Introduction

It is a common question in modern times, "Why is my back pain worse when sitting?" While numerous health and fitness experts have provided band solutions and quick fixes for lower back pain caused by sitting, such as yoga, physiotherapy, stretching, Pilates, chiropractic, and massage, it is crucial to identify the root cause of the pain to address it effectively.

This article is not here to provide a temporary solution; it is intended to guide and question why you have lower back pain while sitting in the first place. We will introduce the reasons behind back pain after sitting too long, present what needs to be done to correct these positions, and provide solutions while showing evidence if sitting is what causes back pain. 

When we look at localized lower back pain from sitting, we often must refer to why this is happening. We will reference studies indicating the reasons for lower back pain when sitting, the tendencies or causalities of lower back pain from sitting, and how traditional methods of alleviating back pain do not work. 

Brief Overview of Sitting

Sitting is a position to help humans rest after movement. While most use sitting as a temporary resting position a study by Bureau of Labor Statistics. (2018) found, “On average civilian workers spend 40.6 percent of the workday sitting and 59.4 percent standing or walking.” This indicates that nearly half of the workers across America are sitting most of the day. Leading to the question, “how do I get out of lower back pain from sitting?” In a recent study, a conclusion stated (Bontrup et al., 2019), "With scientific discussion to date leading to unclear relationships between sedentary lifestyle, sitting behavior, and low back pain," a study by (Bontrup et al., 2019) found the following: 

A greater association was found between sitting behavior and chronic LBP than for acute pain/disability, which was a possible result of the fact that participants with chronic pain have a higher level of awareness to pain-free sitting positions and pain-provoking movements compared to individuals affected by acute pain. (p. 6)

While the argument may be about how to fix lower back pain from sitting, many studies show that sitting is not the leading cause of back pain. 

Why does my back hurt only when sitting?

Lower Back pain when bending over or sitting occurs for several reasons, one being the position of the pelvis in a posterior tilt during the seated or standing position; another is the lumbar spine flexion with no support while sitting. There are many claims of bad posture being the cause of lower back pain while sitting or standing, but those claims do not have integrated corrections to help with these issues. 

A common reason for back pain is that the slouched or hunched-over position strains the vertebra and causes the fluid in the cushions to move, which protects the vertebrae from rubbing together. These may be the symptoms of lower back pain that someone may have, depending on the circumstances; many people claim to be in pain while sitting at their desks all day. 

A few of the common reasons could be: 

Herniated discs

Sometimes people will experience pressure on their discs. This stresses the spinal cord and nerves, causing pain and sometimes numbness. Discs will degenerate with people who move incorrectly or damage them with heavy barbell lifts, deadlifts, yoga, and most traditional weight training. When people have degenerative disc disease, the pain can be severe in the lower back, glutes, and thighs and tends to worsen lower back pain when sitting down or bending over. 

Sciatica

A common pain area is sciatic nerve pain. This pain runs down the base of the spine into the back of the leg. This can be very painful and often debilitating to many people, and sitting for long periods worsens things, even causing lower back pain sitting at a desk. 

Posture

Bad posture is a common reason people have lower back pain when bending over or sitting. Lacking intra-abdominal air pressure, lordosis, anterior pelvic tilt, and many other postural issues create pain in the lower back. The question is how to fix lower back pain from getting up from sitting. To correct posture, look at our article about Posture, Pain and Body language – Functional Patterns; when our structure is not aligned correctly, it could lead to pain in the lower back or any other body region. 

Now that we understand some symptoms, you might wonder how one sits correctly or gets out of pain while sitting.

How do I prevent back pain when sitting?

Before asking yourself, “How do I prevent back pain when sitting?” the answer is more straightforward than many may think. While you may think it has to do with correcting the posture while sitting, this is not the root cause of the problem. Here at Functional Patterns, we correct these dysfunctions from a fundamental level, first while doing the FP Big 4 standing, walking, running, and throwing. In a recent study by (Radebold et al., 2001) found the following: 

Patients with chronic low back pain demonstrated poorer postural control of the lumbar spine and longer trunk muscle response times than healthy control volunteers. Correlation between these two phenomena suggests a common pathology in the lumbar spine. (p.1)

 Sitting is a resting position not meant to be painful on the body. After long periods, many have back pain symptoms, and people start flaring up again and may adjust to a different sitting position for lower back pain. This is why we need to look at what is causing back pain while sitting in the first place. 

Functional Patterns (FP) is a training approach that aims to prevent body issues by optimizing muscles to perform the FP Big 4: standing, walking, running, and throwing. By training these functions, we can build stronger, more symmetrical bodies with less pain and longer lifespans. Neglecting to train these functions can lead to higher pain, injury, and lower back pain from sitting.

"The way the human body moves through space is unique to other animals in that we can stand on two feet while doing so."

At Functional Patterns, we aim to help those in need get pain-free. Your exercise routine should enhance your life as a human by eliminating pain, reversing injury, and building muscle in ways that count.

With many forms of popular exercise that cause pain in people, we see precisely the opposite. We are here to provide the solution. While considering this, the results are confident that moving in a way that enhances our biological blueprint provides a pain-free structure while sitting, moving, and doing daily tasks. The ability to perform day-to-day tasks enables us to create a more productive environment.

Solution

Those who sit for the majority of their workday avoid doing movements related to enhancing glute function. Sitting is similar to movement that orients around, cycling, squats, and deadlifts, which will only worsen their issues. Performing exercises in hip flexion, primarily in the sagittal plane (forward and backward), can cause adaptations formed in positions overused daily by sitting at a desk. While cycling has some cardiovascular benefits, the position is oriented around hip flexion- the same goes for a squat or a deadlift. 

