Back pain can ruin your day and your dating plan, and most of us experience this symptom at least once in our lifetime. But what if you continuously feel back pain after sitting or while you’re still sitting?
This symptom is usually referred to in the lower part of the back. This region, known as the lower back, corresponds to the lumbar spine. In this region, we can find the lumbar vertebrae.
They are 5 cylindrical bones, very sturdy and solid as compared to other vertebrae. They need to be resistant because they take and handle the weight of the upper body. In this part of the spine, there’s a natural curve inward that balances the weights.
So, imagine yourself sitting in a poor position, probably hunched forward or slouching. The spine adopts this position, and the natural curves are lost. What will happen to the lumbar vertebrae?
You’re sitting, and your legs are not carrying the weight. But your spine is still working to hold your upper body. Since you’re not keeping a natural spine alignment, they won’t be able to handle the weight. The end result is lower back or hip pain, and you don’t even need an underlying medical condition.
However, many ailments can contribute to how severe pain is and its frequency. In this article, we’re going through the most common and what to do about it.
Causes of lower back pain
We mentioned above bad posture as a cause of lower back pain when sitting. It is definitely an important cause, especially if you detect recurrent slouching. Sitting with a very straight spine may also cause pain problems.
You want to adopt a natural posture, where you stay straight but feel rested without any muscle tension. It is also a good idea to use an ergonomic chair, especially if you remain sitting for hours. These chairs mimic the natural curve of the spine (lumbar lordosis) and prompt a good posture.
But even if you’re not adopting a poor posture, you might experience lower back pain while sitting. When this is the case, doctors may need to rule out these causes:
- Sciatica pain: The sciatic nerve runs down from the lower spine to your legs. It travels through your buttocks, and you basically sit on it. When this nerve is pressed by other structures or becomes inflamed, it causes pain. Sciatica pain does not have the same characteristics all the time. It can feel similar to an electric shock, or you may experience a dull ache instead. But regardless of the characteristics of pain, it becomes worse when you sit for a long time. It is also common on one side of the body and may irradiate to your buttocks and legs (1).
- Herniated discs: You could read above the vertebrae’s importance as a support for the upper body. Their facet joints and bodies need to withstand a lot of pressure every day and have special structures for that. But when these structures fail to support the vertebrae, the inner structures bulge outwards. This is a herniated disc, and it often places a strain on the local nerves. A herniated disc is more common as we age, and in some cases, it might be expected in older adults. Common triggers include elderly falls, osteoporosis, and repetitive movements in younger individuals. It causes different degrees of pain, depending on the severity of the condition. Patients also refer to numbness in the area of the affected nerve (2).
- Degenerative disc disease: This ailment and herniated spinal discs are usually found in the same patient. They are more common in older patients, especially when they have bone mineralization problems. Degenerative disc diseases feature problems in the structures of the vertebrae. These intervertebral discs are located between one vertebra and the other to cushion them. But they can tear or have an injury, and the structures inside the disc start protruding. This causes a large number of problems, usually associated with back pain. For example, when it protrudes backward, it compresses nerve roots. Then, patients feel back pain, which irradiates to the legs. Still, you can have degenerative disc disease and not show any sign at all. Or maybe trigger the symptoms only when you engage in prolonged sitting (3).
- Spinal stenosis: Another spinal column problem that triggers lower back pain is spinal stenosis. As the name implies, it is the growth of abnormal bone in the spinal canal. We all know that the spinal cord runs inside the vertebrae, and there’s a hole or canal for it. In spinal stenosis, bone growth narrows down the available space. The spinal cord is squeezed in a very tight spinal canal, causing considerable pain. In some cases, people may also experience muscle weakness and numbness. This problem is more common in patients with arthritis, after a spinal injury, and in certain types of infections (4).
- Muscle strains: Back pain can also be triggered by muscle tension or a muscle strain. More specifically, one common muscle affection that causes lower back pain is the lumbar strain. This is a lesion in the muscle tissue of the back. It commonly happens in people who stretch too much or continuously twist the back. It feels like muscle pain is located on the lower back, which irradiates to the buttocks. But it doesn’t run down to your legs, and it is worsened by muscle movements. People who have a lumbar strain will also have a stiff back, tender to the touch. This condition usually improves after one month or before if measures are taken (5).
- Weakened core muscles: In some cases, an extremely low muscle mass may also lead to lower back pain. We have a series of muscles that provide stability when walking or sitting. They are known as core muscles and include the abdominal muscles, the lower back, and others. They all work together to support the spine and keep your posture. You may experience back pain when your core muscles are considerably weak. Strengthening your core is a good idea, and you can use exercises for this.
- Other medical problems: Certain medical conditions may also trigger lower back pain. For example, kidney stones. The kidneys are located deep inside, in the abdominal cavity. But they cause a referred pain that is often found in the lower back. A gallbladder issue may also lead to this symptom or a tumor in the abdominal cavity.
Depending on your condition, you may have one of these signs and symptoms:
- Lower back pain: This is the main symptom, but one we should investigate. With associated leg pain, sciatica pain, and kidney stones should be ruled out. When it irradiates to your buttocks, you also need to rule out sciatica pain or a muscle strain. The severity and type of pain may also provide important clues. It can be either acute pain or chronic pain.
- Tenderness: In some cases, lower back pain worsens when you touch the area. Sometimes patients prefer not to sit because sitting automatically triggers back pain. That’s particularly the case of sciatica pain. In a lumbar strain, pain symptoms feel worse when you twist your back.
