The body's responses to sitting are complex and involve the anatomy and physiology of the sitter as well as the structure of the seat, the desk and the environment. In the light of recent research, the major reactions of the spine, the muscles and the spinal discs are discussed. Their interactions when adopting sitting postures are described. Reasons are given why certain sitting postures are to be preferred. The mechanisms that may give rise to muscle and disc damage, as well as back pain, as a result of adverse sitting postures are outlined. The design consequences of the research are then presented, showing how the seat shape arises from the previously described data. The influence of backrest design on sitting comfort and in the reduction of loading on the body is shown. Finally, a brief discussion of the influences from the work surface illustrates how the combination of seat and workplace can reduce the risks of injury by mitigating body loadings over the working day.