The healthy office: evidence-based advice for the workplace

This guide is a general overview and does not include specific exercises. If you would like an assessment of your own workplace, you can book a meeting.

Try it yourself: With our workplace check you can upload a photo of yourself at your desk and get an assessment of your chair, desk, screen and sitting position with concrete suggestions.

1. Set up: can the workstation be adjusted to each person?

Adjustable equipment works best when employees also learn how to use it. Instruction on its own has a weak effect.

Make sure everyone can adjust their chair, desk and screen. In a study of office workers, a highly adjustable chair combined with ergonomics training reduced symptoms over the working day. Training alone did not (Amick et al., 2003). The training did, however, improve both knowledge and working postures, with and without a new chair (Robertson et al., 2009).
Consider equipment that supports variation. Sit-stand desks are well documented (see section 2). Among call centre workers, a wide forearm support combined with training led to less neck and shoulder discomfort than training alone (Rempel et al., 2006).
Do not promise too much from specific products. The evidence for walking pads and balance boards is thin.

Level of evidence: a Cochrane review rates the evidence for ergonomic interventions among office workers as mostly low to very low quality (Hoe et al., 2018).

2. Vary: what is the best working posture?

There is no single correct way to sit. The most important thing is to change position often: your next posture is your best posture.

Switch between sitting and standing. For example, start by standing after coffee, meetings or toilet breaks. Sit-stand desks reduced sitting time by about 100 minutes a day in the first months and by roughly an hour after 3 to 12 months (Cochrane, Shrestha et al., 2018; low-quality evidence).
Do not make long periods of standing the goal. Standing can also cause discomfort. In laboratory studies, lower back discomfort appeared after about an hour of continuous standing, and sooner in people prone to pain (Coenen et al., 2017).
Stop chasing the perfect posture. A review of 41 systematic reviews found no consensus that particular postures, including sitting at work, cause low back pain (Swain et al., 2020). A review of sitting at work specifically found no link with low back pain (Roffey et al., 2010).
Build small movements into the day. Walk over to a colleague instead of sending an email, and take the stairs. More breaks in sitting time are linked to better metabolic markers such as waist circumference and blood sugar (Healy et al., 2008, a cross-sectional study). In UK Biobank data on more than 450,000 people, climbing stairs daily, more than five flights a day, was linked to a lower risk of cardiovascular disease (Song et al., 2023).

3. Strengthen: does exercise work in small doses too?

Yes. Danish research shows that even 2 minutes of daily resistance band training can reduce neck and shoulder pain.

Research from the National Research Centre for the Working Environment (NFA) in Denmark has documented the effect:

Specific strength training works better than fitness training. In women with chronic neck muscle pain, specific strength training reduced the worst pain by about 79%. General fitness training on an exercise bike had only a small, short-lived effect (Andersen et al., 2008).
Just 2 minutes a day works. Among employees with frequent neck and shoulder pain, 2 minutes of daily resistance band training reduced pain. 12 minutes a day had a slightly larger effect (Andersen et al., 2011).
Exercise during working hours works over time. In a one-year trial with 549 office workers, both specific strength training and all-round exercise reduced the duration and intensity of neck and shoulder discomfort (Blangsted et al., 2008).

Sedentary work makes physical activity even more important. A meta-analysis of more than 1 million people found that 60 to 75 minutes of moderate activity a day appears to remove the higher risk of death linked to a lot of sitting (Ekelund et al., 2016).

The WHO recommends 150 to 300 minutes of moderate physical activity a week plus muscle-strengthening activity on at least 2 days a week. The Danish Health Authority recommends that adults get at least 30 minutes of physical activity every day plus muscle-strengthening activity at least twice a week.

4. Act early: why does it pay to respond to minor discomfort?

The longer pain lasts, the greater the risk that it becomes long-term. That is why it pays to act early.

