Does sitting cause lower back pain? This is a question that we receive each and every week from curious readers who suffer from agonizing lumbar symptoms that begin, or worsen, when seated for an extended time frame.
Although humans, and their evolutionary ancestors, have utilized various seated postures for countless millennia, many people still feel that sitting is inherently bad for the lower back. This is simply not true.
However, sitting does enact some structural changes in the lumbar spine that may exacerbate some forms of back pain. Therefore, sitting is not a completely innocent activity either.
This discussion finally takes a deep look into the controversial topic of seated lower back pain and sciatica. We will provide an analysis of the anatomical changes that are caused by sitting and explain how these changes might influence the degree of pain that is experienced by the patient.
To answer this question simply; sitting does not universally cause lower back pain through any known physical process. However, sitting does change the lumbar anatomy is definite ways.
Traditional seated posture does put a severe bend in the lumbar spine and redistributes weight on different structures than would normally support the body when it is standing or lying down. Weight is transferred to the buttocks and thighs, instead of borne by the legs, hips and torso. Direct pressure may be applied to the sciatic nerve.
The increased curvature of the lumbar spine can interact with pre-existing structural conditions that exist therein. Remember that the lower lumbar spine degenerates at the most noticeable rate of any region in the vertebral column. Disc desiccation, osteoarthritic buildup and other possibly pathological conditions reside here in virtually every adult human.
When disc pathologies, atypical spinal curvatures, spinal arthritis conditions and other anatomical irregularities interact with this increased curvature, the patient may feel better or worse, depending on many parameters. Statistically, herniated discs, mechanical pain and facet arthritis tend to be aggravated by sitting, while lumbar central spinal canal stenosis symptoms are often relieved.
Less commonly, sitting might cause other particular anatomical alterations that might be part of the back pain source process. These changes might include circulatory constriction, neurological compressions and soft tissue problems internal or external of the spinal anatomy.
Sitting might also cause or contribute to lower back pain through purely psychological means. Conditioning is a major source of chronic pain. Since sitting has a bad reputation for worsening lumbar symptoms, it is no surprise that many patients suffer flare-ups when seated. There may be no physical basis for this pain to occur, yet the mindbody interactions still cause the reaction to exist.
There is certainly no denying the power of the mind to cause back pain. We exhaustively detail this terrifyingly common source of suffering in our psychological back pain section.
It is virtually impossible to completely avoid sitting, although it is certainly plausible to sit less often and for a shorter duration.
Patients often write to us saying that they need some solution to their sitting back pain, in the form of an ideal chair or cushion. The internet is full of actively marketed products that seek to take economical advantage of people’s pain. There is no shortage of companies willing to take your hard-earned money to pay for some “special chair for back pain”.
We do not recommend this path, since statistically, most patients do not cite their considerable monetary investments to be worthwhile, once the product is received.
A better bet is to find solutions that work for you, without investing in overpriced products that take advantage of patient’s ignorance, through the sordid marketing efforts of predatory health product companies.
We recommend any of the following free methods of sitting for increased comfort in the lower back:
Try different seated positions. Try different types of chairs that you already have available. Some might be far better than others in terms of causing or relieving pain.
Try to use pillows or cushions to support you while sitting. Some patients find that extra padding on the seat and some support pillows really bring tremendous relief.
Try standing more often or kneeling when working. Most office chairs can be reversed and used as excellent kneeling chairs, with no special investment required.
Try treating the psychoemotional aspects of the condition with knowledge therapy. If sitting-related pain is truly a programmed response, then this is certainly the most effective method of care. Best of all, knowledge therapy is free and highly potent for ending many types of mindbody symptoms.
Sitting never seemed to particularly bother my back, more than any other position, for the first few decades of my enduring struggle with dorsalgia. Actually, I sat often and for long periods of time and never seemed worse-for-wear. These early years of my back pain story were filled with acute flare-ups and involved very little chronic pain.
I managed to cure my pain completely for several years, using the mindbody approach to care detailed throughout this site. However, in 2008, my pain returned. This is when I noticed that sitting was the worst possible position for me.
I struggled with seated postures for a few years, always feeling worse after prolonged periods in a chair. I tried to decondition myself, using all the facts I already knew about sitting being innocent of negative influence over my back, but this was to no avail.
Eventually, I simply acquiesced to sitting as little as possible and begin working while standing up. Over time, I integrated kneeling on my backwards-facing office chair, as well. Now, I work using both of these positions and find that my back has responded positively.
I have no definitive explanation why standing and kneeling are better for me than sitting, but then again, I do have a great number of structural problems in my spine, as well as a known history of psychoemotional contributors to my pain.
What works for you? How do you cope with back pain that is aggravated by sitting? We would love to hear your ideas on the subject and know that other readers would enjoy further discussion of this common conundrum, as well.
Please share your story on our back pain forum and get involved in helping yourself and others to be free of this afflictive horror known as back pain.