Why does my back feel worse when I sit for too long?

Does WFH (work from home) have your lower back not feeling so hot? Let’s talk about it!

When it comes to lower back issues, most people generally fall into one of two categories:

  1. Pain reproduced with more “flexion-based” activities- this includes anything where the spine is in a flexed position. For example: sitting, loading the dishwasher, or reaching down to tie your shoes.

  1. Pain reproduced with more “extension-based” activities- this includes anything where the spine/trunk is in a more upright position. For example: standing, walking, sleeping on your back, or lying on your stomach. 

If your back feels sore from sitting all day for work, you most likely fall into the first category. 

Why does this happen?

When you are sitting for a long time, your posture slowly becomes more and more slumped. This position isn’t necessarily bad for a short period of time, but when you stay in this position for prolonged periods, that’s where you can run into trouble. What happens over time is known as a “creep” phenomenon where a low load on the lower back over a long duration can lead to changes in ligament and tissue length and tension. For the spine, this change in tissue length and tension puts other structures such as the intervertebral discs at higher risk of being overloaded. 

This doesn’t only apply to tissues that make up the spinal column, but also any muscles that attach to it. For example, long periods of sitting create a shortening of one of your big hip and trunk flexors called your iliopsoas, which is a combo of 2 muscles called your psoas and your iliacus. As you can see from the picture, the psoas attaches to the lower back and so when it’s shortened it can create more of a pull into a flexed position. 

Bottom line: The human body was made to move! If you find yourself spending more hours of your day in a flexed position, then you need to balance that out by dedicating some time to more extended positions to change the stresses on tissues in your lower back.

What can I do to fix this?

  1. Change your position regularly 
  • Set a timer on your phone or computer to remind yourself to get up every hour
  • When you get up, you can go get a glass of water or just take a lap around the room or floor of your home- anything to move around a little bit (see below for tips on stretches)
  • Switch to a standing position while working. Some people may have access to a standing workstation or can create a makeshift one if they have a high kitchen counter or barstool area. This doesn’t mean that you need to stand the entire day either. Remember, the idea is to create a change in your static flexed position, not just switch to another static position entirely. 

  1. Add a lumbar support pillow to your chair
  • DIY options: Try rolling up a large bath towel and tying it to the lower part of the back of your chair. You can also try placing a regular pillow in the same area (see picture for guidance).
  • Online purchases: There is a wide variety out there! I would recommend trying one of the DIY options first to see if it actually helps your back before you go trying to spend money on a commercial product. Products online range from a small lumbar pillow attachment, to mesh cushion add-ons, and even office chairs with a built in lumbar support system. The picture above is just an example, and is not endorsed or specifically recommended by me. 

  1. Try these stretches in between periods of sitting:
  • With increased pain and sensitivity in more flexed positions, your symptoms are more likely to resolve with positions/stretches in the opposite direction (i.e. extension)
  • Cobra stretch
  • Start by lying flat on your stomach with your hands flat on the ground close to the side of your body (top picture)
  • Slowly press up from your hands to push your back into an extended position until any sort of resistance is felt (bottom picture)
  • You may feel 1 of 2 things- a stretch in your abdomen or a pinch in your lower back
  • If you feel a pinch in your lower back, stop at this point and do not push past it and return to the starting position. On your next repetition, push up into extension up until the point of the pinch again, and then return to the starting position
  • Perform 10-12 repetitions total 

  • Seated spinal unloading: 
  • Use your desk chair (or any chair with armrests)
  • Place hands on the armrests as seen in the picture
  • Push through your hands to lift your bottom off the seat of the chair and support your body weight through your arms. Hold your bottom up and let your lower body feel heavy. You should feel a mild stretch in your lower back
  • Hold for 10-15 seconds. Repeat 3-4 times

  • Kneeling hip flexor stretch
  • Position yourself with one knee on the ground and knee up with the foot planted (as seen in the picture). The knee on the ground is the side you will be stretching. Use a pillow or cushion between your knee and the ground if the front of your knee is sensitive to the pressure of putting weight on it. 
  • Tuck your tailbone underneath yourself (i.e. move your pelvis into a posterior pelvic tilt). Then, shift your weight forward onto your front leg while maintaining that pelvic tilt. A stretch should be felt in the front of your thigh and hip area on the back leg.
  • Hold for 30 seconds. Repeat 2-3 times. 

I hope this helps! If you find that these tips are not helping you with your pain, then call our office to schedule a visit and we can provide a more individualized treatment plan to help get you sitting pain-free!