lower back pain when sitting

  • 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. 

References

  1. Princeton University Athletic Medicine, (n.d.), Lumbar/Core Strength and Stability Exercises, retrieved from https://uhs.princeton.edu/sites/uhs/files/documents/Lumbar.pdf
  2. UCLA Health, (n.d.), Ergonomics for Prolonged Sitting, retrieved from https://www.uclahealth.org/spinecenter/ergonomics-prolonged-sitting
  3. Mayo Clinic, (n.d.), Sciatica, retrieved from: https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435#:~:text=Pain%20that%20radiates%20from%20your,of%20your%20thigh%20and%20calf.
  4. Physio UK, (n.d.), Postural Pain, retrieved from https://www.physio.co.uk/what-we-treat/musculoskeletal/conditions/lower-back/postural-pain.php
  5. American Association of Neurological Surgeons, (n.d.), Low Back Strain and Sprain, retrieved from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain
  6. Chen, H. M., Wang, H. H., et. al., (March 2014), Effectiveness of a Stretching Exercise Program on Low Back Pain and Exercise Self-Efficacy Among Nurses in Taiwan: A Randomized Clinical Trial, retrieved from https://www.sciencedirect.com/science/article/pii/S1524904212001713?casa_token=mLMLooM9CNgAAAAA:ZOrUJFv4ryS2wAAbfFn5DBw_cAFUm-fYB5ZE2pogOjhzzIXs1Q_mVakp0srXNsR1enBXVPSptAbY
  7. Pillai, D., and Haral, P., (October 2018), Prevalence of Low Back Pain in Sitting Vs Standing Postures in Working Professionals in the Age Group of 30-60, retrieved from https://www.ijhsr.org/IJHSR_Vol.8_Issue.10_Oct2018/20.pdf
  8. Ibid.
  9. Wong, A. Y., Karppinen, J., & Samartzis, D. (2017). Low back pain in older adults: risk factors, management options and future directions. Scoliosis and spinal disorders, 12, 14. https://doi.org/10.1186/s13013-017-0121-3
  10. Gupta, N., Christiansen, C. S., Hallman, D. M., Korshøj, M., Carneiro, I. G., & Holtermann, A. (2015). Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study. PloS one, 10(3), e0121159. https://doi.org/10.1371/journal.pone.0121159
  11. Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2007). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283–298. https://doi.org/10.1007/s00586-006-0143-7
  12. Ibid.
  13. Versus Arthritis, (n.d.), What should I know about back pain?, retrieved from https://www.versusarthritis.org/about-arthritis/conditions/back-pain/
  14. Ibid,
  15. Weill Cornell Medicine, (n.d.) Types of Back Pain, retrieved from https://comprehensivespine.weillcornell.org/conditions-we-treat/back-pain/types-of-back-pain/
  16. Ibid.
  17. Ibid.
  18. Chou, L., Brady, S., Urquhart, D. M., Teichtahl, A. J., Cicuttini, F. M., Pasco, J. A., Brennan-Olsen, S. L., & Wluka, A. E. (2016). The Association Between Obesity and Low Back Pain and Disability Is Affected by Mood Disorders: A Population-Based, Cross-Sectional Study of Men. Medicine, 95(15), e3367. https://doi.org/10.1097/MD.0000000000003367
  19. Mayo Clinic, (n.d.), Sciatica, retrieved from: https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435#:~:text=Pain%20that%20radiates%20from%20your,of%20your%20thigh%20and%20calf.
  20. Ibid.
  21. Ibid.
  22. Cleaveland Clinic, (n.d.), Sciatica, retrieved from https://my.clevelandclinic.org/health/diseases/12792-sciatica
  23. Ibid.
  24. Ibid.
  25. Ortho Info, (n.d.), Herniated Disk in the Lower Back, retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/#:~:text=A%20herniated%20disk%20is%20a,leg%20pain%20or%20%E2%80%9Csciatica.%E2%80%9D
