This is a slightly modified version of an internal p2 post I did at work to try to gather ideas. I decided to publish it publicly to share with others and try to gather more ideas before I go and buy something.
I had spinal surgery about 2.5 years ago now, I’ve been kinda muddling through with my current work ergonomics solution since then and trying to put my focus at rebuilding the muscles that were preventing me from really sitting/standing at my desk. COVID threw off some of my PT routines and in-person appointments so I focused on other things and the pain was reduced. Now I’m restarting PT in earnest and all the pain has really come back so I think I need to optimize my setup for where I am currently at rather than where I hope to be.
The root issue with my body is leg and back pain. I start most days at a 3 or 4 on the 0-10 pain scale, and am at a 5 or 6 by the end of the day. At a 6 I can’t focus any more. A 5 I can work mostly through – and work is wonderfully distracting. Sometimes the pain is in my lower back, but mostly it is burning nerve pain in my feet/legs plus spasticity (legs jumping/twitching involuntarily). Any soreness gets translated by my nervous system into burning 🔥, and PT ramps up the soreness. I could increase my pain meds, but they tend to make me more tired, and I spent four miserable months last year trying to reduce them.
What I’ve been doing
Here is what my setup has been for over a year:
- In the morning I work from an old lazy-boy chair so that I can stay reclined. My abs are too weak and difficult to engage to hold me up for long, so when I sit up I naturally end up slumping which eventually puts my back in lots of pain. The chair is pretty terrible, but I’ve tried many other solutions and nothing has been as good. I add some extra lumbar support and that does help. Reclining and raising my legs up is very helpful for blood flow to my legs. But the leg rest is maybe not great. Getting in and out of the chair to stretch and move is also not super easy.
- Usually by early afternoon I am no longer comfortable in that chair, particularly the pain in my legs has ramped up so I move to sitting sideways on a hard sofa where I can have my legs straight out and the pressure of my legs evenly distributed. My legs being flat reduces the leg nerve pain, but sitting up on the couch (I’ve tried lots of different back support solutions) is pretty rough on my back.
- For both of these positions I’ve been just using my laptop in my lap. Terrible ergonomics on my arms/shoulders/neck, but the pain from that is minor in comparison.
- Stretching my legs out straight helps a lot. Presumably better blood flow and nerve signal.
- Single point of contact on my legs when having them raised is probably causing more pain. I can’t really feel the pressure, but I think it is a problem.
- Leaning back is better. I’ve tried a couple of rounds and variations on transitioning back to my sit/stand desk (good chair and desk) and every time it has just been worse and completely unsustainable. Ideal would be completely flat. Discussed this with my PT today and he really agrees.
- Moving my legs around to different positions is helpful, but tough to do with a laptop on me all the time where I am also trying to optimize reaching the keyboard and seeing the screen.
Prototyping a new solution
I’ve been iterating a bit on my setup this week and completely moved all the furniture around my office to try prototyping a new solution.
My current prototype:
- Use the lazy-boy chair so I can recline.
- Put a big sofa pillow on the leg rest of the chair so that my leg weight is better distributed. Also raises my legs up another six inches.
- Sitting next to my sit/stand desk with an Ergotron monitor arm so I can have the big monitor kinda tilted down at me and easy to reposition.
- I have a cutting board on my lap with my mouse and keyboard on it. Resting it on the arm rests is too high.
- Using an inflatable airplane pillow as a headrest when I want to lean back farther and angle my head at the monitor.
Results of current prototype:
- I do seem to be able to sit in this setup for a lot longer and with a lot less pain. Got through the whole day today and my pain never quite got above a five. I’m still sitting here at 7pm. Also, all day long this felt like the best solution I have.
- I can’t recline back quite as far as I would like and the lazy-boy doesn’t transition to every angle.
- The monitor only tilts down 5-10 degrees so is at a bad angle when I recline all the way back.
- My headrest solution for reclining back farther has my neck bent too much.
- The keyboard on my lap is not at the right angle. The arms of the chair are kinda in the way so my arms are up too high also. Feeling some pain in my arms from resting on the armrests in odd ways.
- The chair back is not great support. I can definitely feel some back pain.
- The seat is a bit deep even when I am fully reclined. Probably just too old and sinks too much. My PT found my psoas (hip) muscles to be super tight from sitting like this which is why he suggests flat (or fixing everything else, but I’ve been working with him for years on everything else and we aren’t there yet).
- My feet hang off the end of the chair and I think that starts to add extra pressure on my calves that eventually results in nerve pain. Alternating crossing my ankles kinda helps a bit, but there is definitely some nerve pain in my feet at times and I think this is why.
- Getting in and out of the chair is tough. I can’t really put down the foot rest without needing to rebuild a lot. The monitor is easy to push out of the way, but getting up to the side requires going over the arm of the chair. The chair is also kinda low to the ground in general. It definitely makes me want to get up less as I worry about pulling a muscle or falling as I do it.
All the solutions I have found are quite expensive ($4,000-$8,000). I really don’t want to buy the wrong thing though they do all seem to have 30 day return policies. I have tried looking for some mid-range solution, but I don’t think there are any. These high-end solutions only seem to sell 75-100 per year so I think the market is just not big enough. I’ve only really found these two companies so far.
- Altwork Signature: Expensive space chair. All the pieces of the chair move with electric motors which makes it easy to adjust and position while you are in position. The monitor and keyboard move with you as you change position which makes it easier to actually change during the day. Optimized for ergonomics in any sitting/reclining/laying position. Also supports standing which I would like to get back to doing at some point (though I do have this nice standing desk Automattic bought me a few years back that I loved while I could use it).
- Altwork Flex: Slightly cheaper option. Manual adjustment of the leg rests, monitor, keyboard. No standing. Maybe tougher to get in and out of also.
- Ergoquest Zero Gravity Chair 3. Cheaper, but not cheap. The headrest is really a pillow, and it has much less adjustability for the legs. Does go completely flat and is all controlled by electric motors. I’d probably pair this with this Ergotron monitor arm that can tilt through a full 180 degrees up and down. Haven’t chosen a keyboard tray yet. I’d probably attach all this to my sit/stand desk which would let me further adjust the height. Then if I can transition to trying standing again in the future I could move to that desk though I don’t see how I would do a gradual transition.
- Ergoquest Zero Gravity Chair 1. The “cheap” option at $2800. The problem is it doesn’t go fully flat, and has a fixed 120 degree seat angle.
Any other ideas? Anything else anyone has tried or heard of?