Does sitting really cause back pain? In my opinion…NO!

Here are two different scenarios:

1. Hurt more standing and get relief upon sitting
2. Hurt more sitting and get relief upon moving around or standing

What are the possible reasons for these situations:

In number one, bad posture and muscle imbalances may be causing the pain. Particularly when there is excessive anterior pelvic tilt, such as when the psoas and/or quadriceps muscles are too tight, pain in the standing posture can be present.

Another issue that can be the cause of pain while standing, especially when there is no pain for a short time, then the pain gradually comes on, is due to ischemia. That is, lack of blood flow to muscles. This is usually due to the type of situation that I just described about anterior pelvic tilt, but there can definitely be biochemical causes of ischemia.

Either way, in this situation, you are likely to say “When I get off my feet, whether that be sitting or laying down, my pain goes away.”

In the number 2 situation, there can also be issues with ischemia, particularly if you have a desk job and sit “hunched” over a computer for 8 hours per day!

Another potential reason is that there may be a structural problem with the spine itself. When a disc bulge is present, sitting can make you feel worse than standing. Why? Because pressures on the spine are significantly higher during sitting than standing.

When I work with patients with disc bulges, I suggest that if possible, they transition their sitting work stations into standing work stations. Yes, it does suck to stand all day, but it’s FAR less painful, and can dramatically speed up the healing process.

The other thing that can cause you to have more pain in the sitting position that relieves upon standing is either spinal disc degeneration, or spinal stenosis. Both of these situations can be related, since they both involve loss of height in the spinal discs, thus increasing pressure on the nerves that exit the spine.

However, just as well, you can have no pain in the seated position, but still have one of these conditions. I have seen patients with other types of spinal derangements, who have no pain sitting, because they sit in such a way that does not increase the pressure on the area that which is dysfunctional!

Bottom line…

Neither is “bad” for you if you have back pain, but either of which CAN make you hurt more depending on what is causing your pain.

–Sam Visnic