  26. Ibid.
  27. Ibid.
  28. Mayo Clinic, (n.d.), Spinal Stenosis, retrieved from https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961#:~:text=Spinal%20stenosis%20is%20a%20narrowing,stenosis%20may%20not%20have%20symptoms.
  29. Ibid.
  30. Ibid.
  31. Physio UK, (n.d.), Postural Pain, retrieved from https://www.physio.co.uk/what-we-treat/musculoskeletal/conditions/lower-back/postural-pain.php
  32. Wenli, K., O’Sullivan P, (July 2020), Movement, posture and low back pain. How do they relate? A replicated single‐case design in 12 people with persistent, disabling low back pain, retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.1631
  33. Physio UK, Op. Cit.
  34. Ibid.
  35. American Association of Neurological Surgeons, (n.d.), Low Back Strain and Sprain, retrieved from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain
  36. Ibid.
  37. Chou, L. et al., Op. Cit.
  38. Ibid.
  39. Ibid.
  40. Ibid.
  41. Shiri, R., Karppinen, J., et. al., (December 2009), The Association Between Obesity and Low Back Pain: A Meta-Analysis, retrieved from https://academic.oup.com/aje/article/171/2/135/130619?login=true
  42. Ibrahimi-Kaçuri, D., Murtezani, A., Rrecaj, S., Martinaj, M., & Haxhiu, B. (2015). Low back pain and obesity. Medical archives (Sarajevo, Bosnia and Herzegovina), 69(2), 114–116. https://doi.org/10.5455/medarh.2015.69.114-116
  43. Harvard Health Publishing, (n.d.), Don’t take back pain sitting down, retrieved from https://www.health.harvard.edu/pain/dont-take-back-pain-sitting-down
  44. Princeton University Athletic Medicine, (n.d.), Lumbar/Core Strength and Stability Exercises, retrieved from https://uhs.princeton.edu/sites/uhs/files/documents/Lumbar.pdf
  45. NIH National Institutes of Neurological Disorders and Stroke, (n.d.), Low Back Pain Fact Sheet, retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet#3102_8
  46. Ibid.
  47.  Molton IR1, Terrill AL1. Overview of persistent pain in older adults. Am Psychol. 2014;69:197–207
  48. Wong, A.Y., Karppinen, J. & Samartzis, D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis 12, 14 (2017)
  49. Mayo Clinic, (n.d.), Back Pain Treatments and Diagnosis, retrieved from https://www.mayoclinic.org/diseases-conditions/back-pain/diagnosis-treatment/drc-20369911
  50. Ibid.
  51. Chen, H. M., Wang, H. H., et. al., (March 2014), Effectiveness of a Stretching Exercise Program on Low Back Pain and Exercise Self-Efficacy Among Nurses in Taiwan: A Randomized Clinical Trial, retrieved from https://www.sciencedirect.com/science/article/pii/S1524904212001713?casa_token=mLMLooM9CNgAAAAA:ZOrUJFv4ryS2wAAbfFn5DBw_cAFUm-fYB5ZE2pogOjhzzIXs1Q_mVakp0srXNsR1enBXVPSptAbY
  52. Rainville, J., Hartigan, C., et. al., (January 2004), Exercise as a treatment for chronic low back pain, retrieved from https://www.sciencedirect.com/science/article/pii/S1529943003001748?casa_token=wKapgh_1qBsAAAAA:_C1GDBMtWSFGXuZ18m6SE7GMSzwWFYyVf1YrjiOSHdxExY1FlE7KwQV2V0fp_hmrbWIQQiJZvPt7
  53. Ibid.
  54. Mayo Clinic, Treatment and Diagnosis, Op. Cit.
  55. Ibid,
  56. Ibid.
  57. Nursing Times, (March 2009), Back Pain, retrieved from https://www.nursingtimes.net/clinical-archive/pain-management/back-pain-23-03-2009/#:~:text=Back%20pain%20will%20usually%20last,reached%20and%20appropriate%20treatment%20given.
  58. Ibid.