• Lower back pain felt by older people after sleeping may be caused by underlying medical conditions, such as disc degeneration, spinal stenosis (narrowing of the spaces in the spine), or herniated discs. 
• Other non-medical factors that cause lower back pain include bad mattress quality or sleeping positions(1).
• Non-pharmacological treatment options, including simple exercises, stretching, and physical therapy, may help with back pain in the morning.
• If low back pain is severe, seniors may seek medical advice from their physicians about over-the-counter pain medications or nonsteroidal anti-inflammatory drugs (NSAIDs)(2).
• Older people may prevent the onset of back pain after sleeping by changing their sleep positions, exercising, or reducing stress, tension, and anxiety(3-4).

Lower back pain after sleeping is a common struggle among older people(5). However, it may be challenging to find a solution to their pain problems, especially if they do not know the cause of their pain and discomfort.

Health Report Live aims to help older people manage chronic back pain by providing relevant information and possible health solutions. Through these solutions, seniors can manage their back problems and start their day positive and pain-free. 

Causes of Lower Back Pain After Sleeping

Early morning back pain or morning stiffness may be caused by an underlying medical condition or non-medical reasons(6). 

Here are the possible causes that explain why an older person’s back may hurt after sleeping:

Degenerative Disc Disease 

According to Mayo Clinic, disc degeneration occurs as people grow older. The condition is characterized by the drying out and shrinking of the discs between the vertebrae(7).

The spinal discs function as shock absorbers for the spine. These discs provide flexibility while resisting forces in various angles and planes of motion(8). 

Each spinal disc has two parts: the annulus fibrosus and the nucleus pulposus(9). The disc’s outer portion is the annulus fibrosus, made up of firm and tough material that can induce pain when damaged.

The nucleus pulposus is a soft, jellylike core that contains proteins, which may cause inflammation to the tissues they touch.

The proteins in the nucleus pulposus may leak out to the nerves of the spinal disc’s outer layer, resulting in painful sensations(10).

Because of low blood supply, discs cannot repair themselves once they are injured. Then, disc degeneration follows in a span of 20 to 30 years(11). 

Acute pain caused by the condition makes normal back movement difficult. The bone where a disc injury occurred becomes relatively unstable over time(12).

Disc degeneration affects sleep as it narrows the space between the vertebrae, making the spine less stable and flexible. The narrowing of the spaces may cause pain, numbness, or weakness(13). 

A patient with degenerative disc disease should see a physical therapist for treatment.

Below are the symptoms of degenerative disc disease(14):

• Feeling pain that worsens when lifting, bending, or twisting. 
• Experiencing lower back pain when sitting. Lower back discs have three times more load on them when sitting than when standing.
• Feeling reduced back pain while walking or running than while sitting or standing.
• Suffering from periods of intense pain that range from nagging pain to disabling pain. This pain may be felt on the lower back, buttocks, thighs, or neck.
• Numbness and tingling in the extremities.
• Feeling weak, particularly in the leg or foot muscles.

Spinal Stenosis

Spinal stenosis is the narrowing of the spaces within the spine. The action puts pressure on the nerves traveling through the spinal column(15). 

The most common reason for spinal stenosis is wear and tear in the spine, a symptom associated with osteoarthritis. The condition may also be caused by the following(16):

Thickened Ligaments

Ligaments are tough cords that hold the bones of the spine together. The tissues may thicken and stiffen over time. If this occurs, the stiff and thickened ligaments may bulge into the spinal canal.

Spinal Injuries

Injuries from car accidents and other trauma may dislocate or fracture one or more spinal vertebrae. The dislocated bone from a spinal fracture may damage the spinal canal. 

Surgery after an accident may also cause spinal stenosis. Swelling of tissues after back surgery may put pressure on the spinal cord and nerves.

The two types of spinal stenosis are cervical stenosis and lumbar stenosis. 

Cervical stenosis occurs in the part of the spine around the neck. Meanwhile, lumbar stenosis occurs in the lumbar spine’s curvature or the lower back(17).

Common red flags of cervical stenosis include(18):

• Neck pain
• Numbness and weakness in the hand, arm, leg, or foot
• Problems with walking and balance
• Bowel or bladder dysfunction

Meanwhile, the symptoms of lumbar stenosis include(19):

• Numbness and weakness in a foot or leg
• Pain in the legs when standing for long periods or when walking
• Back pain

Tumors

Tumors are abnormal growths inside the spinal cord or within the membranes that house the spinal cord. The formation of tumors may also occur in the space between the vertebrae and the spinal cord. 

Herniated Discs

A slipped or a herniated disc occurs when the nucleus pulposus pushes out through a tear in the disc’s outer layer. 

A herniated disc can irritate surrounding nerves and cause pain, numbness, or weakness in an arm or leg(20). 

Several people with a herniated disc experience no symptoms. Surgery is not always needed to relieve the problem(21).

