If you're like me, spending hours on end parked in front of a screen, you might be all too familiar with that nagging back pain. It's no secret that sitting for prolonged periods can wreak havoc on your back, but have you ever wondered why?

The Impact of Sitting on the Back

Understanding the Mechanics

When I'm working with patients who complain of back pain, I often find that they can't pinpoint a single injury or event that caused their discomfort. Instead, their symptoms creep up on them, often after long periods of inactivity like a cross-continental flight or hours hunched over their laptop. It's not just a nuisance; it's a deep, grabbing pain that makes standing up from a seated position an excruciating task. They describe having to "ratchet" themselves up to a fully upright position, a slow and painful process.

The culprit behind this pain is not as obvious as you might think. It's not just poor posture or a weak core – although these factors don’t help. The real issue often lies with a critical but commonly overlooked muscle called the psoas. It runs from the lower back, curves around the spine, and then extends to attach to the inside of each hip, making it a key player in hip and leg movement.

Prolonged Sitting and Back Pain

The psoas is critical for walking and standing as it helps pull your hip and upper leg forward. But its position and role in the body mean that it's particularly susceptible to problems stemming from sitting too much. In a seated position, the psoas muscle is contracted, akin to how it would be if your leg was raised. Spend hours like this, and the muscle can effectively "learn" this shortened state, leading to a tightness that's difficult to undo.

When you finally stand up, the shortened psoas muscle doesn't lengthen as it should, causing a pull on the lower back. That’s why standing tasks after prolonged sitting can be painful; the muscle is overstretched, leading to discomfort that can worsen the longer you stand. You might find temporary relief when you sit back down or lie flat because these positions allow the psoas to return to its now-preferred, shortened state.

Traditional treatments like anti-inflammatory medications and simple back stretches often fail to alleviate this pain because they don't address the root of the problem. To effectively treat this pain, strategies that stretch, strengthen, and properly align the psoas muscle need to be employed. However, this knowledge doesn't translate to instant relief — it's crucial to recognize which habits contribute to psoas tightness and how behavioral adjustments can play a significant role in managing back pain.

Causes of Back Pain from Sitting

Poor Posture

When sitting for extended periods, Poor Posture becomes a principal contributor to back pain. I often see clients who've spent hours at their desks, hunched over keyboards, leading to a curvature of the spine not meant for our anatomy. This unnatural arch puts undue pressure on the spine and, specifically, the psoas muscle. This vital muscle suffers because it's forced to prop up the upper body in an inefficient position, which exacerbates pain upon standing. The key symptom many report is the need to 'ratchet' themselves upright gradually, which is a hallmark of the psoas being in distress.

Weak Muscles

The role of weak muscles, particularly the core and back muscles, cannot be overstated. These muscles are designed to support our spine and when they're not engaged, the psoas tries to compensate. However, the psoas isn't meant to be a primary spine stabilizer during sitting. When the core is weak, the psoas inevitably becomes overworked and tense. This imbalance can contribute to pain, especially when the body attempts to return to a standing position after being seated for a long time.

Lack of Movement

Our bodies are built to move, but the modern lifestyle has us fixed in place for hours on end. Lack of movement leads to a tight and contracted psoas muscle. When we sit, the psoas muscle remains in a shortened position, similar to when you're lifting your leg. Over time, without adequate movement, the psoas doesn't get the chance to stretch out or release, which can create that gripping, nasty back pain my clients describe.

From what I've seen in my practice, remedies such as anti-inflammatory medications and simple back stretches often fail to provide long-term relief. That's likely because they don't target the psoas directly, which, in the scenario we're discussing, plays a lead role in the back pain experienced after sitting.

How Sitting Leads to Back Pain

Increased Pressure on the Spine

When I talk to my patients about their routine, it's clear that spending hours in a seated position is common, especially during long plane flights or a full day behind a computer. This prolonged sitting can dramatically increase pressure on the spine. Since the spine is designed to bear weight evenly, any sustained posture that disrupts this balance will inevitably lead to discomfort. The weight of the upper body when seated compresses the spine outwards, creating an unnatural curve that strains the spinal discs and can eventually lead to grabbing, nasty back pain.

Decreased Blood Flow and Nutrients

let's delve into what's happening at a more microscopic level during long sitting spells. The blood flow needed for muscle health and function decreases in a seated position. Muscles, such as the psoas, require a consistent supply of blood to provide necessary nutrients and to remove waste products. Without adequate circulation, these critical processes are interrupted, which contributes to muscle fatigue and pain. Limited blood flow can also result in the stiffness associated with trying to "rachet yourself" into an upright position after sitting.

