stomach, the cervical spine is rotated to one side all night, the lumbar spine curves excessively, and unnecessary strain is placed on joints and muscles. If someone is accustomed to this position and cannot change it, they can at least place a flat pillow under their abdomen to reduce the arch in the lower back.
Just as important as position is the quality of the mattress and pillow. The mattress should be firm enough to support the spine but flexible enough to conform to the body's curves. There is no universal "best" mattress – the choice depends on body weight, preferred sleeping position, and individual needs. Generally speaking, however, a mattress older than eight to ten years probably no longer serves its purpose and deserves to be replaced.
As the renowned American orthopedist and author of books on back pain Stuart McGill once noted: "The spine is like a ship's mast – it's held up by taut ropes from all sides. When some ropes are too weak or too tight, the mast tilts." This metaphor beautifully captures the essence of the problem. It's not about one specific position or one specific muscle. It's about overall balance, about how a person treats their body twenty-four hours a day.
For office workers who want to start working on their posture, there are several simple steps that require no special equipment or major time investment:
- Set up your workstation so that the monitor, keyboard, and chair meet ergonomic recommendations
- Stand up every thirty minutes, walk around, and do a brief stretch of the neck, shoulders, and back
- When standing, consciously check the position of your pelvis, shoulders, and head
- Before bed, check the height of your pillow and consider placing a pillow between your knees when sleeping on your side
- Incorporate at least ten minutes of targeted exercises into your daily routine to strengthen the deep stabilizing system of the spine
These changes may seem trivial, but their cumulative effect is enormous. The body is an extraordinarily adaptable system – it adjusts to whatever we repeatedly offer it. If we repeatedly offer it hunched sitting, a forward head posture, and a worn-out mattress, it will adapt to that too, but at the cost of pain and limitation. If, on the other hand, we offer it conscious care for proper posture, it will reward us with greater energy, better sleep, and the absence of unnecessary pain.
It's interesting that many people invest considerable sums in fitness, supplements, and healthy eating, yet overlook the basic ergonomics of their everyday life. Yet that is precisely the foundation upon which everything else rests. No amount of excellent gym training can outweigh eight hours a day in a poor position. And no matter how high-quality a mattress is, it won't help if a person lies on it in a position that harms their spine.
Petr from our example says today, a year later, that the biggest change wasn't brought about by any specific exercise or any miracle product. The biggest change came from awareness – he simply started noticing how he sits, how he stands, how he lies down. And once a person becomes aware of these things, it's surprisingly easy to gradually change them. The body naturally gravitates toward proper positions – we just have to give it the chance to assume them.
