Pain over the lower portion of the back below the rib cage is called as low back pain or lumbar back pain. It is a very common medical condition and invariably affects all age group.
Low back pain that worsens upon sitting is generally caused due to pressure build up over the lumbar discs while sitting for prolonged periods of time. A normal spine has a S bend. Inappropriate posture while sitting can gradually cause change in the normal S bend curvature to abnormal C bend curvature. This increases the intra-disc pressure causing pain over the lumbar region. This over a period of time can flatten the lumber disc leading to pinching of the nerves passing through that area.
What Causes Low Back Pain When Sitting Down?
Low back pain is most commonly caused by mechanical reasons. These include:
- Muscle Strain as a Cause for Low Back Pain When Sitting Down: Muscle strain usually occurs after certain abnormal movement such as twisting, lifting heavy objects etc. or after a sudden jerk in traumatic events such as motor vehicles accidents, falls etc.
- Low Back Pain When Sitting Down Caused Due to Spondylolisthesis: Characterised by slippage of one vertebra over another, Spondylolisthesis can cause low back pain while sitting down.
- Low Back Pain When Sitting Down Caused Due to Disc Herniation: It is a condition where the intervertebral disc bulges into the space containing the spinal cord causing low back pain. The pain is more when sitting down as the disc space gets reduced further.
- Arthritic Changes: Degenerative changes over the vertebrae leads to low back pain when sitting down or with any activity.
- Spinal Stenosis: Pain and discomfort caused over the low back in view of narrowing of the bony canal causing build-up of pressure over the nerves.
Other Causes of Low Back Pain Include:
- Functional causes
- Systemic infection
- Inflammatory conditions such as rheumatological issues
- Vertebral fracture
- Referred pain
Symptoms of Low Back Pain When Sitting Down
The symptoms of Low back pain with sitting down may include:
- Pain, tenderness and discomfort over the lower back that worsens upon sitting for prolonged periods of time and with movement such as bending, lifting heavy objects etc.
- Limited flexibility and restricted range of motion.
- Inflammation over the affected area.
- Muscle spasms and rigidity.
- Pain radiating to other areas such as lower extremities, upper back, hips, buttocks, groin area etc.
- Numbness, tingling or burning sensation.
Diagnosis of Low Back Pain When Sitting Down
The first step in diagnosis includes obtaining a detailed case history followed by a thorough physical examination by an experienced physician or an orthopaedist. Physical examination includes general palpation over the spine to check for tenderness and numbness, and other specialist tests such as straight leg lift test, evaluation of range of motion etc. Imaging studies are considered for further evaluation and management. These include:
- X-ray of the lumber spine
- CT scan
Specialized blood test may be done to check blood count and to rule out evidence of infection and inflammatory diseases. In certain cases, bone density test may be done.
How is Low Back Pain When Sitting Down Treated?
Most low back pain improves on its own with home remedies. However, in certain cases, low back pain may require intervention by an experienced physician or an orthopaedist. One may also consider follow up with a pain management specialist, chiropractor or physical therapist. Treatment modality of low back pain includes:
- Oral Medications to Provide Relief from Low Back Pain When Sitting Down: Pain medications such as Aleve, Advil and Tylenol etc. can be taken when required. In severe cases, muscle relaxants and tricyclic anti-depressants are also prescribed along with anti-inflammatories.
- Topical Medications: To get some immediate symptomatic relief from back pain when sitting down or with any activity, a number of gels, ointments, sprays and creams are easily available in pharmacy shops.
- Epidural Injections: In severe cases of low back pain when sitting down or with any activities, epidural injection in the back may be considered.
- Physical Therapy to Treat Low Back Pain When Sitting Down: Physical manipulation of the spine and lower back by an experienced physiotherapist helps in reducing the low back pain and improves flexibility.
- Lumber Corsets: Lumber corsets may be worn to provide stability to the back and prevent pain in the back when sitting down or with any other activities. However, it should not be worn for prolonged period of time.
- Specialized Techniques: Other techniques that can help provide relief from low back pain when sitting down include intradiscal electro thermal therapy, nucleoplasty and radiofrequency lesioning.
- Surgical Intervention for Treating Low Back Pain when Sitting Down: In advanced cases, surgical intervention may be required by an orthopaedic surgeon. Surgical techniques include discectomy, foraminotomy, spinal fusion, spinal laminectomy/spinal decompression etc.
- Hot & Cold Compress: Using hot and cold compresses alternatively over the affected area helps in reducing back pain when sitting down. To improve back stiffness, one can also take warm showers in the morning.
- Alternative Medicine: Alternative medicine such as massages, acupressure and acupuncture, and chiropractic therapy can also be considered to reduce low back pain when sitting down.
Prevention of Low Back Pain When Sitting Down
- Maintaining Appropriate Posture: It is advised to sit straight with adequate back support while sitting for prolonged period of time to avoid getting back pain. The knees should be kept slightly higher than the hip and the feet should be flat on the ground. Also, it is advised to avoid sitting in the same position for long hours. One can use lumbar support devices sold in the market or a simple pillow to provide lumber support while sitting. It recommended using a chair with adequate back support at work place. It is also advised to maintain proper posture while walking and sleeping.
- Regular Exercising: Being physically active and exercising on a regular basis helps in reducing the risks of developing back pain. Regular exercising helps in improvement of flexibility and range of motion.
- Weight Loss: Risks of developing low back pain increases with weight gain. Thus, it is advised to maintain weight within acceptable limits.
- Lifting Action: It is advised to bend at knees rather than at the waist while lifting heavy objects to prevent back pain.
- Appropriate Clothing: One should avoid tight fitting clothing that may restrict sitting, bending and movement in general. Wearing high heels on a regular basis also increases risk of developing back pain.
- Avoid Carrying Heavy Bags: Carrying heavy back packs and briefcases causes straining over the lower back. Carrying heavy wallet in back pocket also causes discomfort while sitting and lead to back pain.
- Avoid Smoking: Smoking restricts the flow of absorption of nutrients by the spinal cord making it vulnerable to pain.
Exercises for Low Back Pain When Sitting Down
Regular exercising reduces the risk of developing back pain. It is recommended to do exercises to strengthen the core muscles to avoid back pain. A large number of home exercises are available on the internet that help is strengthening the core muscles. Complex manipulation should be done only under the supervision of a physical therapist.
Low back pain is a very common condition that affects every individual at least once in their lifetime. Pain over the lumber region is generally caused due to inappropriate posture while sitting and other activities. This causes change in the normal curvature of the spine, causing increased pressure over the intervertebral discs. The increased pressure over a period of time can cause nerve compression leading to pain and discomfort. The pain generally dissipates with simple home treatment; however, in advanced cases, specialized attention may be required. Pain medications and muscle relaxants are recommended for management of pain and inflammation. Physical manipulation by a physical therapist is also beneficial. It is advised to maintain appropriate posture to avoid the risk of causing back strain and low back pain when sitting down.
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