“Why Does My Back Hurt When I Sit?”
For most of you, life calls for long days at a desk working on a computer, an art table, taking inventory or maybe routing calls and organizing files. You get up every couple of hours to stretch your legs or take a quick walk, but as the day wears on the gnawing ache in your back gets worse, maybe even starts to travel down one or both of your legs. Sound familiar? It should. According to one Mayo Clinic study, back pain accounts for 23.9% of all US doctor visits. Although back pain can be grueling, you have a lot of company. Almost 25% of Americans have had back pain in the last 3 months. Most low back pain is mild and disappears on its own, but most acute back pain has at least 1 reoccurrence, and many times that pain worsens and can even spread to both legs. Most non-traumatic diagnoses are not serious and don’t need diagnostic testing to assist with recovery, as X-Rays, CT scans, and MRI’s are often not helpful. (Actually, patients who have an MRI spend $4,793 more on average with similar outcomes.)
There are remedies to your aches and pains. Once you understand why you are ailing with your back and what’s causing the pain, treating your back pain and preventing future outbreaks solely requires a consistent self-treatment plan.
The most common causes of low back pain are postural stresses. Positions including prolonged sitting in a bad position, extended bending in a poor position, heavy lifting, standing or lying for a prolonged time in poor postures can all increase or decrease low back lordosis. Lordosis is the normal inward curve of the low back and neck.
Robin McKenzie, a famous physiotherapist from New Zealand, developed a system of treatment that is based on counteracting the movements that caused the pain and symptoms in the first place. In his book, Treat Your Own Back, McKenzie generally suggests using backward movements to counteract pain during sitting, bending, and slouching, and bending forward to counteract pain with standing, walking and lying down.
If you have pain with bending forward, try these exercises to see if the pain improves:
“The Most useful and Effective First-Aid Procedure for the Treatment of Acute Low Back Pain.”
Press ups: Push your upper body up off the floor using your arms. Push up only as far as comfortable and slowly lower yourself down. Perform 10 repetitions, then continue for another 10 if the symptoms improve.
Press ups should be used to counteract the pain, as a first response and should never increase the pain. Once the pain has decreased, maintenance exercises are necessary to combat any future sitting issues.
“The main Tool in Prevention of Further Low Back Problems”
Extension in Standing: Bend your trunk backwards at the waist as
far as you can, using your hands as a fulcrum. It is important to keep your knees straight, maintain this position for a second or two, then return to the starting position. Perform 10 repetitions multiple times per day. (This exercise can replace Press Ups during times of acute pain if lying on the floor is not an option).
While pain due to sitting and bending is MUCH more common, occasionally back pain can occur with standing and walking. In this case, your first line of defense is bending forward.
Flexion in Lying:
Lie on your back with your knees bent and feet flat on the floor.
Bring both knees up to your chest using your hands and arms to gently but firmly pull the knees as close as the pain does not increase. Hold for one to two seconds and return to the starting position. Repeat 10 times per hour while in acute pain, and 10 times a couple times per day for a maintenance program.
McKenzie recommends that flexion exercises must always be followed by 10 repetitions of Press ups.
If lying is not available, Flexion in Sitting or Standing is an always an option:
Follow the same procedure as Flexion in Lying for both Flexion in Sitting and Flexion in standing.
As with any time that you are trying to treat yourself, you must understand that if the symptoms worsen, please stop and listen to your body. If the low back pain worsens, you may be going in the wrong direction, or it may be more complicated than originally thought.
Sometimes your back pain needs outside help.
If at time, you are unable to pinpoint the exact causes of the pain, or are not making the progress on your own with treating your own back. It may be time to speak to a physical therapist. A physical therapist will:
Review your health history
Discuss your specific symptoms
Perform a thorough examination that includes assessing the quality and quantity of your movements, and how your back reacts to those movements
Attempt to identify signs and/or symptoms that may indicate a serious condition that may require a consult by a medical doctor
Assess how you use your body at work, at home, and during sports
All this information together will give the therapist a groundwork to treat YOUR back, as everyone’s back pain is different and effects your life in different ways. The therapist-with a thorough history in hand-will do a check your motion, posture, and strength, and perform a few tests to develop a plan specific for you. This plan may include:
Manual Therapy, including spinal mobilizations or manipulations, soft tissue releases, and/or myofascial release
Specific strengthening and flexibility exercises
Training in lifting, bending, sitting, sport related movements, and sleeping positions.
Education on how to better take care of your back
Use of ice, heat, and/or electric stimulation to help decrease your pain
Information in how to avoid any conditions in the future.
If you feel that you need a therapist, be sure to find one that is experienced in treating musculoskeletal issues, especially back injuries. We are partial to someone specific, but no matter who treats your back, make sure the treatment is well-rounded and oriented toward your goals. No matter if you can self-treat or you need some guidance from an experienced therapist, it is incredibly important to realize that your back pain is a temporary condition that with the right treatment will not be a chronic condition. Back pain is not an “I’m getting old” condition or a “I have a bad back problem.” Back pain can be treated and can be eliminated, so you can
Be Physical, Move Forward, and Live Well.
Kinkade Scott. “Evaluation and Treatment of Acute Low Back Pain” American Family Physician. 2007 Apr 15; 75(8): 1181-1188
Move Forward Guide: “Physical Therapist’s Guide to Low Back Pain” http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=d0456c65-7906-4453-b334-d9780612bdd3 - top
St. Sauver, et. al. “Why Patients Visit Their Doctors: Assessing the Most Prevalent Conditions in a Defined American Population”.