Close this search box.

Beverly Hills Chiropractic - low back pain sittingI commute a lot by car. Over the last ten years, I have driven over one hundred thousand miles. When we throw in flying and train rides, you can imagine how much passenger sitting I have done. This can be hard on the body. As a result, I have had to experience pain, learn from which tissue it came, and construct a protocol by which to resolve it. This article is for anybody who suffers low back, pelvic, hip or buttock pain as a result of long-term sitting, whether at a desk, in an automobile, or on planes. I will provide treatment options for you to look into, along with some supportive devices, as well as stretches and exercises which might help strengthen the areas in question as a preventative to future pain or discomfort.

Specific Causes of Low Back Pain from Prolonged Sitting

The first problem which can arise for a person who sits a lot is stress to the sacroiliac joints (SIJs) and ligaments. The sitting mechanism actually splays the pelvis, since the ischial tubes (sit bones of the pelvis) move medially pushing the innominate bones (pelvic crest) out laterally. In some people, this can lead to SIJ separation and, over time, ligamentous stretching, which can then lead to low back pain. While men can, and do, get low back pain from weakened SIJ ligaments, the problem is more common in women (due to the differences in the female pelvic anatomy). Nonetheless, for either sex, long hours of sitting can lead to SI dysfunction and low back pain.

West Hollywood Chiropractic - low back pain sittingProlonged sitting can also stress the lumbar spine causing low back pain. Lumbar joints can subluxate – in other words, they can fixate or get stuck. Subluxated joints cause pain. They cause pain through their stuckness, for sure, but also they do so by catalyzing joint inflammation and muscle spasm. Typically, the most common symptom for a person suffering from fixated joints in the lumbar spine is difficulty sitting. It may be too painful for this person to sit at all, or more likely, painful when he or she gets up from a seated position. These people may find it difficult to stand completely upright. Nor is it uncommon for these people to go into severe muscle spasm, which can quite literally knock some folks to their knees.

Because subluxated joints prevent normal intervertebral disk (IVD) motion, the center of the disk – called the nucleus pulposus – can squeeze outward, creating an excruciating condition called disk herniation. Three levels of herniation exist in varying degrees of severity: bulges, frank herniations, and sequestrations. Bulges are the most common of the three and they are also the easiest to correct; they can, however, cause enough pain to send the sufferer to the chiropractor (or medical doctor). People with lumbar spine (low back) disk bulges might have to lean to one side (usually opposite the side of the herniation) to relieve pressure from the disk. People with bulges also have trouble sitting and getting up from a seated position, but they may also have excruciating pain going from standing to sitting, standing to lying down, or have pain while walking. One major sign of disk herniation is that the sufferer might feel sharp pain on increased intraabdominal pressure, so things like laughing, coughing, or sneezing can all elicit the pain.

Frank herniations, the second level of disk herniation, generally cause pain and sciatica. It is not uncommon for these patients to be carried into their chiropractor’s office by a friend or family member. Frank herniations are a more compete squeezing-out of the nucleus from the rest of the disk, with the nucleus then pushing up against a lumbar nerve root. The resulting sciatica is a feeling of a sharp, electrical sensation down one leg, which can travel to the thigh, shin, foot or toes. If the sciatica is severe, or left untreated (thus becoming chronic), it can lead to foot drop – a serious neurological condition which can become permanent.

The third type of disk herniation is called a sequestration, where the herniated nucleus actually breaks-off from the rest of the disk. This level is the most serious of the three and also the most difficult to treat, often needing surgery. Patients with sequestered herniations don’t have as severe low back pain (if at all) but their sciatica (called radicular pain) is often intense. Anybody who has ever suffered from sciatica, knows the unnerving feeling of intense pins and needles, loss of sensation, and sometimes inability to lift a foot or toe(s). Regardless of type, all three levels of disk herniation can come about from prolonged sitting.