Reduced Core Strength

Another unexpected side effect of extended sitting is the gradual reduction of core strength. Essential in maintaining proper posture and spinal alignment, the core muscles weaken over time from underuse. My patients often find that after sitting for prolonged periods, it becomes increasingly difficult to stand for long without experiencing a sharp pain. This is because the psoas muscle, critical for posture and leg movement, tries to compensate for the weak surrounding muscles but ends up overworked and strained. Optimal core strength provides support and reduces the burden on the psoas, which is why it's essential in preventing and managing sitting-induced back pain.

Preventing Back Pain from Sitting

Maintain Good Posture

As an acupuncturist, I've seen numerous cases where improper posture contributes to back pain. The symptoms – a nasty, grabbing sensation after prolonged sitting – often highlight poor spinal alignment. Good posture is key. To maintain this, ensure your back is supported, your feet flat on the floor, and your computer screen at eye level. Use a chair that reinforces the natural curve of your spine. An ergonomic setup can significantly reduce the strain on your spine and the pressure on the psoas muscle, mitigating the risk of back pain.

Stretch and Strengthen Muscles

It's no secret that muscles can become tight from extended periods of inactivity. The psoas muscle, running along the spine and curving to the hips, is particularly susceptible. When you sit for long durations, it shortens and tightens, similar to its position when your leg is raised. This can lead to discomfort and limited mobility. To combat this, I recommend stretching and strengthening exercises focused on the core and psoas muscles. Incorporate exercises such as:

• Psoas stretches

• Pelvic tilts

• Abdominal engagement routines

Regular exercise keeps these muscles flexible and strong, equipping them to better cope with the demands of prolonged sitting.

Take Frequent Breaks to Move

Standing up and moving frequently is essential. Don't rely solely on anti-inflammatory medications or passive stretching, which often provide minimal relief. I advise my patients to take regular breaks – at least every hour – to stand, walk, or perform light stretching. This activates the muscles, stimulates blood flow, and helps prevent the psoas from contracting in a shortened state. Dynamic movements encourage muscular balance and can be particularly therapeutic. Incorporate activities like:

• Short walks

• Leg lifts

• Gentle bends and twists

Taking these steps not only helps prevent back pain but also promotes overall well-being. Remember to listen to your body and pace yourself; effective prevention is about consistent effort over time.

What to do if you have psoas pain?

Experiencing acute or chronic intermittent psoas pain can be extremely discomforting and often resistant to medication. In such scenarios, seeking treatment from an acupuncturist skilled in psoas release techniques can be highly effective. It's important to understand that addressing psoas pain involves more than just focusing on the back.

Dr. April employs precise orthopedic tests to determine the specific side of the psoas that is most affected and identify other impacted muscles. Based on these assessments, she tailors a treatment plan that not only releases the psoas but also other affected tissues. This approach helps in rebalancing the pelvis. Typically, a treatment session lasts about 75 minutes and may include various modalities such as pelvic blocking, electrical stimulation, fire cupping, and traction, alongside acupuncture (Learn about acupuncture for back pain).

Believing firmly in patient empowerment, Dr. April provides guidance on at-home care practices. Most patients receive personalized instructions on stretches and exercises specifically designed to address their unique psoas constriction patterns, fostering further recovery.

Conclusion

Let's face it, sitting may be a part of our daily routine, but it doesn't have to mean living with back pain. I've shared some key strategies to help keep your spine happy and your muscles limber, even with a desk job. Remember, it's the little changes that can make a big difference. Adjust your workspace, get your body moving regularly, and don't skimp on those core exercises. Your back will thank you for it. Stick with these habits, and you're on your way to a healthier, pain-free posture. Keep at it, and let's say goodbye to back pain for good.

Frequently Asked Questions

How does sitting for long periods cause back pain?

Sitting for extended periods can strain the spine and psoas muscle, potentially leading to back pain due to poor posture and muscle tightness.

What can I do to maintain good posture while sitting?

Use an ergonomic chair, ensure your computer screen is at eye level, and be conscious of keeping your back straight and shoulders back to maintain good posture.

Why is an ergonomic chair important for preventing back pain?

An ergonomic chair supports the natural curve of your spine, promotes better posture, and can be adjusted to fit your body, reducing the risk of back pain.

How can I reduce the strain on my psoas muscle when sitting?

Prevent psoas strain by taking breaks to stand and walk, performing stretching exercises, and avoiding sitting in a single position for too long.

What kind of exercises help prevent back pain from sitting?

Strengthening and stretching exercises that target the core and psoas muscles, like planks and hip flexor stretches, are effective in combating back pain from prolonged sitting.

How often should I take breaks from sitting to prevent back pain?

Aim to take short breaks every 30 minutes to stand, walk, or stretch to activate muscles and stimulate blood flow, which can help prevent back pain.