Why Does My Lower Back Hurt When I Sit?
If your lower back starts to ache after sitting at your desk, driving, working from home or relaxing on the sofa, you're certainly not alone.
One of the common questions we hear at Ellie Physiotherapy is:
โWhy does my lower back hurt when I sit, but feel better when I move?โ
The answer isn't always as simple as having โbad postureโ or a โweak coreโ.
Lower back pain can be influenced by a combination of factors, including how long you sit, your activity levels, previous episodes of back pain, sleep, stress and how sensitive your back is at that particular time.
For most people, experiencing back pain when sitting doesn't necessarily mean that sitting is damaging their spine.
Why can sitting make my back hurt?
1. Sitting for a long time can aggravate your symptoms
Sometimes, the issue isn't necessarily sitting itself โ it may be staying in one position for too long.Research suggests that prolonged sitting can temporarily increase low back pain in some people. However, this doesn't mean that sitting is necessarily causing damage or creating a new back problem.
Your back may simply become more uncomfortable when it remains in the same position for a prolonged period.
This is one reason why changing position and taking regular opportunities to move can be helpful.
2. There isn't one โperfectโ sitting posture
You may have been told that you need to:
Sit completely upright
Keep your back perfectly straight
Pull your shoulders back
Keep your feet in a particular position
Never slouch
However, there isn't good evidence that one specific sitting posture is responsible for causing low back pain.
Slouching isn't automatically harmful, and sitting perfectly upright doesn't guarantee that you won't develop back pain .
Rather than trying to maintain one โperfectโ posture all day, it can be more useful to find positions that are comfortable for you and change position regularly.
So, should I improve my sitting posture?
Yes โ but think โcomfortable and changeableโ rather than โperfect.โ
Try adjusting your chair, desk or screen so that you feel comfortable. Use the backrest if it feels helpful, and allow yourself to change position throughout the day.
You could try:
Changing your sitting position regularly
Standing up and walking around periodically
Taking short movement breaks during long periods of desk work
Alternating between sitting and standing if practical
Avoiding spending the entire day in one position
Continuing with your usual daily activities where possible
The aim isn't to find a single position that you have to maintain all day.
Instead, think about varying your positions and keeping yourself moving where possible.
What about a standing desk?
A standing desk can be useful for some people, particularly if it helps them reduce prolonged sitting and vary their working position.However, standing all day isn't necessarily better than sitting all day.Simply replacing one prolonged position with another isn't necessarily the solution.
If you use a standing desk, consider using it as one way of varying your working position, rather than feeling that you need to stand for the entire day.
Do I need to strengthen my core?
Exercise can be an important part of managing lower back pain, but you don't necessarily need to spend hours doing abdominal or โcoreโ exercises.There are many different types of exercise that can be beneficial.
Depending on your individual circumstances, this could include walking, strengthening exercises, Pilates, swimming, running or other forms of physical activity.
The most appropriate exercise programme will depend on your symptoms, your current abilities and the activities you want to get back to.
The important thing is finding an approach that you can maintain and gradually building your confidence and tolerance for activity.
What can I do if sitting hurts my back?
Instead, you can gradually work on improving your tolerance.For example, if you normally notice your symptoms after 30 minutes of sitting, you could try changing position or taking a short movement break before the discomfort becomes significant.
As your symptoms allow, you can gradually increase the amount of time you spend sitting.
The aim isn't to become afraid of sitting.
It's to help your back become more comfortable with the activities and positions that are part of your everyday life.
Staying active can be helpful
When your back is painful, it can be tempting to stop doing everything that hurts.However, for most people with uncomplicated lower back pain, continuing with normal activities where possible and gradually returning to exercise can be helpful.You may need to modify an activity temporarily, but this doesn't necessarily mean that you have to stop moving altogether.A gradual approach can help you build your confidence and tolerance again.
If you're experiencing recurring lower back pain, a physiotherapy assessment can help identify the factors contributing to your symptoms. Learn more about lower back pain physiotherapy in Didsbury.
If your symptoms also include pain travelling into your buttock or leg, read more about sciatica physiotherapy.
When should I see a physiotherapist?
If your back pain is persistent, keeps returning, or is affecting your work, sleep, exercise or everyday activities, an assessment with a physiotherapist may be helpful.
At Ellie Physiotherapy & Wellness, I can assess your symptoms, movement, strength, activity levels and individual circumstances.I can then help you understand what may be contributing to your symptoms and develop a rehabilitation plan around your individual needs and goals.
You don't necessarily need an MRI or X-ray to understand or manage lower back pain. In many cases, a thorough assessment and appropriate management are more useful.
Imaging may be considered when there are specific reasons for it and when the results are likely to change how your condition is managed.
When should I seek urgent medical advise?
Most episodes of lower back pain are not caused by a serious condition.However, back pain can occasionally be associated with more serious problems.
Seek urgent medical assessment if you develop symptoms such as:
New problems controlling your bladder or bowel
Numbness around the genitals or anus
Significant or progressive weakness in both legs
Severe symptoms following significant trauma
Other symptoms that make you feel seriously unwell or concerned
If you have unexplained weight loss, a fever, a history of cancer or other concerning symptoms, seek medical advice rather than simply treating the pain yourself.
The bottom line
If your lower back hurts when you sit, it doesn't necessarily mean that your posture is damaging your spine.
For some people, prolonged or static sitting can make their symptoms more noticeable.
Instead of searching for the โperfect postureโ, focus on:
Changing position regularly.
Staying active where possible.
Gradually building your strength and tolerance.
Finding positions that feel comfortable for you.
Returning gradually to the activities that are important to you.
If sitting is consistently causing you pain, there may be more to the story.
An individual physiotherapy assessment can help you understand your symptoms and work out what approach may be appropriate for you.
I can help you understand your symptoms, build confidence in movement and work towards getting back to the activities you enjoy.
Move better.
Feel better.
Get back to doing what you enjoy.
If you're unsure whether physiotherapy is appropriate for your symptoms, you can book a physiotherapy assessment in Didsbury.
Disclaimer
The information in this article is provided for general educational purposes and is not intended to replace an individual assessment, diagnosis or treatment from a qualified healthcare professional. Every person's symptoms and circumstances are different, so the information provided may not be appropriate for everyone. If your symptoms are persistent, worsening or concerning, please seek advice from an appropriately qualified healthcare professional.