Along with SIJ and lumbar disk stresses from long-term sitting, muscular strain and tightness can also be a source of low back pain. One muscle commonly affected by prolonged sitting is the piriformis muscle. Sitting underneath the gluteus maximus, and thus subject to enormous weight-bearing pressure, the piriformis can become strained. A strained muscle often gets inflamed and can become sore to the touch. To compound problems which exacerbate low back pain, the sciatic nerve in most people passes just underneath the piriformis muscle on its way to the thigh. Thus, some of the same things that cause pain and inflammation in the piriformis muscle, do so in the sciatic nerve as well, which can lead to sciatica.

Increased sitting, particularly the type of sitting I described myself doing (travelling long hours in cars) can lead to tight hamstrings. When sitting in a car, upright and unable to move around much for the shear fact of motor vehicle operation (being the driver, not passenger), the hamstrings remained flexed. I have described in another article how you might best understand what it feels like to contract (or flex) a muscle for an extended length of time: hold a baseball bat out in front of you (or to your side) with an outstretched arm for one minute (sixty seconds). You will see how difficult and painful this exercise is to do. Try it for two minutes (good luck). Try it for three or longer (on second thought, don’t…you can take my word), you will then understand what happens to any muscle in your body which contracts for hours. Hamstrings when put under these stresses cause leg pain (obvious), butt pain (because they attach to the sit bones), and low back pain (as a result of rotating the pelvis backward).

Increased sitting on planes, on the other hand, or in any seat which is reclined (therefore, also be a car seat) can lead to increased strain on the hip flexors (iliopsoas) and quadriceps femoris (rectus femoris to be exact). Very few people know this; that is why so many recline in their seats, because they assume that leaning back takes pressure off the low back. Wrong. Reclining in a seat actually causes the hip flexors to contract, and you can read again above what happens to chronically contracted muscles. Same holds true for hip flexors. However, the hip flexors can cause both low back pain and frontal hip (pelvic) pain due to their anatomical location. People suffering from tight hip flexors might have a slight forward lean, or a jack-knifed appearance, so that their upper torso is leaning forward relative to the lower torso. When the iliopsoas becomes strained, these sufferers can have difficulty sitting, walking, or finding a comfortable position lying down.

Solutions to Low Back Pain Caused by Prolonged Sitting

So, what are the answers to these painful low back conditions associated with prolonged sitting? How does one address each element, from the joints to the ligaments to the disks to the muscles? Each one of these areas requires different things, which I will discuss below, but the thing they all have in common is that they should not be neglected or left to resolve on their own. Not one of these conditions will get better over time without putting attention into lengthening or strengthening the affected tissue. Some will need active therapist intervention; others will need stabilizing support. The following is a quick guide to addressing each form of low back pain caused by prolonged sitting.

West Hollywood Chiropractic - low back pain sitting

If you are having low back pain, the first thing you must absolutely do is visit a chiropractor. Chiropractic doctors are trained to evaluate the cause of your low back pain. You must learn the cause if you are going to have the pain addressed successfully. Chiropractic doctors are experts at identifying the tissue involved in your low back pain, whether joint, ligament, disk, muscle or nerve. And equally important is that a chiropractor does not have to send you out for treatment with a therapist – chiropractors address the problem in-house, correcting the underlying condition, and then reassessing your improvement over time. Further, chiropractic doctors use natural, non-pharmaceutical means to eliminate your low back pain. Medications for low back pain only give temporary relief – they do not address the root of the problem – making them potentially habit-forming.

Sacroiliac subluxations need releasing. This is done through a chiropractic adjustment. Stuck joints cannot be released by stretching, exercising, massaging or drugs. Muscle relaxants will not correct a fixated joint. Different chiropractors use different techniques to release subluxated joints. Some use tools like special tables, mechanical adjusting tools and/or blocks. Most chiropractors use their hands. Subluxations must be released; anything else will be incomplete – the pain and dysfunction will return. I have had patients come under my care after having tried various other treatments, like massage or acupuncture. While both practices are effective for a number of different types of pain, neither can unstick a fixated joint. For that, you will need a chiropractic adjustment.