Deal with specific problems before they grow. Workplace interventions that combine treatment, coordination and adjustments to the work shorten sick leave for musculoskeletal disorders (Cullen et al., 2018).
Start treatment early. Among more than 32,000 patients with low back pain, physiotherapy within 14 days was linked to fewer scans, operations and injections, and lower costs, than starting later (Fritz et al., 2012).
Get a specific assessment based on measurement. With our sensors, we find out which loads the body is not ready for and what triggers the pain. The intervention can then be tailored to the individual. Read about the Individual program and the Ergonomics program.

The bigger picture: why is furniture not enough?

Equipment alone rarely solves the problem. Interventions that also involve management and the working environment work better.

Psychosocial working environment. Stress, high demands and low control are linked to more neck, shoulder and arm discomfort. The link is moderate, and perceived stress is the most consistent factor (Bongers et al., 2006).
Management and culture. In a smaller trial, sit-stand desks combined with management support and individual coaching reduced sitting time far more than the desks alone (Neuhaus et al., 2014). A larger trial confirmed the effect of the combined intervention after 12 months (Healy et al., 2016, Stand Up Victoria).
The home workstation. With hybrid working, many people spend more hours at home, and that workstation is often overlooked. Include it in your risk assessment (the APV in Denmark).
Screen and eyes. The distance and height of the screen and the lighting matter for comfort. Check your own setup with the workplace check.

Want to know where your workplace needs action?

We come to you, measure and give you a specific plan for both the team as a whole and each individual employee. Book a meeting, or write to mail@precure.dk.

Shall we talk?

Book a meeting with Søren Würtz to talk about how we can help you and create concrete results in your workplace.

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Sources

Effect of office ergonomics intervention on reducing musculoskeletal symptoms, Amick et al., Spine, 2003
The effects of an office ergonomics training and chair intervention on worker knowledge, behavior and musculoskeletal risk, Robertson et al., Applied Ergonomics, 2009
A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators, Rempel et al., Occupational and Environmental Medicine, 2006
Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers, Hoe et al., Cochrane Database of Systematic Reviews, 2018
Workplace interventions for reducing sitting at work, Shrestha et al., Cochrane Database of Systematic Reviews, 2018
Associations of prolonged standing with musculoskeletal symptoms: a systematic review of laboratory studies, Coenen et al., Gait & Posture, 2017
No consensus on causality of spine postures or physical exposure and low back pain: a systematic review of systematic reviews, Swain et al., Journal of Biomechanics, 2020
Causal assessment of occupational sitting and low back pain: results of a systematic review, Roffey et al., The Spine Journal, 2010
Breaks in sedentary time: beneficial associations with metabolic risk, Healy et al., Diabetes Care, 2008
Daily stair climbing, disease susceptibility, and risk of atherosclerotic cardiovascular disease: a prospective cohort study, Song et al., Atherosclerosis, 2023
Effect of two contrasting types of physical exercise on chronic neck muscle pain, Andersen et al., Arthritis & Rheumatism, 2008
Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial, Andersen et al., Pain, 2011
One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers, Blangsted et al., Scandinavian Journal of Work, Environment & Health, 2008
Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality?, Ekelund et al., The Lancet, 2016
WHO guidelines on physical activity and sedentary behaviour, World Health Organization, 2020
Fysisk aktivitet: anbefalinger for voksne 18-64 år, Sundhedsstyrelsen, 2023
Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions, Cullen et al., Journal of Occupational Rehabilitation, 2018
Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs, Fritz et al., Spine, 2012
Epidemiology of work related neck and upper limb problems: psychosocial and personal risk factors and effective interventions, Bongers et al., Journal of Occupational Rehabilitation, 2006
Workplace sitting and height-adjustable workstations: a randomized controlled trial, Neuhaus et al., American Journal of Preventive Medicine, 2014
A cluster randomized controlled trial to reduce office workers' sitting time: effect on activity outcomes (Stand Up Victoria), Healy et al., Medicine & Science in Sports & Exercise, 2016

Written by a physiotherapist. General information, not a diagnosis: see a doctor or physiotherapist about your own pain.