The Spine in a Sedentary World: A Warning from Neurosurgeon Dr. Larry Davidson on Why Sitting Is a Public Health Crisis

In an exclusive interview, neurosurgeon and spine health expert Dr. Larry Davidson explains the subtle but serious damage our chairs are causing, and why movement is the most potent medicine.

A young professional with chronic back pain. A retiree who struggles to walk a single city block. A teenager whose neck feels permanently stiff. These stories aren’t outliers; they’re signs of a larger cultural problem. The human spine, designed for motion, is being reshaped by an era of stillness.

According to the World Health Organization (WHO), sedentary behavior contributes to more than 3.2 million deaths each year worldwide, a toll so significant that experts have dubbed it “the new smoking.”

Dr. Larry Davidson, a board-certified neurosurgeon and spine health expert, says this is the clinical reality reshaping our long-term health. “The human spine was not built for eight-hour Zoom marathons,” he explains. “What we’re witnessing now is an epidemic of premature wear and tear. It’s not one big injury but years of small, cumulative strain that builds into a significant long-term problem.”

What Happens to Your Spine When You Sit?

Sitting might feel like rest, but Dr. Larry Davidson says it’s anything but neutral. “Our spines evolved to support an active lifestyle,” he explained. “But prolonged sitting, especially with poor posture, can disrupt the spine’s natural mechanics.”

Lumbar Strain and Disc Dehydration

The lower back takes the brunt of it. Without proper support, the spine’s natural curve flattens, unevenly loading the intervertebral discs. This puts even more uneven pressure on the intervertebral discs, increasing the compressive force on the spine by up to 30% more compared to standing upright.

“The very act of resting in a chair,” Dr. Larry Davidson explains, “puts more destructive pressure on your spine than standing does.” Over time, this constant pressure leads to disc dehydration and height loss, essentially accelerating the degenerative changes that naturally occur with age.

‘Tech Neck’ and the Cervical Spine

The sedentary crisis is compounded by the rise of tech-driven posture problems. The habit of craning our necks toward screens has birthed terms like “tech neck” or “text neck,” and the biomechanical strain from this habit is staggering. The average adult head weighs 10 to 12 pounds, but a mere tilt of 60 degrees forward to look at a smartphone can exert up to 60 pounds of force on the cervical spine. The excessive force leads to specific muscle imbalances, such as the lengthening and weakening of the anterior cervical muscles and shortening of the posterior cervical muscles.

“We have teenagers coming into the clinic whose neck x-rays show changes we used to see in much older adults,” Dr. Larry Davidson shared, highlighting the importance of establishing healthy habits early.

A Generational Problem

Sedentary culture has no age limit. Dr. Larry Davidson walked me through how it’s shaping different stages of life.

• Children and Teens: With the average American child spending 7.5 hours a day on screens, there’s less time for active play or sports. Only about 20% of adolescents meet the recommended 60 minutes of daily physical activity. This can lead to weaker core muscles and poor postrual habits during crucial developmental years. “We are essentially conditioning young spines for a lifetime of sitting,” Larry Davidson noted with concern.
• Working-Age Adults: For many adults, work is the primary source of sedentary time, with desk jobs often requiring eight or more hours of sitting each day. Working remotely, standard 9-to-5 office routines have been stretched to 8-to-6 on a computer. Add in commuting and evening relaxation, and it’s easy to spend most of the day in a chair. Larry Davidson emphasized that the cumulative hours matter. “Sitting might not hurt you in one marathon session, but doing it every day for years absolutely will,” he shared. “It’s the repetitive stress, day in and day out, that reshapes spines and stiffens joints over the years.”
• Older Adults: Many adults over 65 spend between eight to 10 hours per day sitting, the highest of any age group. For some, this is a result of health issues or reduced mobility, but inactivity can create a challenging cycle. Less movement can lead to muscle loss and frailty, which in turn can make activity more difficult, increasing the risk of back pain.