Beverly Hills chiropractic beltIf your chiropractor finds that you have, in fact, stressed or sprained the ligaments surrounding the SIJ, then he or she may recommend for you to wear a supportive belt. Weakened ligaments respond effectively to elastic, which when wrapped around the injured tissue, holds it firmly in place, allowing the ligaments to tighten and heal. It is precisely what is done to treat ankle sprains. Ace bandages are used as compressive support for any type of ligament strain. The SI joints are no different. Over time, the ligaments do retighten and heal. A good Chiropractic Belt can be found at many chiropractic offices, and it should not cost you an arm and a leg. If you need a Chiropractic Belt to heal your unstable-SIJ-caused low back pain, please contact my office to order one.

Herniated disks, depending on the type, have different treatment options. No doubt, pharmaceutical meds can help here. Anti-inflammatories can reduce the swelling of the disk, while muscle relaxants can help with the muscle spasms and guarding. Ice, of course, will be invaluable in reducing inflammation and pain. Even acupuncture can help with some cases. Chiropractic is enormously effective in treating disk bulges and frank herniations. When sciatica is involved, here too, chiropractic can help. While sciatica will unlikely go away overnight, chiropractic can help reduce, and ultimately eliminate, the pain and disability that comes along with sciatica. Unfortunately, sequestrations really push the limit of conservative care. To be clear, chiropractic at this stage is hit or miss – that is, it has about a 50/50 chance of working to alleviate the symptoms associated with a sequestered herniation. It could be worth the effort to visit a chiropractor and try; however, time is of the essence here, so you do not want to take too much time waiting for results. Nonetheless, it is worthwhile to visit a chiropractor first if you are having radicular-type pain like sciatica, as it could be coming from the piriformis muscle.

When the piriformis muscle gets short and tight it can cause both low back pain and sciatica. A strained piriformis muscle needs TLC like myofascial release (a form of massage) and post-isometric relaxation (PIR, a muscle relaxation technique). But eventually, a tight piriformis needs stretching. A chiropractor or good therapist can stretch the muscle for you in-office, but the ultimate way to lengthen your piriformis muscle and, in turn, get long-term relief is to stretch the muscle yourself regularly. Watch the video below to see the best stretches for the piriformis muscle.

Tight hamstrings also need stretching. Nothing feels better for the low back stiffened by long hours of sitting than a good hamstring stretch. Watch the video below to see how to stretch the hamstrings most effectively without putting the lumbar disks at risk. For people who get pain high up into the hamstrings or closer to the sit bones, watch the second video for high hamstring stretches.

The hip flexors must all be stretched individually. The first stretch is for the iliacus which is part of the iliopsoas complex. I call this stretch the high lunge. Do it daily to open the hip flexors and prepare you for more advanced stretching. The second stretch is the low lunge, which is more advanced and hits the psoas major muscle. Then you will also need to stretch the rectus femoris of the quadriceps muscle group. Watch the video to find your level and do this stretch daily. You can advance to more complex stretches over time.

If you sit a lot, like I do, while travelling or in front of a computer for work, then you are likely no stranger to low back pain and discomfort. If you are not in full blown pain YET, then great, maybe start doing the stretches I have provided and you will stand a better chance of preventing low back pain before it happens. If you are in pain, then seek help for a chiropractor. If you are in Los Angeles, Beverly Hills, or West Hollywood, then please contact my office for an evaluation. If you have chronic low back pain and think you might benefit from a Chiropractic Belt, contact my office. If chiropractic can help you, you should know rather quickly by getting results. If it cannot, then you may need a referral to a neurologist. A good chiropractor can refer you to a neurology office for a consultation. Hopefully, your low back pain does not get to the point where you need a surgeon to help find relief. If you start early with chiropractic and stretching, you can preserve your body through a return to functional joint motion, stabilization of weak ligaments, lengthening of tight muscles, and strengthening weak ones. Don’t let your necessity to sit turn into a crisis. Do the right things early and consistently and you will find you won’t have to. But also feel confident that if you find yourself in pain from long-term sitting, you have a solution available which can get you back to feeling your best, and that’s complete and comprehensive chiropractic health care.