As you continue to engrain poor movement patterns, you will slowly become disconnected in your ability to move another way. When our glutes do not perform hip extension, we can predict that the body will begin to associate itself with this position over time. When the glutes do not perform hip extensions, the body often develops and arches or overextends the lower back. The orientation around hip flexion becomes more prominent as the glutes begin to atrophy or dehydrate. 

For Deadlifts and Squats, the hinging phase is not the issue- the problem arises as the torso approaches a vertical position and tension shifts from the posterior chain to a purely vertical compressive force. Coaches may cue squeezing the glutes to keep the posterior chain engaged, but if the exercise does not promote this muscle contraction, it may not be ideal for stimulating it. The posture observed at the end of the lifting phase can also be problematic. Individuals may shift their hips forward, hyperextend the lumbar spine, and flex the thoracic spine, rounding the upper back, and causing spinal compression. 

Although there may be short-term benefits to the back squat, it can lead to asymmetrical shifts and twists over time, especially with aging and repetitive spinal compression. Asymmetries can dehydrate and worsen, increasing the likelihood of joint problems in the future. The SAID principle highlights the importance of training for movements that prepare individuals for real-life demands, as adaptations from bilateral glute exercises may not translate effectively to functional movements outside of the gym. While performing squats over time will lead to lumbar compression and pain later. 

Why are those exercises going to worsen symptoms? 

• Deadlifts: Bilateral movement, hip flexion to hip extension in a bilateral position. Exercise does not promote glute contraction at the extension phase and can lead to lumbar compression.

• Squats: Bilateral movement, Hip flexion to hip extensions training glutes in a bilateral position. This will not promote functional glutes outside of the gym.

• Cycling: From a biomechanics standpoint, cycling happens primarily in hip flexion

Exercises that do not consider how our body works naturally can worsen our problems instead of helping us feel better. Some people do stretch or corrective exercises that ignore our body's natural abilities and dehydrate the tissue, worsening our pains over time. This can cause wear and tear because we are not using our bodies how humans evolved to move. To relieve pain, we must understand how our bodies move and what challenges we face. This knowledge helps us move without pain and prevents lower back pain when bending over or sitting. 

A place to start becoming pain-free is combining functional patterns (FP) with avoiding grains can be a helpful approach for individuals looking to address pain symptoms. Grains, particularly those containing gluten, can cause inflammation and exacerbate existing pain conditions. By avoiding grains and focusing on a nutrient-dense, whole-food diet, individuals can reduce inflammation in the body and support overall health. Additionally, FP can help correct any imbalances or compensations in the body's movements, reducing the likelihood of pain and injury. By combining these two approaches, individuals can take a holistic approach to pain relief and improve their overall quality of life. Eliminating grains can help you turn pain into progress by understanding your body as a system and not correcting only your symptoms.

The origin of the FP Big 4: Standing, Walking, Running, and Throwing. 

Functional patterns aim to address the underlying cause of pain and injury that arises from how you move. Improved movement patterns lead to physical and mental wellness and facilitate proper hydration throughout the body, enabling it to function as a reciprocal system. Adequate nourishment, in turn, enhances your capacity to perform functional activities. By engaging in physical activity that addresses your current mental state and enhances your biomechanics, you establish a sustainable lifestyle that can be passed on to future generations. This is the essence of genuine regeneration. 

Functional Patterns is a holistic approach that addresses the underlying causes of pain and injury by emphasizing the importance of adequate nourishment, avoiding grains, getting into nature, and changing behaviors to enhance an individual's capacity to perform functional activities. This unique approach promotes a sustainable lifestyle that can help you live a happy and healthy life by addressing your biomechanics in the way nature intended, through activities such as walking, running, throwing, and standing. By adopting these principles, individuals can improve their physical and mental well-being and establish a foundation for long-term regeneration. So, if you're looking to live a better life outside of your work environment, Functional Patterns can help you achieve your goals and promote overall health and well-being.

Conclusion

Back pain relates to how we move in space and how we have addressed our asymmetries. When we approach pain and issues that someone has, that will allow for more opportunities not to be injured or in pain while sitting. While many suffer from pain and want immediate relief, holistically, we want to approach it in a way that provides a long-term solution. 

Our body is stuck in a position because it does not respect where it is in space and does not move to complement our movements, which is why we are in pain. If we do not address our biomechanics at the fundamental level, we leave ourselves empty-handed when addressing our pains. 

At Functional Patterns, we account for all factors that contribute to the optimal movement, not just correcting symptoms but the systems that help our bodies perform optimally. 

Ready to be pain-free? Our Practitioner list lets us provide you with the best hands-on approach to solving your pain and discomfort. Our practitioners also have an extensive background in providing a systems approach.

References:

1. Bontrup, C., Taylor, W. R., Fliesser, M., Visscher, R., Green, T., Zemp, R., & Wippert, P.-M. (2019, July 15). Low back pain and its relationship with sitting behavior among sedentary office workers. Applied Ergonomics. Retrieved March 15, 2023, from https://www.sciencedirect.com/science/article/pii/S0003687019301279?via%3Dihub

2.  Radebold, Andrea MD; Cholewicki, Jacek Ph.D.; Polzhofer, Gert K. BA; Greene, Hunter S. MD. Impaired Postural Control of the Lumbar Spine Is Associated With Delayed Muscle Response Times in Patients With Chronic Idiopathic Low Back Pain. Spine 26(7):p 724-730, April 2001. 

3.  Bureau of Labor Statistics. (2018). Occupational requirements survey — Sit and stand. U.S. Department of Labor. Retrieved from https://www.bls.gov/ors/factsheet/2018/sit-and-stand.htm