Sitting for a short duration can be a relief after a long walk, run, exercise or any activity which requires physical exertion and induces fatigue. But sitting for long hours at a stretch can cause the muscles and joints to stiffen up. Over time, it could lead to chronic lower back pain.
With modern lifestyles increasingly keeping people sedentary, back pain has become one of the most common ailments around. Being mindful of the sitting posture, taking regular breaks to move and stretching the muscles are crucial to avoiding lower back pain, say experts.
Sitting and lower back pain
Most activities in daily life — such as reading, working (desk jobs), driving and watching television — are done in a seated position.
Dr Pavan Chebbi, senior consultant orthopaedic surgeon, Apollo Spectra Hospitals, Koramangala, Bengaluru, says people’s posture while sitting is one of the biggest reasons for back pain.
“There are three reasons for back pain while sitting,” says Dr Chebbi. “The first reason is if the posture is not right. The next cause is the place of sitting, that is, if you are not sitting on an ergonomic table and chair. The third cause is the duration — you may be sitting in the right posture, you may be using an ergonomic chair and table, but if you sit for long hours at a stretch, it can cause backache.”
Komala Sai PT (MPT-neurology) of Master Physio Clinic, Bengaluru, explains the progression of lower back pain — from mild stiffness to a chronic issue.
“The spine has a specific structure (S-shaped curve),” says Sai. “Due to improper sitting posture, tension begins in the back muscles, causing it to get fatigued. This leads to back pain. When the pain begins, initially it is mild and for short periods, because the back tries to heal itself and restore the structure of the spine. In this case, rest, a night of good sleep and avoiding sitting for long hours of work may be helpful. But in the long run, sitting for long hours applies continuous pressure on the back muscles, tampering with the spinal structure, and then the pain persists and becomes chronic. This calls for a diagnosis.”
Physical assessment is the first step in the diagnosis. An X-ray is also taken — in the lateral and anterior-posterior views. The X-ray is analysed for changes in the spine curvature. It is to ascertain if the spine’s curvature is lost, has become straight or worse, or reversed if there are reduced disc spaces or a disc bulge/prolapse. These need immediate medical attention. An MRI can be done to check if there is nerve involvement.
Sitting in the right posture may help in reducing the chances of back pain or prevent existing back pain from worsening.
“I would recommend a 90-90 posture — that is, whenever a person is sitting, they should keep a 90-degree angle at the knee and a 90-degree angle at the back,” says Dr Chebbi. “The neck must be straight, with a small bend of less than seven or 10 degrees. So, if you keep a 90 degree at the knee that means you are keeping it at an angle where your thighs are completely supported and your foot is rested on the ground or a footrest.”
Dr Chebbi adds, “Then there is [also] a back support at the hip region, where it connects to the lower lumbar region, and makes an angle of 90 degrees — thus it [back] is completely supported at the lumbar region. The hand [from elbow to the wrist] has to rest completely on the table, and the neck has to be straight.”
Ergonomic chairs and back supports
Dr Lokesh H, consultant, Health India Hospital, Bengaluru, emphasises the need for proper back support for those who can’t avoid sitting for long hours.
“The back works constantly for you, so ergonomic chairs are designed in such a way that they give some cushioning and support to the back,” says Dr Lokesh.
Komala adds, “Ergonomic chairs help in maintaining the right posture and the hip and pelvis alignment, which is very important to prevent the slouching and forward head posture. It will also reduce repeated trunk movement.”
Dr Chebbi says there are two types of back support. “One is in the chair — a back support which is adjustable [and] which can be used while you are sitting or standing,” he says. “The other is the posture-correction back support. It’s more of a brace which a person uses to correct the posture. You can use this back support along with a good amount of exercises to strengthen the back muscles and core of the body. The only problem with this back support is people’s compliance. Sometimes they use it a bit too much — so that they stop doing exercises and completely rely on the back support. And sometimes they use it sparingly — where it really doesn’t give any such help.”
Take a break
People who sit and work, focused, tend to forget to take breaks. Though they start work by sitting in the right posture, through the hours, they begin to slouch.
Driving for long hours, especially if done while wearing tight trousers, too might lead to dangerous complications like blood clots. Experts suggest taking a two-minute break to stretch the muscles a little. Taking regular breaks during long drives, and while sitting and watching television or reading, is also helpful.
Stretches and exercises
Stretching and exercises are advised for those with back pain, but experts say it is necessary to decide on the exercises under the guidance of a medical professional — an orthopedist or a physiotherapist. But some simple stretches can be done by all individuals who spend a lot of time sitting.
“Small stretches for bending the back, touching the toes, turning left and right, moving the neck up and down, rotating it clockwise and anti-clockwise, and stretching the gluteal muscles can be done,” says Dr Lokesh.
Sai adds, “I recommend back-strengthening exercises along with hip bridging, cat and camel poses, which are good for the upper back and lower back.”
Dr Chebbi also stresses the importance of regular exercise.
- Lower back pain can be the result of sitting for long hours.
- Sitting in the right posture, using an ergonomic set-up and taking regular breaks with stretches can help avoid back pain.
- Have sticky notes or alarm beeps to remind you to take breaks during long working hours.