What Should I Do About My Lower Back Pain When Standing?

During the holidays we often find ourselves standing for long periods of time while cooking, shopping, or going to parties.  If you aren’t used to standing for long periods your low back may feel tight or stiff, sometimes nagging for the rest of the day.
Do not fear!  This is a common problem and it is estimated that 80% of our population suffers from back pain at some point in their life. We want to share some possible causes, a few tips to prevent this from happening and some stretches to help relieve the pain when it does.

​Postural Stress and Muscle Fatigue

Postural Stress - In standing, the pelvis pushes or drops forward, increasing the curve in the lower back and thus increasing the pressure on the spine and the surrounding muscles. The increased pressure on your spine can make the lower back muscles tighten and go into spasm and cause pain.
​
Muscle Fatigue - Without good core/abdominal muscle strength AND endurance to offset the load on the spine during prolonged standing, the muscle spasm or pinching of the nerves will occur sooner and may be more intense.  People who are overweight may be at increased risk for muscle fatigue while standing for long periods. 

Common Underlying  Spinal Changes

If your body and spine has any underlying degenerative changes, pressure on the nerves may be increased and pain may be more intense with postural stress and fatigue.  Here are some common causes of back pain...

Spinal Stenosis- This is a narrowing of the spaces along the spine which increases pressure on the spinal cord and nerves.  Spinal stenosis symptoms may include leg weakness, numbness in the buttocks or the back of the legs, and relief by leaning forward.

Degenerative Disc Disease - With age, the protective discs between each vertebrae may have “wear and tear”, shrinking or loss of height due to loss of water, or bulging/herniated discs. The degeneration of the disc leads to pressure between the vertebrae and along the nerves coming out along the spine.

Hyperlordosis - Also known as “swayback”, this is an excessive curvature of the lumbar spine causing the stomach to stick out and the buttocks to become more prominent.  This increased curvature places pressure along the back of the spine. It also creates  a muscle imbalance between the abdominal muscles and back muscles, leading to core weakness and decreased spinal stability.  

Osteoarthritis - This is wearing of the cartilage along the bones in the joints, which affects the smooth movement of the bones and can cause pressure on surrounding nerves. 

Pinched Nerves or Sciatica -Pain from the nerves may be caused by pressure from any of the above changes in the bones, cartilage, or muscles surrounding the spine. ​

Prevention Tips

1. Practice Good Posture in Both Sitting and Standing.  This means activating your stomach muscles to keep the back and pelvis upright, not leaning forward, and not slumping. 
2. Use Good Lifting Techniques.  When lifting large pots, carrying shopping bags, or picking up delivery boxes make sure to bend from the legs, not the back.  Keep the weight as close to the center of your body as possible.When standing in one spot for a long period, make sure to frequently shift your weight back and forth on each leg.   Do not stand with the knees locked.  If possible, put one foot up on the inside of the cabinet or on a step to relieve the pressure on the spine and decrease the curvature.  
3. Wear Proper Footwear.  Your feet are your first point of contact with the ground and ground reaction forces.  If you are not aligned at your feet, the amount of force transmitted to the spine is increased.  You can wear supportive shoes or orthotics in the shoe to provide postural support. Avoid high heels if possible!  We offer custom Foot Leveler Orthotics here fitted and prescribed by a physical therapist. Click Here if  you would like to be fitted for orthotics. 
4. Take sitting rest breaks, BEFORE your back starts to hurt! Once your muscles start to spasm, it is hard to relieve the pain without being able to stretch out.  Remember, an ounce of prevention is worth a pound of cure.​
5. Practice Self Care with Daily Exercise at Least 30 Minutes a Day.  Keeping strong will help you tolerate prolonged standing with improved muscle endurance. Exercise should include a mix of cardiovascular exercise, stretching, and strength training. 

How to Relieve the Pain Standing for a Long Period of Time

1. Stretching.  Take a few moments to lay down, rest the muscles that support the spine and stretch them to relieve symptoms.   Here’s a short video that goes over three easy stretches to relieve spasm in the back.
2. Ice or Heat.  Both are helpful and provide relief in different ways.  Heat will increase the blood flow to the muscles and decrease spasm. Heat usually feels really good, but doesn’t always provide long lasting help.  Ice will be helpful in calming inflammation and calming the pain.  It is not always very comfortable, but tends to provide longer lasting pain relief.  Use whichever provides the most relief for you.

What if I Can't Relieve My Back Pain When Standing or Walking?

If the low back pain remedies listed above do not help, it may be worth seeing a physical therapist.  We are movement specialists and can get to the root cause of your pain and assess exactly what exercises and pain relieving techniques you need to use.  Click Here if you need to speak with a movement specialist!