The Best Thing For Your Back Is This Chair

Back pain—especially lower back pain—is no joke. According to the 2010 Global Burden of Disease Study, lower back pain is the single leading cause of disability worldwide. Costs associated with lower back pain in the United States exceed $100 billion.

“People can develop lower back pain for a variety of reasons,” says Jay Greenstein, DC, of Sport & Spine Rehab. “It could be chronic, repetitive stress or postural issues. It could be an acute trauma like a sports injury or a car accident or a slip or a fall. There are many different causes of lower back pain.”

When it comes to back pain and posture, says Greenstein, we should be thinking of our spines as layers of “bricks and jelly donuts”: The vertebral bodies are the bricks, and the discs are the jelly donuts. When those bricks and donuts curve in an unusual way—say, slumped in front of a desk—it leads to pain and inflammation over time. With so much compression over time, you might end up even slipping a disc, which is when the jelly in the donut bursts.

Kneeling chairs are designed to create a pelvic shift that forces the lower back to arch. “You can decrease pressure on what's called the facet joint,” the joints in your spine that make your back flexible, says Greenstein. Decreasing pressure on that joint relieves it of pain. “A kneeling chair [is designed] to maintain the the natural curve in the lower back, which can potentially help patients who have lower back pain.”

Indeed, a 2015 study showed that a kneeling chair can help people with back pain reduce lumbar lordosis—the inward curve of the lower back, which contributes to a lot of back pain—versus a regular office chair.

Standing tall leads to more than just joint pain relief. A good power posture, tall and confident, can affect how we behave subconsciously. For example, one study showed that people who had a tall posture were more confident and more likely to feel in control. Another study from 2009 showed that those with good posture were more likely to think more positively of themselves. If these reasons aren’t good enough to seek out a better posture, then maybe your health is.

“Maintaining good posture is critically important to good spinal health. It’s also important for the public to understand is that once a disc herniates, or a disc degenerates, you can't regenerate it,” says Greenstein.

Managing your posture on a day-to-day basis is critically important. Typical office chairs have you sit at a 90-degree angle, which puts pressure on your spine, curves it, and causes you to slump. Kneeling chairs work by making you sit at about a 20-degree slant so that you sit more upright. According to a 2008 study in Studies in Health Technology and Informatics, ergonomic kneeling chairs set at 20 degrees (or more) inclination can maintain standing lumbar curvature—your posture—to a greater extent than sitting on a standard computer chair. And further research has shown that practicing good posture while seated can improve your standing posture, as it trains your back and core muscle to support your skeleton in the correct way.

“You're putting the most pressure on your spine when you sit,” says Steven Conway, DC, who serves on the Board of Directors of the National Board of Chiropractic Examiners (NBCE). “Laying down is the best, standing up [is second best]. But, when you sit there's the most compression.” Kneeling chairs are meant to lessen that compression, evening out the donuts and disks.

“A lot of regular chairs, when you're sitting, people would slump or they would be static,” Conway continues. “So what happens with these kneeling chairs was it actually changes your posture. You could go to this chair, lean forward, and it changes all the structure of your lower back and the angles and the pressure. And a lot of people feel good doing it.”

Conway points out, though, that without proper cushioning, your knees could end up feeling pretty sore. He encourages people with kneeling chair to get up fairly often, which gives your knees a break if they’re sore, and taking a break encourages movement. Consistent movement is one of the ways lessen the impact of poor posture at your desk.

Part of how kneeling chairs work is by engaging your core as you sit. Kneeling chairs can help strengthen your abdominal muscles by forcing you to sit more upright, making your abs activate more to keep your spine stable. It’s commonly referred to as “active sitting.”

“If your core is not activating [as you sit],” says Greenstein, “then all that stress and pressure goes on the ligaments instead of the muscles that are designed to support the spine.”

Indeed, a 2015 survey of several studies found that strengthening the core muscles is more effective in fighting lower back pain than typical resistance training that’s meant to relieve lower back pain. The core and the back are actually much more intertwined than you may think.

“The goal of these chairs is to get the core muscles engaged to stabilize and control the spine in an appropriate posture in order to decrease stress, decrease inflammation, and thus decrease pain,” says Greenstein. “The chairs are designed in order to get that spine into a lumbar lordotic—the inward curving of the lower back—as well as causing the muscles to engage to create stability for the spine so that all the stress is not born by the discs and joints.”

Don’t get too excited: You probably won't end up with a six pack after two weeks with your kneeling chair. But you will end up a stronger core, better posture, and less pain in your lower back.