Although most herniated discs commonly occur in the lower back, slipped discs may also occur in the neck. The condition’s symptoms depend on where the herniated disc is situated and whether the disc is pressing on a spinal nerve(22).  

Below are some of the symptoms of herniated discs(23):

Numbness or Tingling

People with a herniated disc often experience radiating numbness or tingling in the body part near the affected nerves.

Arm or Leg Pain

If the slipped disc is located in the lower back, the patient may feel pain in the buttocks, calf, and thigh. Pain may also radiate to the foot.

However, if the herniated disc is in the neck, typically, the patient feels the most pain in their shoulder and arm. The pain may be felt when the patient moves their arm, coughs, or sneezes. 

Weakness

Muscles near the affected nerves tend to weaken, causing the individual with a herniated disc to stumble or struggle when holding objects.

Fibromyalgia

Fibromyalgia is a musculoskeletal medical condition characterized by widespread pain and fatigue. Problems in sleep, memory, and mood are also associated with the condition(24). 

Researchers suggested that the condition may amplify painful sensations by affecting how the brain and spinal cord process painful and non-painful signals(25).

Fibromyalgia’s primary symptoms include(26):

Widespread Pain

Patients with fibromyalgia experience a constant dull ache that lasts for roughly three months. Discomfort associated with fibromyalgia is felt on both sides of the body and above and below the waist.

Fatigue

Fibromyalgia patients feel tired after waking even though they slept for a long time. Sleep in patients with the condition is also often disrupted by pain.

Cognitive Difficulties

Another symptom of fibromyalgia includes “fibro fog,” which impairs the patient’s ability to focus on mental activities.

Stiffness

Fibromyalgia also causes stiffness which may be most severe when the patient has been in the same position for a long time. This sleeping position issue may cause pain and discomfort in patients when they first wake up in the morning(27).

Vitamin D Deficiency

According to a 2019 study found in The Permanente Journal, vitamin D deficiency and insufficiency may cause and exacerbate neck and back pain(28).

The authors noted that the condition may also trigger and worsen muscle spasms(29). 

The 2019 study suggested that vitamin D played a crucial role in managing musculoskeletal system chronic pain. The authors noted that treating vitamin D deficiency and insufficiency improved the subjects’ symptoms(30).  

Poor Sleeping Positions

Back pain after sleeping may also be caused by poor sleeping posture. Poor sleeping positions add pressure on the spine, causing its natural curve to flatten(31).

Experts stated that sleeping on the stomach may cause body pain since it pushes on the muscles and joints and flattens the body’s natural curve. The position also forces a person to turn their neck while sleeping, which may cause neck and upper back discomfort(32).

To address this issue, older people may change their sleeping position to help them get better sleep and improve their spine health and overall wellness.

Bad Mattress

If an older person’s lower back pain does not go away even after they fix their sleeping posture, the pain may be caused by their mattress’ poor quality. 

Replacing their old mattress may provide them with pain relief and a good night’s sleep.

According to a 2009 study about back pain published in the Journal of Chiropractic Medicine, authors noted that replacing mattresses over nine years old may improve sleep quality and reduce stress and pain in the back muscles(33).

When choosing a new mattress, older adults should look for an adjustable bed and a medium-firm mattress with enough back support.

To know more about the other possible causes of lower back pain in the mornings, seniors may visit the National Institutes of Health (NIH) website, where they may read more about the condition and its causes.

Lower Back Pain Treatment Options

Exercises

A 2016 study published in the Scientifica journal noted that strengthening exercises relieve lower back pain and improve body functions in elderly people(34).

The authors noted that physiotherapists may recommend strengthening exercises to prevent disability and improve physical functions(35).

Regular exercise throughout the day may help alleviate back pain. Anything that gets seniors moving and off their feet, such as walking, may help strengthen their back. 

If an older person wakes up with back pain, they may try doing light exercises to alleviate discomfort throughout the day.

Stretches 

One way to reduce back pain is to stretch before getting out of bed. 

While lying on their back, seniors should stretch their arms up above their head as far as they can. At the same time, they must stretch their feet out in the opposite direction.

They can bring their knees to their chest and hold for a few seconds for a lower back stretch. 

After sitting up, older adults should plant both feet on the ground, shoulder-width apart. They can stretch by raising their arms over their head, then stretching from side to side.

Planks

Physical activities beneficial for older adults include planking, push-ups, pull-ups, squats, and lunges(36). 

A plank stretches the entire body, especially the core muscles. Strengthening the abdominal muscles puts less strain on the back(37). 

Doing a plank may prevent a person’s core from weakening and avoid the occurrence of neck, shoulder, and lower back pain(38).

To properly do a plank, the senior should lie facedown on the floor. Curl the toes and keep the elbows and forearms in line with the wrists. 

As they lift off the floor, they must push themselves to their upper back and keep their chin close to the neck.

Stay in the position for up to 30 seconds, crunching the abdomen tight as if bracing for a punch in the stomach. As the person holds the pose, they must also contract their glutes and thighs. 

