Does Sitting Cause Back Pain?

I remember during physical therapy school, one of the lectures we received was titled “Is Sitting the New Smoking?” and it hypothesized that part of the reason we have such a high prevalence of back pain in our society is due to excessive sitting. After all, approximately 80% of people will experience low back pain in their lifetime. Clearly, it is a big problem. Interestingly, roughly 50% of the class was standing the next day due to the lecture. I remember thinking at the time that sitting was the root of all evil and that maybe one day we would look back on sitting the way we look back at smoking.

What Can We Do to Prevent Back Pain?

Let’s assume that sitting does cause back pain. The first question I would propose is: what can we do about it? Obviously, standing desks are becoming more popular and affordable, but they are still rare. Also, I have seen several patients who developed back pain after using a standing desk because their body was not used to standing for a long period of time.

We condition our bodies to sit for prolonged periods of time at a young age. Schools encourage young kids to sit for hours at a time, which sets the standard for sitting at work as an adult. It is admirable to want to change the system, but this is a systemic issue.

Also, most people know that they sit for a long time. It turns out that it is easier and more comfortable to sit than it is to stand. It is a similar conversation to the “fight” against obesity. I love when I see all of this media devoted to identifying the “healthy” foods that obese people should eat. Spoiler alert: most people know they shouldn’t sit for so long and they know that they should eat “healthier.” Until you change a person’s circumstances and meet them where they are, you have no hope of enacting actual change.

Another important factor to consider: is back pain actually becoming more of an issue? We can agree that people are sitting more than they did in 1990. What if I told you that there was a 10% decrease in back pain from 1990 to 2020? It is easy to assume the problem if you already have the solution. People want to blame something as simple as sitting before they even determine if back pain is a worsening problem. This is the difficulty with making population-based claims in healthcare. There are so many circumstances that lead to back pain. Blaming sitting is worsening the problem.

The Power of Influence

Going back to my class in physical therapy school, I wish I had asked how many of my classmates had back pain prior to that lecture. We saw our professor as an expert and we were open to hearing what they had to say. Instead of living our lives and focusing on class, I bet that a bunch of my classmates became acutely aware of how their backs were feeling. Things that may have been ignored became annoying and annoying pains became significant.

I speak to many clients who have been to other physical therapists. They come in with back pain and leave with 5 other diagnoses. Their back pain comes from a weak core, tight hip flexors, glutes that forget to turn on, bad posture, and decreased hamstrings flexibility. Those findings were probably present before their back started hurting, but there is no way to know. This is the more scientific version of telling someone that sitting will cause their back pain and being stunned when the next day everyone has back pain.

So, What Do We Do About Back Pain?

The answer is to not panic. Back pain is prevalent in 80% of people. You are strange if you do not have back pain. Take a deep breath and try to relax. You need to relax mentally, but you also need your muscles to relax. They are tense from pain and adding stress is not making things better.

Some practical advice: determine which way it hurts to move. If it hurts a lot (greater than 5 out of 10) then avoid that direction. If it is less, try to gently move in the painful direction and see if it improves.

Here is an example: it hurts to bend forward (6/10) and touch your toes. Take some time and stretch the opposite way like a cobra pose. Spend more time standing (sitting is smoking after all) and go for walks. Once your pain decreases, move to the next step.

If the pain was only a 2/10, try gently stretching into bending forward like a child’s pose or hugging your knees to your chest. If this is comfortable, gradually progress the loading of the movement. Continue pushing your mobility as the pain recedes.

If you want the best results, see a physical therapist. You can try to fix something with YouTube videos (check out our YouTube channel!) or you can go right to an expert. Find someone who can give you a thorough assessment and provide individual suggestions based on your needs. Maybe you do need to cut back on sitting, or maybe you need to avoid standing because it is making things worse. All bodies are different.

In summary, sitting is not the new smoking. Smoking is bad for everyone. Sitting is bad for people who have pain with bending forward. Standing is bad for people who have pain with bending backwards. Learn to relax and move in different ways. Find a physical therapist who can give you good advice. Look for the physical therapist who did not stand up after the “sitting is the new smoking” lecture. I did not stand up because I realized that I did not have back pain from sitting. Come by my office in Sterling, Virginia if you want treatment options that veer away from the cookie cutter approach.