Office Work and Back Pain: Why Your Symptoms May Not Reflect the Cause

Back pain for office workers

You may not be surprised to hear that the most common complaint movement expert and physical therapist Theresa Larson hears from office workers is pain in the low back and neck. Walk into any office and you’ll find plenty of people hunched over a keyboard slouching toward a screen.

What may come as a surprise, however, is the origin of that pain. Dr. Larson, who co-founded the San Diego-based physical therapy and movement education company Movement Rx, says that, while patients come to see her when they have “thrown out” their neck or low back, it’s actually a stiff upper (thoracic) spine that is often at the root of the problem. So common is this cause, in fact, that Larson and strength and conditioning coach Anders Varner authored the eBook The Low Back Fix: A Starting Point for Anyone with Low Back Pain to explain the mechanics behind these injuries.

As Dr. Larson noted in a previous post for SafetyNet™, low back pain costs Americans  more than $100 billion per year, 2/3 of which are a result of lost wages and reduced productivity.

In recognition of National Ergonomics Month, we reached out to Dr. Larson to learn about what ails the world’s “desk jockeys”—and what to do about it.

Q: Why does sitting at a desk cause neck and low back pain?   

A: When you sit in a chair all day, your shoulders round and your back softens. Your neck moves forward on the shoulders and you no longer use your glutes, rounding your lower back. Meanwhile, the thoracic spine—the area that holds the diaphragm and protects the lungs—gets stiffer and stiffer to protect that area.

What happens over time is that people get up to move and the low back and neck is basically stuck or tight. It’s adapted to this new posture. So now the low back, a prime stabilizer, isn’t able to do the job it is supposed to do any more. Over time, the low back becomes weak and the joints push and pull a little more. Eventually those tissues push so much they create a bulge or herniation.

Q: How can people tell if they are headed for an injury?

A: Just ask yourself: “How many times did I get up and bend over with a neutral spine?”  Can you move without discomfort? We’ve almost forgotten the fact that we should be able to move pain-free!

Q: In addition to reading The Low Back Fix, what are a couple things people can do to avoid injury from sitting all day?

A: There are two top things I would recommend.

First: whether you are at a sitting or standing desk, move every 25 minutes. Walk. Do some hip stretches or a few heel raises with a stool.  Or do 5 squats next to your chair.

Second: breathe! When you are breathing in your chair, make sure you are getting air into that belly, that diaphragm.  Don’t breathe into the chest. That will really help improve the thoracic spine, the mid-back mobility. Breathe deeper—not just through your shoulders, but really work to expand your rib cage.

As an additional benefit, breath control will help with concentration. When you have more oxygen in the body you’ll feel calmer throughout the day because your sympathetic nervous system is more in check.  That’s something all workers can benefit from.


For desk dwellers looking to avoid taking sick leave or who fear losing the ability to work altogether due to permanent injury, understanding how to better care for their spines before they need medical intervention is invaluable.

Theresa Larson bio

Dr. Theresa Larson (aka “Dr. T”) has become one of the fitness world’s most sought after experts on movement health. Dr. Larson earned her doctorate in physical therapy from the University of Saint Augustine in San Diego, CA. A former Marine Corps Engineer Officer and Combat Veteran, Theresa also played professional softball in Italy as well as semi-professional softball in the United States, was an All- American Division I softball player at Villanova University, as well as a former Body-for-Life Champion. Theresa founded Movement Rx with her husband in 2013 in order to break free from the limitations that traditional physical therapy puts on practitioners and patients. The result was a company where skilled practitioners can authentically treat patients with the time, care, and movement education they deserve.