Pharmacological Treatment

Painkillers

In some cases, physicians may recommend pharmaceuticals to relieve severe back pain in need of immediate relief. 

The doctors may prescribe NSAIDs, such as ibuprofen, to manage pain. NSAIDs are pain relievers and anti-inflammatory medications that reduce inflammation contributing to the patient’s discomfort. 

Acetaminophen, a painkiller and fever medication, may also be an option to reduce occasional back pain if the patient cannot take NSAIDs.

Another treatment to consider is the use of a transcutaneous electrical nerve stimulation (TENS) machine. 

According to a 2008 study in the Current Rheumatology Reports, TENS may relieve severe chronic musculoskeletal pain. However, patients must first need to build up a tolerance to the electrical currents(39). 

Seniors must first ask their doctors if using a TENS machine may be the best solution for their back pain.

Topical Remedies

Older adults may also try topical remedies to relieve pain. They may apply natural and essential oils, such as turmeric and peppermint, infused in carrier oils to the affected area.

However, before trying alternative treatment options, seniors must first consult their doctor to avoid worsening their pain or other adverse reactions.

Tips to Prevent Back Pain After Sleeping

The onset of lower back pain in the mornings is preventable by making simple changes in a person’s sleeping habits. Having a good sleeping posture may protect a person’s back(40). 

Below are some recommendations on how to improve a person’s sleeping habits, regardless of the position they sleep in(41):

If a person is a side sleeper, they may draw their legs up towards their chest and place a pillow between their legs to put less strain on their backs.

Meanwhile, if an individual sleeps on their back, they may place a rolled towel under their neck and a pillow underneath their knees to help maintain their lower back’s natural curve.

They may also use a rolled towel under the small of their back for additional lower abdomen support.  

Sleeping on the stomach may strain the back. If an older adult cannot sleep any other way, they may reduce the strain on their back by placing a pillow under their pelvis and lower abdomen. 

They must also use a pillow that does not place excessive strain on the back. If changing the pillow does not relieve back pain after sleeping, they may try sleeping without a pillow under their head.

Below are other helpful tips to keep in mind to prevent experiencing lower back pain in the morning(42):

• Stay active and exercise regularly
• Reduce extreme stresses and strains on the back 
• Be careful when lifting objects 
• Strengthen back muscles
• Lose excess weight; older people may use a body mass index (BMI) calculator to determine whether they have the appropriate weight for their height
• Try not to sit for long periods
• Wear flat footwear with cushioned soles to reduce the stress on the back
• Avoid muscle strain or sudden movements
• Make sure to have a good-quality mattress that provides enough back support
• Fix back posture when watching television or using computers or phones 
• Try to reduce any tension, stress, and anxiety

• Sleeping on the side with partially bent knees and a thin pillow between the knees may minimize lower back pain after sleeping(1). The head pillow should only be enough to fill the neck and mattress gaps to maintain natural alignment while sleeping.
• Research supports using medium-firm mattresses to help maintain low back pain(2-3).
• Lower back pain (LBP) is either acute or chronic. Acute LBP is short-term yet may develop into long-term chronic back pain if untreated(4).
• Despite lower back pain, adults must aim for at least seven hours of sleep in a day for general wellness(5). Some lifestyle practices to achieve this include setting and following a sleep-wake schedule.

Older people with lower back pain may struggle with sleeping problems. At the same time, sleeping problems affect a person’s recovery from their lower back pain. 

Health Report Live covers everything older folks with lower back pain can do for better sleep.

This article will outline which sleeping positions are the best for those with chronic back pain and which positions exacerbate the condition.

Health Report Live highlights the best sleeping positions that may help alleviate one’s lower back pain so one can go back to enjoying the simple things for a pain-free and improved quality of life.

The Best Sleeping Positions for People With Lower Back Pain

It is imperative to maintain the body’s alignment while asleep. 

However, a person’s favorite sleeping position could be causing them worsened lower back pain. 

The best and most comfortable sleeping positions for lower back pain are listed below.

Lying Sideways

Studies exploring the relationship between sleep posture and spinal symptoms state that side sleeping generally protects people from spinal concerns(6).

The American Academy of Family Physicians encourages people with back pain to sleep on their side. 

The organization suggests that the best sleeping position for lower back pain is lying sideways with the knees partially bent7).

To get into a comfortable side sleeping position, one should:

1. Be sure the left shoulder or right shoulder (depending on comfort level) and the rest of that side of the body makes contact with the mattress.
2. Fill any gaps between the waist and the mattress with small pillows or rolled-up towels.
3. Place a small or thin pillow between the knees to help maintain spinal alignment.

Sleeping on the side with a thin pillow between the knees helps keep the hips, pelvis, and spine in better alignment for a good night’s sleep.

Another side-lying option is the fetal position. 

To do this, one should:

1. Lay on the back, and then gently roll over to one side.
2. Tuck the knees toward the chest, gently curling the torso toward the knees.
3. Switch sides from time to time to prevent muscle or spinal imbalances.

