Back Pain When Sitting: Why It Happens and What You Can Do
Experiencing back pain while sitting? You're not alone. Learn the common reasons why you may feel back pain when you sit, how sitting affects the spine, practical steps to reduce pain, and when to seek urgent care. It also describes typical treatment approaches supported by current clinical guidance and how OrthoNJ can help if pain limits your daily life or work.
Sitting for long periods is a common trigger for low back discomfort but the cause can come from several sources: strained muscles, irritated nerves, discs, or spinal joints. Many people improve with changes to how they sit, move, and strengthen supporting muscles. For others, targeted medical care is needed to address nerve irritation or structural problems.
Why Sitting Can Make Your Back Hurt
Sitting changes how the spine supports your weight compared with standing. Holding a fixed posture for long periods can cause muscle fatigue, reduced blood flow, stiffness, and increased loading of spinal structures.
Research shows that sitting typically increases pressure inside the intervertebral discs compared with standing, and disc pressure rises further when you slouch or lean forward. This higher loading can aggravate a bulging or degenerated disc and contribute to pain that is worse with sitting.
Common Symptoms to Watch For
Low back ache that worsens after sitting for a while
Pain that travels into the buttock or down the leg, which may indicate nerve irritation
Stiffness when you stand up after long sitting periods
Tingling, numbness, or weakness in a leg that appears with prolonged sitting
These symptoms may come from muscle strain, a disc pushing on a nerve, sciatica, or arthritis of the spine. A clinical exam and sometimes imaging help determine the specific cause and guide treatment.
How Sitting Affects Specific Spinal Structures
Different parts of the spine can be affected by prolonged sitting. Brief plain-language descriptions follow:
Muscles and ligaments: Holding a posture wears on muscles and supporting soft tissues, which can lead to aching, tightness, or spasms.
Intervertebral discs: Sitting tends to increase disc pressure relative to standing, especially with a rounded low back. If a disc bulges, it can press on nearby nerve roots and cause leg symptoms.
Facet joints: These small joints at the back of the spine can become sore with poor posture and prolonged stiffness.
Nerves and sciatica: Compression or irritation of a nerve root can cause pain, numbness, or tingling down the leg, often worse with sitting or forward bending.
Practical Seat Setup and Posture Guidance
Setting up your chair and workstation to match common ergonomic standards often reduces strain on your back. Aim for these practical adjustments.
Seat height should allow your feet to rest flat on the floor with knees at about 90 degrees and thighs parallel to the floor.
Hips should be level with or slightly above the knees to promote a neutral low back position.
Use a lumbar roll or small pillow to support the natural curve of your low back when sitting upright.
Keep your monitor so the top of the screen is at or just below eye level to avoid forward head and shoulder posture.
Position your keyboard and mouse so your elbows are near your sides and forearms are roughly parallel to the floor.
Stand up or walk briefly every 30 to 60 minutes to restore circulation and reset your posture.
Proper chair setup plus regular movement is often more helpful than a single special device. If your work requires long periods of sitting, consider a sit-stand option, scheduled movement breaks, and a workplace assessment for personalized adjustments.
Quick Stretches and Moves You Can Do at Your Desk
Try these gentle moves to relieve stiffness. Hold each for 15 to 30 seconds and repeat a few times as comfortable.
Hip flexor stretch: Stand, step one foot back and bend the front knee slightly while keeping the back leg straight. You should feel a stretch in the front of the hip.
Seated spinal twist: Sit tall, cross arms over your chest or hold the chair back, and twist gently to each side.
Hamstring stretch: Place one heel on a low step or chair, keep the knee soft, and lean forward from the hips.
Glute release: Sit and cross one ankle over the opposite knee, then lean forward until you feel a stretch in the buttock.
Exercise and Rehabilitation
Guideline-based care for most people with back pain emphasizes active rehabilitation. Strengthening core and hip muscles, improving flexibility, and gradual conditioning can reduce symptoms and help prevent recurrence.
Core exercises: pelvic tilts, bridges, and modified planks as taught by a physical therapist to ensure safe technique.
Hip and glute strengthening: clamshells, standing hip extensions, and resisted lateral walks to support pelvic control.
Cardio conditioning: walking or light aerobic activity improves overall function and recovery.
Physical therapy programs typically combine exercise, education, and activity progression and are recommended early when pain limits function or does not improve with initial self-care.
Medical Treatments Used at OrthoNJ
Many people improve with self-care and physical therapy. When symptoms continue or there is nerve involvement, OrthoNJ clinicians may recommend additional options guided by clinical practice principles.
Medications: Short term use of nonsteroidal anti-inflammatory drugs or acetaminophen may help reduce pain so you can participate in rehabilitation. Use NSAIDs only as directed and talk to your provider before use if you have a history of stomach ulcers or bleeding, kidney disease, heart disease, uncontrolled high blood pressure, are taking blood thinners, are pregnant, or have an allergy to NSAIDs.
Physical therapy: Evidence-based guidance supports early active therapy that focuses on exercise, function, and education rather than prolonged rest for most nonurgent low back pain.
Injections: Targeted injections, such as epidural steroid injections for nerve root pain, may provide short-term reduction of radicular symptoms to allow participation in rehabilitation. Injections are considered when conservative care has not sufficiently relieved symptoms or when they are used to confirm a pain source prior to further treatment.
Surgery: Surgery is considered when there is progressive neurologic deficit, confirmed nerve compression with persistent severe leg pain that does not respond to appropriate conservative care, mechanical instability of the spine, or rare emergencies. Surgery is not routinely recommended for uncomplicated back pain that occurs only when sitting.
When to Seek Urgent Medical Care
Some signs require prompt evaluation. Contact your healthcare provider or go to an emergency department right away if you have any of the following red flag signs.
Cauda equina syndrome signs: new numbness in the saddle region of the groin or inner thighs, new difficulty urinating or inability to empty the bladder, new loss of bowel control, or new severe weakness in both legs. These symptoms need immediate medical assessment.
Progressive neurologic weakness: new or worsening weakness in a leg that affects walking or the ability to stand.
Severe unrelenting pain that is not relieved by rest or medications and limits movement.
Fever or signs of infection: fever with back pain, especially after recent infection or invasive spinal procedure.
Recent significant trauma such as a fall or motor vehicle crash with new back pain.
If you have concerning symptoms, OrthoNJ can evaluate your condition promptly, order appropriate imaging when indicated, and recommend the next steps in care aligned with your goals.
Practical Next Steps
Begin with practical changes: adjust your chair to match the ergonomic points above, set a timer to stand and move regularly, and try the desk stretches. If pain limits work or daily activities after about 4 to 6 weeks despite these efforts, schedule an exam so we can assess and guide treatment. Early evaluation helps match care to the problem and prevent progression.
OrthoNJ clinicians provide examination, imaging as needed, and evidence-informed treatment plans to help you return to comfortable sitting and daily activities.
Find An OrthoNJ Location
Contact one of OrthoNJ's locations spread out through all of New Jersey.
This treatment info is for informational purposes only.Treatment and recovery vary person to person, and you should consult with your treating physician and team for details on your treatment and recovery process.
