Low back pain and sitting time, posture and behavior in office workers: A scoping review

Abstract

Background: Office workers spend approximately two-thirds of their daily work time in a sitting position. Objective: This scoping review aimed to identify and categorize key themes and knowledge gaps in research on how sitting time, posture, and behavior affect the risk of low back pain among office workers. Methods: The authors conducted a comprehensive literature search in electronic databases [MEDLINE [via PubMed], SCOPUS, CINAHL, PEDro, and CENTRAL] from inception to March 2024, resulting in 22 studies involving 7814 participants. The methodological quality of these studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Seventeen studies [77%] were rated as high quality, four studies [18%] as moderate quality, and one study [5%] as low quality. Thirteen studies assessed sitting time, ten assessed sitting posture, and thirteen assessed sitting behavior. Among the studies investigating sitting time, five showed no relationship with low back pain (LBP) prevalence, while eight demonstrated a relationship with LBP prevalence. For studies exploring sitting posture, seven found a relationship with LBP. Regarding studies on sitting behavior, only one showed no relationship between LBP prevalence, while twelve indicated a relationship. Conclusions: Longer sitting time, poor sitting posture, fewer breaks and more static sitting in sitting behavior, were found to be associated with LBP. The strongest evidence for an association with LBP was found for sitting behavior. When considering workplace ergonomics and interventions for LBP, it is advisable to consider all factors, including sitting, posture and behavior.