People with degenerative disc disease, such as a herniated disc, are prone to sciatica and other back problems(8).

Discs are cushions between the spinal vertebrae. When disc degeneration occurs, parts of the disc push out of their regular space, pressing on spinal nerves and causing weakness and nerve pain(9).

Curling into a fetal position, with the knees drawn up, opens the spinal joint and lessens the spine’s curvature. Sleeping in this position on a firm surface may help prevent low back pain(10).

Lying Face Up

Some people may find sleeping on their back the most comfortable position to relieve their lower back pain.

However, a study has noted that sleeping face up increases the risk of developing LBP by 1.9 times(11).

To get a restful sleep while lying face up, one should:

1. Lay flat on the back.
2. Place a pillow under the back of the knees. The extra pillow helps keep the spine in a neutral position, maintaining the lower back’s natural curve.
3. Substitute the small pillow with a rolled-up towel or any comfortable cushion for added support.

Sleeping on the back distributes the body’s entire weight evenly across the widest parts.

This position places less stress on pressure points, allowing for better alignment of the internal organs and the spine.

Adjustable beds can make it easier to raise a person’s mattress to the most comfortable position while lying on their back.

The Worst Sleep Position for Lower Back Pain

Lying face down is perhaps the worst sleeping position for people with lower back pain. Sleeping on the stomach may add stress and cause neck pain.

Still, some people find it difficult to go to sleep unless they are on their stomachs. 

To make stomach sleeping less damaging to the spine, one should:  

1. Place a pillow under the pelvis and lower abdomen to relieve some pressure off the back.
2. Use a small pillow for the forehead to allow breathing space between the face and the mattress. 

Meanwhile, some people may find having no head pillow more comfortable when sleeping on their stomach (prone position).

However, sleeping in the prone position inflicts more pressure on the spinal joints and muscles. This position flattens the spine’s natural curvature and puts force on the neck. Stomach sleepers may experience upper back and neck pain(12).

Placing a pillow on the lower abdomen area may relieve stress from the discs’ spaces.

The Relationship Between Sleep and Lower Back Pain

Constant pain may lead to sleep disorders, impairing the pain recovery process(13).

Individuals with lower back pain may experience sudden pain surges, affecting their sleep cycle.

Moreover, people with sleeping problems are prone to pain. Experts suggest that sleep deprivation affects moods and makes people more sensitive to pain(14).

Researchers have collected evidence from animal experiments and human studies linking sleeping problems with lower back pain(15).

Existing evidence has made experts agree that both conditions mutually reinforce each other(16).

What to Look for in a Pillow

Pillows should fill the spaces between the body and mattress to maintain the body’s alignment while sleeping.

People who find more comfort in lying down on their back must fill the space between their neck and the mattress.

Memory foam is a firm pillow material that molds specifically to an individual’s head and neck and provides hip and shoulder support(17). This material may help improve spinal alignment for side sleepers(18).

For side sleepers, firm pillows with an extra-wide gusset may help connect the space between the ear and neck with the mattress.

Placing a pillow between the knees may provide additional relief for lower back pain(19).

Individuals may use a rolled-up towel instead of a pillow between the knees. As long as the body’s alignment is maintained while one sleeps, any comfortable object may suffice.

Body pillows may provide extra support for side sleepers. These large pillows may provide added comfort for people who need to feel something against their stomach while aligning the body during sleep.

Although sleeping on the stomach is considered bad for the back, some people may find this position the most comfortable.

Individuals who need to lay on their stomach to sleep may place a small pillow under the abdomen to help align the back while sleeping.

Overall, one should fill in the spaces between the body and the mattress filled with supporting body alignment while sleeping.

Meanwhile, placing a pillow under the shoulders when sleeping is not a good idea. A pillow under the shoulders puts stress on the neck and affects its alignment with the rest of the body.

What to Look for in a Mattress

An individual’s comfort preferences factor into a person’s ideal mattress. These preferences vary further based on a person’s most comfortable sleeping position, body weight, and body size.

Most people spend almost one-third of their lives lying in bed(20). This fact highlights the necessity of choosing a quality mattress for managing lower back pain.

Existing research suggests medium-firm mattresses to help manage lower back pain(21-22).

However, one survey of 268 people with lower back pain stated no difference in sleep quality between individuals who used a firm mattress and those who slept on a medium-firm mattress(23).

The same survey stated that those who used very firm mattresses had the poorest sleep quality.

Meanwhile, soft mattresses that conform to the body’s natural curves may help align joints and relieve back pain(24).

However, people may sink into extremely soft mattresses, twisting their joints, which may worsen lower back pain(25).

People may try placing a plywood board under their current mattress to gauge whether a firmer mattress is ideal for them.

Conversely, individuals may try using mattress toppers as a new layer above their current mattress without replacing their entire mattress.

Memory foam is a new mattress foam material for people to try without buying a whole mattress. Materials include cotton, latex, polyfoam, polyester, and a mixture of materials.

