Recently, it’s been widely reported that sitting too much is bad for you. Studies suggest that it’s associated with an increased risk of dying, especially from problems relating to cardiovascular disease. More surprisingly, this association of sitting with negative health outcomes still holds, even amongst people who exercise regularly. So, depressingly for many office workers, it’s starting to look as though you can’t make up for the 40 hours a week you spend sat at a desk by doing a few high-intensity training sessions in the evenings.

So what can you do about this? Prompted in part by this evidence, standing desks have had a resurgence. Some of the most popular versions available are adjustable in height (so-called sit-stand desks) to enable people to mix periods of sitting with more time spent standing up.

The logic makes sense – when you’re standing up, you burn more calories, your muscles have to work harder, and it may help your body to control blood sugar levels better, leading to a lower risk of metabolic diseases. So far, so good.

There’s also a theory that it may help to reduce the risk of sitting-related back pain. Standing up uses more activation in the trunk and core muscles than sitting does, and regular periods of standing may help to keep these muscles from becoming weak and atrophied, contributing to musculoskeletal pain.

Is there any research to prove any of this?

In March this year, Cochrane Library published a systematic review of 20 studies of “workplace interventions to reduce sitting at work.” These were quite small studies – there were only 2174 participants in total; averaging just over 100 in each study. In addition to sit-stand desks, the interventions studied also included policy changes and information and counseling. Some of the studies also included treadmill desks or pedaling workstations, which take the idea further by adding movement. They concluded that there was “low-quality evidence that sit-stand desks may decrease workplace sitting between 30 minutes to two hours per day without having adverse effects in the short or medium term. There is no evidence on the effects in the long term.”

Look at that again. A sit stand desk might help slightly reduce the amount of sitting time during the day without causing you any additional problems (such as sore muscles or loss of productivity). The authors weren’t looking at whether there was an actual health benefit, though – they just measured how much people reduced their sitting activities. Any conclusions about health effects have to be extrapolated from the other literature about the health risks of sitting – and this runs the risk of assuming there’s a causal link when there may not be.

Let’s say that you get a sit-stand desk with the intention of spending half of your eight-hour working day standing up; this evidence says that most people don’t manage that much. It’s possible that you have better stamina and willpower than the average person in the study, but it’s also possible that your expectations are unrealistic.

Even if you do make good use of your sit-stand desk, is it actually achieving much except for making you feel virtuous? The small number of extra calories burned probably isn’t enough to help you lose weight, or prevent type 2 diabetes (especially if you reward yourself for using your standing desk by having an extra cookie), but as far as research on the topic goes, there’s not much direct evidence one way or the other.
A small study published in 2016 looked at chronic lower back pain, and concluded that workers suffering from lower back pain with access to a sit-stand desk reported significantly better pain scores than those without. Another very small study with just 10 participants showed that a standing desk reduced the amount by which blood glucose increased after a meal. It’s possible that this may be a factor in the improved metabolic health of people who spend less time sitting down. But if you’re looking for large, randomized controlled trials comparing the health of people who use standing desks for part of the day with those that don’t – I’m afraid there aren’t any.

But a standing desk can’t hurt, can it?

That depends. There’s some evidence that prolonged standing may increase the risk of varicose veins and even deep vein thrombosis. And for some kinds of back pain, prolonged standing may make it worse rather than better.  As with many of these things, there’s a balance to be struck. Sitting all day isn’t healthy, but too much standing isn’t either.

The verdict – plausible, but unproven. If you like the idea of standing up to work, then by all means give it a go. It may help some people with back pain – but remember that not all back pain is the same, and individual results will vary. (You should really check first with your therapist or doctor whether a standing desk is appropriate for you.)

Human bodies are built to move. Staying for too long in any one position, whether sitting or standing, will eventually cause problems. Being able to switch between different positions (as with the sit-stand desk, for example), allows you to distribute the strain better, and might turn out to be a good option for some people. The jury is still out; so if you don’t wish to spend your money, then you might get just as much from taking regular movement breaks during the day, and making sure that you get up from your chair at regular intervals.