I bought a stand up desk a half year ago for ergonomics. I was fed up with sitting (for many of the reasons that Mark Sisson recently wrote about) so I hired a handyman (through the online classifieds) to build me a standup workstation. It was pretty expensive ($450), but it’s top quality and I plan to use it extensively for many years to come. It’s gigantic: 3′ deep and 5′ wide, giving me plenty of room to do both computer work and paperwork. It’s height adjustable within a few inches for fine tuning (via a screw mechanism between the legs and the tabletop).
I find that standing is nice but as Mark pointed out, static standing has its drawbacks. But since you’re not locked in a chair, it’s easy to move around or stretch once in a while—I like to drop into a grok squat once in a while. Foot soreness can be extreme at the beginning if you’re unaccustomed to standing for long periods. But your feet will adapt in a week or two, and will become even better adapted over longer periods. I use an anti-fatigue mat, the kind that cashiers and other workers sometimes use. It makes the transition much easier and is really nice to stand on. Good posture is really important to avoid back soreness—just stand as tall as you can (like you do when you’re getting your height measured). It also helps to have a tall stool to sit down once in a while so you’re not always in one static position.
My workstation also features dual monitors (24″ and 19″), which is a big productivity booster. I keep them below eye level and angle them upwards to reduce eyestrain—when you look down, your eyelids close more and your eyes don’t get as dry.
I also use the Microsoft Natural Ergonomic Keyboard 4000 which I can’t recommend highly enough. The split keyboard keeps your wrists in natural alignment and the front is raised, creating a slight negative angle which also does wonders for the wrists. I can’t stand regular keyboards anymore, it feels like typing handcuffed. I can type much faster and much more comfortably on my ergonomic keyboard.
Rather than using wussy computer speakers, I hooked up my 500W 5.1 surround sound system. I can only send it a stereo signal, but it’s still awesome.
I recommend a standing workstation if you put in a lot of time at your desk. Otherwise, you might want to try some of the cheap alternatives that Mark suggests.