Studies on the appropriate mattresses that influence sleeping comfort and health are limited. Still, the existing investigations highlight the necessity of proper sleeping support to prevent sleep-related musculoskeletal disorders, such as scoliosis(26).

Sleep Hygiene

Typically, adults need seven to nine hours of sleep in a day(27). 

As lower back pain disrupts a person’s sleep cycle, maintaining healthy sleep hygiene becomes imperative.

To improve sleeping habits, one should(28):

• Set a sleeping schedule by going to bed at a particular time and then waking up at the same time each day. Consider putting the alarm to wake up on time.
• Exercise and perform lower back stretches for 20 minutes to 30 minutes a day. However, avoid doing heavy physical activities a few hours before going to bed.
• Avoid caffeine and nicotine products late in the day. Experts have linked nicotine consumption to adverse effects on sleep and mood(29).
• Avoid consuming alcoholic drinks before bed. Although alcohol has sedative effects, its consumption leads to poor sleep quality and duration(30).
• Perform relaxing activities before bed. Try some relaxing routines, such as taking a warm bath, reading a book or calming Tai Chi body movements.
• Try calming scents, such as lavender to promote relaxation. Experts have noted lavender’s purported therapeutic and relaxation-inducing properties(31).
• Avoid using television or mobile devices to help go to sleep. Continued exposure to blue light from mobile gadgets could disrupt sleep cycles by affecting the sleep hormone melatonin(32).
• Consult a doctor for medical advice if sleeping problems or unusual tiredness throughout the day persists. Most sleep disorders are reversible and effectively treatable.

Nights tend to become shorter and lighter for the elderly. People over 60 years old may resort to medications to help with sleep interruptions(33).

Standard pharmacological treatments for insomnia in the elderly include(34):

• Benzodiazepines and nonbenzodiazepine sedatives
• Antidepressants
• Melatonin receptor agonists
• Herbal supplements
• Orexin receptor agonists

Types of Lower Back Pain

Acute and chronic are the two primary types of lower back pain.

Acute Lower Back Pain(35): This short-term type of lower back pain lasts for a few days or up to a few weeks. Only in a few cases do acute lower back pain symptoms take a few months to disappear.

Acute lower back pain is common with no permanent effects. With healthy lifestyle habits and self-care, this condition may improve in a few days(36).

Chronic Lower Back Pain(37): This long-term type of lower back pain tends to persist for over 12 weeks. Around 20% of acute lower back pain cases develop into chronic pain(38).

Despite the prevalence of lower back pain, its exact cause is unknown. Experts suggest that more than one event causes existing lower back pain. Heavy lifting and arthritis are some causes linked to chronic back pain(39).

When to See a Doctor About Lower Back Pain

A person experiencing any type of lower back pain must watch out for any of the following signs to decide whether they need professional medical attention(40):

• Back pain after falling hard or getting a severe blow to the back
• Hematuria or blood in the urine
• Urinary tract infection (UTI) or burning sensation with urination
• History of cancer
• Incontinence or loss of control over urine or stool
• Pain that travels down the legs below the knee
• Pain that worsens when lying down
• Surging pain that wakes a sleeping person
• Swelling or redness along the back or spine
• Severe pain that prevents a person from getting comfortable
• Unexplainable fever with back pain
• Numbness or weakness in the lower extremities (pelvis, buttocks, thigh, and leg)

Other more alarming conditions include the following signs:

• Unintentional weight loss
• Necessary use of steroids or intravenous drugs
• Different or worse sensation compared to their history of back pain
• The current back pain episode lasts longer than four weeks

FAQs

Why is lower back pain worse in the mornings?

Some issues that contribute to morning back pain include poor sleeping position, bad mattress quality, disc degeneration, spinal stenosis, and herniated discs(41).

Does lying on a hard floor help with lower back pain?

While there is no proof that sleeping on the floor improves lower back pain, Existing research suggests using medium-firm mattresses to help manage lower back pain(42-43).

How long does lower back pain last?

Acute lower back pain is common with no permanent effects. With healthy lifestyle habits and self-care, this condition may improve in a few days(44).

However, acute LBP that develops into chronic back pain may last over 12 weeks(45).

When should one be worried about lower back pain?

If lower back pain persists for more than four weeks, other underlying causes requiring medical attention may be contributing to the pain(46).

Some alarming signs include worse back pain compared to a past episode and unintentional weight loss.

How long should one rest for lower back pain relief?

People with lower back pain may experience more pain when resting for extended hours(47). Resting for more than 48 hours may increase muscle and spine stiffness(48).

It is suggested to move around at times and find a comfortable position when resting.