How Spinal Health Impacts Mental Well-Being

The damage caused by excessive sitting goes beyond bones and muscles, impacting neurological and mental health.

Direct Neurological Consequences

“The spine is the central pillar of the body, and when posture problems cause issues like disc bulges or misalignment, the nerves housed within this central highway are often caught in the crossfire,” Dr. Larry Davidson explained. For instance, a nerve impingement such as sciatica can often be traced back to extended periods of sitting. The pressure from a slouched posture can cause a lumbar disc to bulge and irritate the nearby sciatic nerve. “A patient might come in with intense leg pain after a week of long flights and conferences, surprised to learn that the trigger was the extended time spent in a chair,” he said.

The Pain-Mental Health Feedback Loop

A growing body of research shows a strong connection between an inactive lifestyle, chronic pain, and mental health. Dr. Larry Davidson noted that inactivity is directly linked to higher rates of depression and anxiety, partly because it reduces the natural mood-boosting effects of physical activity. There is a significant feedback loop between chronic pain and mental health. Dealing with persistent back or neck pain can cause feelings of hopelessness and anxiety, which can then increase pain perception.

“I remind patients that pain is not ‘all in their head’, but the head is a big part of how we experience pain,” he explains. When someone is both sedentary and struggling with back pain, addressing their mental health becomes a crucial part of the treatment plan. The body, mind, and nervous system are all interconnected, and the modern sedentary existence puts each of these systems at risk.

Solutions and Interventions: From Ergonomics to Daily Habits

Fortunately, the sedentary spine crisis is not without solutions. There is a range of interventions, from smarter workplace ergonomics to small daily habit changes, that protect your spine and overall health.

Optimizing Your Workspace: A Guide to Spine-Friendly Ergonomics

One of the primary defenses is enhancing the environment to promote better posture and more frequent movement. Ergonomics and workplace design are crucial in reducing the strain associated with sitting. Dr. Larry Davidson notes that many spinal problems can be avoided by arranging workstations to support natural spinal alignment. This includes basics like:

• Ergonomic chairs with adjustable height and lumbar support ensure your feet rest flat on the floor and your lower back maintains a healthy curve. This is not just about comfort; by maintaining the natural ‘S’ curve of the spine, an ergonomic chair helps ensure the spine’s delicate discs and nerves are not compressed, which can reduce the risk of conditions like sciatica.
• Desk and monitor height: Screens should be at eye level or slightly below to prevent constant neck craning. Keyboards and mice placed so your arms form a 90-degree angle help keep shoulders relaxed.
• Standing desks or sit-stand converters: While not a cure-all, standing desks are popular for a reason. Studies have shown that alternating between sitting and standing can help reduce shoulder and back pain. They encourage a healthier flow of posture, easing some spinal load and engaging different muscles, even if used for just a few hours a day.

• Posture wearables and reminders: A new wave of tech gadgets can help monitor and correct your posture, such as small wearable sensors or smart chair devices, that can sense when you slouch and give a gentle vibration or alert. Over time, such biofeedback can train you to maintain better form. Early studies on posture-correcting wearables suggest that they can indeed enhance spinal awareness in users.

The goal of ergonomics isn’t to promote perfect stillness but to make good posture feel natural and encourage frequent movement. “Supporting natural posture through intentional workspace design makes it easier for healthy habits to become routine,” Dr. Larry Davidson shared.

For example, having a desk setup that allows you to stand easily for a phone call or providing enough space to do a quick stretch can help incorporate movement into your workflow. Many companies are now investing in activity-friendly workplaces, including treadmill desks, breakout areas for walking or stretching, and policies that promote walking meetings or breaks. These changes recognize that keeping workers more active can improve concentration, reduce discomfort, and likely lower injury rates.

However, Dr. Larry Davidson warns that even the best ergonomics won’t help if you ignore your body’s need to move. “Even a thoughtfully designed office chair cannot make up for staying in one position for hours,” he says. In other words, a great chair plus no breaks still causes issues. This is where personal habits become important.

