Do you spend hours a day sitting in an office, driving a car or truck, or even relaxing, watching television or playing video games? There’s a good chance you’ve experienced back stiffness or pain.
According to the World Health Organization, low back pain is the most common cause of disability worldwide. Frequent sitting is a real problem: a 2021 meta-analysis of 27 studies found that a sedentary lifestyle, especially sitting for long periods and driving, is one of the most important risk factors for low back pain.
According to the experts we spoke to, our tendency to enjoy sitting or resting seems to go against what our bodies were designed to do.
The spine and surrounding muscles are not designed to stay in the same position for long periods: “For most of human history, we have been in constant motion,” said Matt Weber, a clinical specialist in orthopedic physical therapy at Johns Hopkins Medicine. “We did not evolve for this level of inactivity.”
If you spend a lot of time sitting, a few small changes to your routine can make a big difference. Here’s what physical therapists and orthopedists want you to know about back pain caused by sitting and how to relieve symptoms.
Why sitting contributes to back pain
Good posture keeps the back in a neutral position, meaning the spine retains its natural S-shaped curve. People with a healthy spine have a natural inward curve in the lower back and an outward curve in the lower back, explained Eseohe Edenojie, an orthopedic physician assistant at UTHealth Houston who specializes in the treatment of back pain.
Respecting these natural curves can help prevent back pain. Not sure if your stance is neutral? When sitting, try to keep your head centered over your body, with the back of your neck behind your shoulders and your chin slightly in front of your collarbone.
It is true that it is difficult to maintain this posture when sitting for a long period of time. According to Edenojie, sitting often causes the neck to curve forward, which “compromises the natural curvature of the spine.” When the lower back is not well supported, it can put additional pressure on the muscles, ligaments, and discs that help stabilize the spine, causing pain.
Weber said keeping muscles contracted for a long period of time can also lead to a buildup of chemicals that cause pain and stiffness.
Posture-related pain can affect any part of the back, from the neck to the lower back, explained Gina O’Brien, a physical therapist at the University of Pittsburgh Medical Center. People who spend a lot of time sitting, he added, often complain of headaches, neck pain, stiffness in the mid-spine and lower back pain that can cause pain, tingling or numbness in the buttocks or legs.
According to Weber, if you lead a mostly sedentary life, it’s also easier to injure your back doing gardening or playing sports, because your muscles simply aren’t prepared for these movements.
Staring at your phone for long periods can put extra pressure on your upper back and neck, causing you to hunch forward and causing stiffness and pain – the notorious “tech neck.”
Additional stress in the neck area can also affect nearby nerves, causing referred pain in the arms and hands, headaches, and increased pressure throughout the spine, which can ultimately lead to lower back pain.
The myth of “perfect posture”
When it comes to preventing back pain, experts say that varying the way you sit will have a greater impact than trying to achieve the “correct” posture all day.
“Any posture you maintain, no matter how correct it may seem, will not be comfortable for a long time,” Weber said. “What is usually healthy is to vary the position of the spine and back muscles throughout the day.”
Spending less time sitting is certainly an important part of the solution, whether it’s getting up to stretch briefly every few hours or exercising throughout the week.
A small study from 2024 compared back pain in people who reduced their sitting time by one hour a day to those who continued sitting for long periods. Over six months, back pain worsened in the group that continued sitting for the same amount of time.
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In a previous study published in Preventing Chronic Disease, a journal of the Centers for Disease Control and Prevention (CDC), people who used a standing desk reduced their sedentary time by 66 minutes per day and experienced a 54% decrease in back and neck pain.
Upon resuming his usual sedentary habits, the improvements disappeared within a few weeks.
According to Weber, incorporating more physical activity into your routine is an even better strategy. In addition to allowing your muscles to rest from being in the same position, movement helps reduce stiffness and strengthens your spine to support it when you have to sit.
How to relieve back pain?
If your back hurts from sitting for too long, here’s what experts recommend:
- Get up and move, ideally every half hour. You don’t need to do a full workout to benefit; O’Brien said even getting up briefly or walking for a minute or two can help reduce stress on your back. If you drive for work, get out of the car and stretch when you get gas or stop to eat or use the bathroom.
- Change your posture frequently. Even small changes in the position of the neck, back and legs can be beneficial. If you have a standing desk, alternate between standing and sitting every hour or two. “It’s important for your muscles to experience new sensations and adopt different postures,” Weber explained.
- Set up your workspace ergonomically. O’Brien recommended sitting in a chair with good support and armrests (elbows should be at a 90-degree angle) and adjusting the desk or monitor to face forward or slightly downward. If possible, Edonojie suggested adjusting the height of the chair so that your knees also form a 90-degree angle.
- Strengthen your core . “Sitting requires stamina, and regular exercise can activate muscles to better support your spine throughout the day,” O’Brien explained. Edenojie added that strengthening your core, whether through weight training, yoga or Pilates, can help your body better support your spine.
- Try the T-lift exercise. Lie face down, extend your arms out to the sides in a “T” shape, then raise them toward the ceiling and repeat the movement for two sets of six or eight repetitions. “This can help strengthen the muscles that support you when sitting,” O’Brien said.
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If you’ve tried all of the above and your back pain persists, make an appointment with your doctor or a physical therapist, who can recommend specific exercises and lifestyle changes.
“It’s never too early or too late to consult with a professional,” O’Brien said.