• Lower back pain may be prevented by regularly doing lumbar support and core strengthening, low back stretching, and exercises(1). Practicing proper posture and ergonomic positioning reduces the amount of stress on the spinal cord(2).
• Prolonged sitting and age-related degenerative diseases may cause sciatica, characterized by low back pain and leg pain(3). Posture and muscle strains may also induce pain in the lumbar area(4-5).
• Pain medications and physical therapy that involves stretching and light exercises targeting back muscle flexibility and strength are said to be safe and effective in low back pain(6).
• It is vital to consult a medical expert before trying any treatments for low back pain. The proper guidance of a physical therapist in performing stretches and exercises for back pain is important. 

Health Report Live discusses the different causes of lower back pain when sitting and the reasons why lower back pain may be exacerbated when one is seated. 

Included in the discussion are the symptoms associated with lower back pain. Signs indicating whether the condition is becoming more severe or chronic are also discussed.

This article covers the top tips to help alleviate lower back pain while sitting and the things one can do at home to minimize lower back pain when seated.

The best sitting positions, exercises, and stretches to avoid lower back pain are also discussed with easy-to-follow instructions.

Sitting And Lower Back Pain

Lower back pain is one of the most prevalent musculoskeletal disorders today(7). Data shows that about 76% of people working in sitting postures have complained of low back pain(8).

Adults age 60 years and older are more prone to lower back pain due to age-related psychosocial and physical factors(9). 

A study on blue-collar workers in their mid-40s showed that sitting time is a crucial factor associated with lower back pain intensity(10). 

Meanwhile, an assessment of the association between sitting and low back pain revealed that sitting alone does not necessarily result in back pain(11). 

However, the combination of poor posture and whole-body vibration with prolonged sitting increased the risk of low back pain(12).

Knowing the causes of back pain is essential in administering the appropriate treatment for the condition. 

Causes of Lower Back Pain

The thoracic region (the back) consists of 24 vertebrae (which make up the spinal column) supported by ligaments, muscles, and discs(13).

When people age, the spine structures become stiff and easily damaged, resulting in back pain(14).

There are two types of lower back pain depending on the severity and frequency: chronic and acute back pain(15). 

Chronic back pain occurs when the symptoms are felt regularly and sporadically. This type of back pain may affect daily activities(16). 

On the other hand, acute back pain is more temporary and sudden(17).

Increased physical work demands, emotional disorders, and old age are some of the known risk factors of back pain(18). Even so, the causes of back pain are not limited to these factors.

For instance, low back pain when sitting may be caused by a herniated disc, sciatica, spinal stenosis, posture, muscle strain, and other degenerative diseases. 

Physical activity and obesity may also contribute to low back pain.

Sciatica

Once the sciatic nerve is pinched due to a herniated disc or, in severe cases, tumors, sciatica occurs. 

Sciatica is characterized by a radiating pain from the lower spine (called lumbar area) that continues to the buttocks and the back of the legs(19). 

Sciatica often presents as mild to excruciating pain, which often feels like a jolt or an electric shock(20). 

Prolonged sitting and a sedentary lifestyle are considered risk factors for sciatica(21). Inactivity limits muscle flexibility, increasing the likelihood of sciatica(22). 

Age-related symptoms may also cause sciatica(23). Aging brings about a natural wearing down of bone tissue and discs in the spine. 

As people age, their nerves are at risk of being pinched or injured by the changes in discs and ligaments.

Nerve pain in people with sciatica may be due to a herniated or ruptured disc that applies pressure on a nerve root(24).

Herniated discs mainly occur in the lower back and cause leg pain(25). This degenerative disc disease is primarily caused by lumbar disc degeneration or water content decrease in the discs(26). 

When water content is reduced, these discs become less flexible, and the spaces between vertebrae become narrower(27). 

The narrowing of these spaces results in a medical condition called spinal stenosis(28). Back and neck pain are two of the common symptoms of this condition. 

Spinal stenosis is commonly observed in people age 50 years old and above(29). Weakness, numbness, balance problems, and paralysis may result from spinal stenosis(30).

Posture

Another common cause of low back pain is bad posture. This postural back pain may be caused by poor standing and sitting postures for long periods of time(31).

A study cited that posture is possibly related to non-specific low back pain(32). Poor posture may lead to muscle sprain and a decrease in range of motion(33).

Muscle stiffness and spasms are symptoms of lower back pain due to slouching or poor sitting posture(34).

Muscle strain

Muscle sprain and strains are common causes of low back pain(35). These conditions happen because the lower back muscles support body weight, and sometimes these muscles are overly stretched or torn(36).

Sports injuries, sudden twisting of the lower back muscles, and tight hamstrings may increase the risk of muscle strains. 

Obesity

Being overweight or obese is said to be associated with low back pain(37). Obesity is believed to have meta-inflammatory and biochemical effects on the spine(38).

Research has shown that women are more prone to obesity and lower back pain than men(39).

A study on low back pain, mood disorders, and obesity attempted to test these propositions in a selected male population. 

Results showed that high intensity low back pain is associated with increased adiposity (obesity), particularly in men with emotional disorders(40). 

Statistical analysis showed that being overweight or obese increased the risk of low back pain(41). 