Small Movements to Protect Your Spine

You don’t need to quit your desk job or make drastic changes to your life to improve your spine health. The key is in small, consistent movements that can add up over time, like adding brief activity breaks and posture resets into your daily routine.

• Microbreaks every 30–60 minutes, even if just for 30 seconds. Dr. Larry Davidson recommends his patients try standing up twice an hour, setting a timer, or using an app reminder if needed. During these microbreaks, do something simple like rolling your shoulders, gently twisting side to side, or taking a quick walk to the water cooler. Research indicates that people who take these regular breaks experience less back pain and may even longer.
• Perform desk-based stretches and strengthening exercises to relieve muscle stiffness. For example, try a quick chest-opening stretch to counteract hunched shoulders and a neck stretch by gently tilting your ear toward your shoulder on each side. Standing up and doing a slight backbend or hip flexor stretch can help ease lower back pain. Many workplaces now offer handouts or classes on desk stretches. Additionally, some discreet core activation exercises can be useful, such as periodically tightening your abdominal muscles for 10 seconds or doing a few seated marching-in-place movements. These mini exercises keep blood flowing and remind your postural muscles to engage.

• Practice ‘active sitting’ to engage your core and glutes. Rather than collapsing into a chair, Larry Davidson advises patients to sit upright, pull in their belly button slightly to activate the core, and keep their shoulders back. Checking in on this alignment throughout the day helps strengthen the supporting muscles, even if it’s just shifting your position from time to time.

• Take walking meetings or calls: Whenever possible, replace sedentary time with active time without sacrificing productivity. If you’re on a phone call or having a casual meeting, consider walking during it, whether inside your office or around the block. Many find they think more clearly when standing, which also gives their spine a break from sitting in a chair. Larry Davidson points out that patients who adopt habits like a 10-minute post-lunch walk or a walking phone call experience less back tightness in the afternoon and have more energy.
• Regular exercise and stretching routines are essential to maintaining a consistent workout schedule. Aerobic activities, such as walking, cycling, or swimming, improve blood flow to spinal structures and help control weight, reducing strain on the back. Strength training that targets the core, glutes, and back muscles builds a strong support “corset” for your spine. Flexibility exercises, whether through yoga, Pilates, or simple stretching, help preserve flexibility and counteract the shortening effects of prolonged sitting.

Small habits practiced daily, such as standing up often, adjusting your posture, and doing light stretches, will accumulate benefits for your spine. And importantly, movement needs to be seen as essential. Dr. Larry Davidson is fond of saying that “movement should be treated like hydration: something essential, not optional.” In other words, just as you wouldn’t go all day without drinking water, you shouldn’t go all day without moving your body. By reframing movement as a fundamental need, we can begin to redesign our routines around it.

Redesigning Life Around the Spine

Ultimately, the spine acts as a mirror, reflecting our culture’s significant shift from an active to a sedentary lifestyle. The aches and pains many experience are not just individual issues but a collective warning. Sitting might be an ingrained part of modern life, but as Dr. Larry Davidson has said, we are not powerless to combat this “silent” public health crisis. By understanding how inactivity affects our spinal health and by taking proactive steps through personalized ergonomics, regular movement, and new technologies, we can protect our backs and overall well-being.

Dr. Larry Davidson urges everyone to see their spine as a lifelong partner that requires care and attention. Small, consistent changes truly make a difference. Stand up and stretch during your next Netflix binge. Encourage your children to play outside after school instead of spending extra hours on video games. If you work at a desk, take a moment to improve your setup and schedule regular breaks. Your spine will appreciate it, and so will the rest of your body. In his words, “We can’t redesign the human spine, but we can redesign how we live around it.” The problem of a sedentary spine can be addressed one microbreak, one ergonomic adjustment, and one healthier habit at a time.