- Neck and upper back pain: This is when different parts of the spine hurt, and your neck is involved. In these cases, the most likely cause is a sitting posture problem.
- Numbness or muscle weakness: This symptom is very important to diagnose spinal problems. It is often found in spinal stenosis, degenerative discs, and herniated discs.
- Scrotal pain: When lower back pain is associated with scrotal pain or pain in the thigh’s inner part, we should rule out kidney stones. There’s a nerve running down this area. When this nerve receives a pain sensation, the brain is not sure how to translate the impulse. That’s why pain is sometimes located in a perfectly normal area. It is a common type of referred pain.
Diagnosing lower back pain
The diagnose of lower back pain can be quite challenging. All of the above are common health problems. But they are sometimes not apparent in imaging studies. The most common steps for the diagnosis include (6):
- A patient’s history: This is a fundamental step in which patients communicate their symptoms. As noted above, digging deeper into what you feel may provide important clues to guide the diagnosis. It is essential to highlight the current symptoms and previous health problems. Doctors may also ask about your sleeping habits, your activity level, and your posture when sitting.
- A physical exam: After getting acquainted with your symptoms, doctors need to feel by hand. This technique is called palpation, and it detects tenderness, muscle spasms, and other problems. As a part of the physical exam, your doctor may also need to perform a neurologic exam. The goal is evaluating your nerves, especially those in your hips and legs. This exam will detect any numbness, loss of sensation, or nerve abnormality. The doctor may also ask you to do specific movements, such as twisting or raising your leg.
- Diagnostic imaging tests: They are useful to evaluate the bony and nervous structures of the spine. The most common imaging test is a simple X-ray to assess fractures, tumors, arthritis, bone spurs, and other abnormalities. CT scans are ordered when nerve structures are likely involved. They provide a clear view of nerve roots and other structures in the spine. MRI scans are useful to evaluate intervertebral discs, muscles, and ligaments.
Best sitting position for lower back
Not all types of lower back pain are indeed caused by the sitting posture. But you can significantly improve your pain if you sit appropriately. As noted at the beginning of this article, you can choose between different ergonomic seats.
They follow the natural curves of the spine to provide better support and reduce back pain. They are also highly adjustable, and you can change the height, seat depth, degree of inclination, headrest, armrests, and more.
But what can you do if you catch yourself slouching in your chair or leaning on one side? Start by drawing an imaginary straight vertical line and aligning your back. Raise your shoulders as high as you can as you extend your neck.
Then, leave them rest and relax your upper back. As you do this, keep your pelvis rotated backward to provide an appropriate pelvic tilt. It should feel natural, without tense muscles. A good sign will be if you feel your back lengthening and stretching.
Home remedies for lower back pain when sitting
It is important to prompt a good posture as frequently as possible. A posture corrector can be a great aid. They do not force your back. Instead, they stretch when you slouch and give you a quick reminder of straightening up. You can also try these recommendations:
- Hot and cold therapy: Temperature can be beneficial if you’re trying to improve back pain. Cold packs are useful to control inflammation and numb down the area, reducing pain sensation. You should apply cold packs for 10-20 minutes or until the area feels numb. Then, you can resume your cold pack therapy when the skin feels warm again. A heating pad is also useful to improve blood circulation and soothe your back muscles. It promotes the healing of soft tissues, especially if you have a sore muscle.
- Over the counter medications: They are usually handy for back pain. You don’t need a prescription, but we recommend talking to your doctor. That way, you will know the maximum dose and which one works better for your type of pain.
- Use a lumbar pillow: If you don’t have an ergonomic seat with lumbar support, you can create one. Just go for a rolled-up towel and place it at the base of your spine. You can also buy a lumbar pillow, which does the same thing and is designed to provide stability to the lumbar area.
- Ask for a massage: If you have muscle tension in your back, a massage can be very helpful for pain relief. Ask for a massage or pay for it. Either way, it will be useful to relax your body and let your mind go. Alternatively, you can use a lumbar roll to give yourself a massage.
- Practice yoga: This discipline is available for everyone regardless of their age. It is useful to strengthen the core muscles and the lower back. By doing so, we can improve our posture and maintain a proper stance.
Stretches and exercise
You can also try with certain exercises that strengthen your back or provide a helpful reset for your spine. They are a part of physical therapy, and you can do them without a physical therapist, too. Here’s a list with helpful ideas (7):
- Planks: They strengthen your back and core muscles. The starting position is similar to that of a push-up. With your elbows aligned to the shoulders and your back straight, support your weight between your forearms and feet. Hold the position for 30 seconds, rest, and repeat.
- Hip raising: This is a helpful stretch that usually relieves an episode of lower back pain. The starting position is lying your back on the ground with your arms to each side. Flex your knees slightly and lift your hips gently while contracting your buttocks. Hold the position for 5-10 seconds, rest, and repeat.
- Bird dog: This is both a stretch and an exercise to strengthen your core. The starting position is on all fours, with your shoulders aligned to your hands. Start by extending one arm and the opposite leg. Hold for a few seconds, go back to the starting position, and repeat with the other arm and leg.
Lower back pain is a common problem, usually associated with sitting. Healthy people can experience lower back pain if they adopt a poor posture. But they may also have an underlying condition that triggers lower back pain. For example, a herniated disc or core muscle weakness. In each case, doctors may recommend different measures to improve your condition.
You may also want to try other solutions. We recommend stretches and exercises to strengthen your back muscles and core. Hot and cold therapy work to relieve acute bursts of lower back pain. And over the counter remedies are also useful but should be administered according to your doctor’s advice.