However, other studies argued that while obesity may cause low back pain, it does not directly influence the condition(42). Further studies are encouraged to verify this inference.

Best Sitting Position for Lower Back Pain

For people who cannot avoid extended periods of sitting down, there are sitting positions that may be best for low back pain. 

• While Sitting Casually

Sitting is one activity that should be done only for short periods.

To prevent back pain, one should:

• Find a firm and high-back chair, which helps straighten the back and elongate the spine. 

It is not advisable to sit on a soft couch, which does not support the spine’s natural curvature.

• Use back support, like a pillow, cushion, or rolled towel.
• Always keep the knees and hips at a right angle with the feet flat on the floor. If the feet do not touch the floor, use a footrest or stool.

• While Working on a Desk With a Computer

• When sitting at a desk, one’s upper arms should be comfortably placed parallel to one’s spine. 
• The forearms and hands should rest on the work surface. At this point, the elbows are bent at a 90° angle.
• One should sit as close as possible to the desk. A space to get the legs (and any armrests attached to the chair) under the desk makes sitting more comfortable.
• Eyes must be at a level where they are aimed at the center of the screen. Otherwise, the screen needs to be adjusted.
• One should always make the conscious effort to press their bottom against the back of the chair. Maintaining an ergonomically supported posture is crucial to spine health.
• Slumping or slouching, which can put extra stress on the lumbar discs and lower back structures, must be avoided. 

Sitting up with a cushion or pillow to support the back can help prevent slouching.

• Taking a break every 30 minutes to an hour is ideal. This time can be spent moving around or walking a short distance.

• While Driving

Sitting in a car is no different from sitting at a desk in the office. One should still take regular breaks, like 30 minutes, where applicable.

When driving, one should:

• Push the seat all the way back, and then lower it as far as possible. The seat must be closest to the steering wheel in order to support the back. 
• Adjust the seat height until the hips are about as high as the knees. 
• Recline the back of the seat to 30-40° and move the steering wheel (if adjustable) all the way up and in towards the dashboard.

The hips must be in a higher position or the same level as with the hips. 

• Most car seats have lumbar support, which can be adjusted to a preferred height or depth. 
• Position the lumbar support in the curve of the lower back. The lowest edge of the support should be placed at the beltline or at the top of the pelvis.

Tips to Prevent Lower Back Pain When Sitting

Generally, back pain may be avoided by doing regular physical activities and exercises that promote stronger back muscles and improve the range of motion like Tai Chi (43). 

Stretches and exercises focusing on the core muscles and lumbar support are some preventive tools that can reduce the risk of having low back pain(44). 

Individuals looking to prevent lower back pain when sitting should:

• Use ergonomic equipment and furniture at home or in the office to ensure good posture and comfortable torso position.
• Switch sitting positions often. Walking periodically around the office or gently stretching muscles can relieve tension(45). 
• Place a pillow or rolled-up towel behind the back to provide lumbar support. 
• Rest both feet on a low stool when sitting for a long time. 
• Quit smoking. This bad habit may limit the oxygen and blood flow to the spinal discs, resulting in the early degeneration of the lumbar spine(46). 

Treatments for Lower Back Pain Due to Sitting

The nontreatment or undertreatment of low back pain in older adults may lead to(47-48):

• Malnutrition
• Sleep disturbances
• Mental stress
• Slow cognition 
• The rapid decline of functional ability
• Withdrawal from recreational and social activities
• Falls

 

The symptoms mentioned above can also be indications that the condition is becoming more severe or chronic.

Over-the-counter pain medicines, like ibuprofen and non-steroidal anti-inflammatory drugs (NSAIDs), are commonly used medical treatments for back pain(49). 

There are also home treatments that may be done to manage the pain, like putting hot or ice packs.

Aside from these methods, chiropractic and physical therapy with a licensed medical professional can provide back pain relief.

Doing light everyday activities can help manage back pain(50). However, it is vital to avoid movements that may induce further pain.

A randomized clinical trial assessed stretching exercise programs for lower back pain. The study suggested that stretching exercises are a safe and effective non-pharmacological alternative treatment for low back pain(51).

Additionally, exercise is said to lessen the risk of back injuries and is a safe treatment for back pain(52). 

Several studies supported exercise as a treatment for flexibility and strength improvement(53).

Diagnosis

In diagnosing lower back pain, a medical professional may instruct the patient to stand up, sit, lift a leg, or walk. These directives are done to assess pain intensity(54). 

These assessments help determine the cause of pain. 

X-ray images can show indications of bone fractures and spinal alignments. 

For scans of nerves, tendons, muscles, and blood vessels, computed tomography (CT) scans or magnetic resonance imaging (MRI) is typically used(55). 

Bone scans are also used to diagnose tumors and more severe bone problems, like osteoporosis(56).

When To See a Doctor

Typically, back pain lasts up to six weeks(57). For persistent and severe pain, it is best to seek a physician or physical therapist’s medical advice.

