Introduction: Low back pain (LBP) is a common condition that, according to standard textbooks and several review articles, is associated with sitting-while-at-work. However, to our knowledge, no meta-analysis or critical systematic literature reviews have been published.
Materials and methods: The Medline, Embase, and OSH-ROM databases were searched for articles dealing with sitting at work in relation to low back pain for the years 1985-1997. Original studies were divided into those dealing with sitting-while-working and those dealing with sedentary occupations. Each article was systematically abstracted for core items. The quality of each article was determined on the representativeness of the study sample, response rate, the definition of LBP, and the statistical analysis.
Results: Thirty-five reports were identified: 14 dealing with sitting-while-working and 21 with sedentary occupations. Eight studies were found to fulfill the above-mentioned criteria. Regardless of quality, all but one of the studies failed to find a positive association between sitting-while-working and LBP. High quality studies showed a marginally negative association for sitting compared to diverse workplace exposures, for instance standing, driving, lifting, bending, and compared to diverse occupations. One low quality study associated sitting in a poor posture with LBP.
Discussion: Out of 35 studies, only eight fulfilled the very basic quality criteria. Nevertheless, both high-quality and low-quality studies are consistently in agreement about the lack of positive association, and we conclude that the extensive recent epidemiological literature does not support the popular opinion that sitting-while-at-work is associated with LBP.