Possible adverse symptoms, like fever, pain down the legs and below the knees, chest pain, and bladder control loss, should be observed(58). 

If these indicators are present, one should contact a doctor immediately. 

If you’ve been suffering from severe lower back accompanied by other uncomfortable symptoms, you may be suffering from lumbago.

This sounds like a strange condition, and you are likely wondering, what is it? Don’t worry – we are going to define this ailment in just a moment, and cover everything you need to know about living with it.

We’ll explain all the possible causes, along with how you can get diagnosed to determine if this is really what’s plaguing you.

Then, we’ll cover the most common treatment options for this issue, and uncover whether there is actually a cure for it or not.

What Is Lumbago?

It sounds scary, but lumbago is really just a general term used to describe lower back pain. And as it turns out, it’s one of the most common ailments there is. Millions of Americans are affected by this condition every year. 

In fact, the NINDS (National Institute of Neurological Disorders & Stroke) claims that 80% of adults are affected by this at some point in their lives.

There is no one cause for it, as you’ll soon learn. Lumbago can happen to just about anyone, but there are certainly groups that stand out as more at risk for developing back pain.

For example, those who live more sedentary lives are more susceptible to just about any condition out there – and lower back pain is no exception. Here are some risk factors to keep in mind:

• Working an office job, sitting for prolonged periods of time
• Lack of exercise
• Poor genetics (weak discs,scoliosis, etc.)

We’ll cover some specific causes of lumbago in just a moment, but first, we want to help you determine whether this is really what you’re suffering from.

Where Does Lumbago Hurt?

We already mentioned what lumbago is – a fancy word for lower back pain. But where, specifically, does it hurt?

Look for pain in the lumbar spine, of course. This pain will be accompanied by stiffness, tension, and aches. In severe cases, mobility will be compromised.

You should be able to pinpoint the pain if it’s lumbago. You’ll really only feel discomfort in a small portion of your lower back. It will be very localized.

In some cases, this condition will mimic sciatica – with the pain spreading from your lower back to your glutes, groin, hamstrings, etc. Any signs of tingling or radiating pain are a secondary symptom to watch for. 

If the pain is enunciated when you cough or sneeze, this is another indication it could be lumbago. 

What Is The Cause Of Lumbago?

We already mentioned some of the risk factors, but what is the cause of lumbago? As with most issues, there are a few different potential causes, so diagnosing this condition is not always easy. 

More often than not, this ailment is simply a symptom of some other condition. A few common causes are:

Inactivity, Overactivity, Or Poor Movement

We already sort of covered this, but it really is the most common cause. Not moving your body enough, and properly for that matter, will lead to lumbago in the long run. Take inventory of your daily activity, and adjust it if you feel that you aren’t moving enough.

You also need to consider whether you are putting too much strain on your lower back. If you work a manual labor job, or any position that has you constantly lifting, bending, or straining, you are quite susceptible to developing an overuse injury that presents itself as lumbago.

This is why learning how to hinge at your hips properly is so important. Strengthen your core, as these small, crucial muscles play a pivotal role in protecting our spines. 

Underlying Spinal Issues

Another common, and usually more serious, cause of lumbago is some other underlying issue or condition in your spine.

There are quite a few of these, and they all more or less have to do with the deterioration of your spine. As you can imagine, these become more common with age.

Two that stand out as more typical than others are osteoarthritis and spondylosis. These are very painful lower back conditions. But, they aren’t the only ones.

You may be suffering from a slipped or herniated disc, which can be incredibly painful. Usually, these are felt at the time of the injury. These aren’t necessary related to degradation of the spine, so they’re easy to diagnose.

But other possible causes that can come on slowly include osteoporosis, stenosis, or tumors in the spine. All of the conditions we’ve outlined in this section are serious, and will require professional care.

How Is Lumbago Diagnosed?

While we’ve given you some good places to start by explaining common causes above, you are still probably wondering, how is lumbago diagnosed?

Start by making a trip to your doctor, a chiropractor, or a physical therapist. They will evaluate you and ask a series of questions to narrow down the root cause.

You’ll undergo physical tests to take note of nerve function and ROM (range of motion). This will help the practitioner get an understanding of how serious your issue is.

You may also need to take chemical tests, such as blood and urine sampling, to rule out something more serious, such as a kidney issue.

More often than not you’ll get x-rays done to get a picture of your spine, muscle tissue, and surrounding organs. This will help identify damaged structures, while also ruling out tumors.

In instances where all of the above still doesn’t provide a definitive cause of your lumbago, you may need to get an MRI or CT scan done.

Can Lumbago Be Cured?

Once you have your diagnosis, you can come up with a treatment plan to start healing whatever ailment is really causing your lumbago, and hopefully, cure it.

Some of the issues we mentioned above, such as stenosis or disc degeneration, are not really curable. But you will learn how to live with the issue, strengthening surrounding muscles, increasing ROM, and managing pain.

Most often, you’ll get to a point where managing your lumbago is a piece of cake, and you don’t even notice it most days!