When I started medical school after a few years away from being a student, I expected having to adjust to all that studying. What I didn’t expect was the lower back pain that came with sitting at my computer for hours. Health professional students are told to treat school like a full-time job, which in the case of quarantine means sitting at a computer screen for hours on end—for lectures, studying, and Zoom meetings.
This virtual reality for school and work is one many people across the world are adjusting to since the start of the COVID-19 pandemic, and with that adjustment has come an increase in lower back pain.
What are the causes of lower back pain when sitting?
Lower back pain is a common health condition typically affecting the lower portion of the spine and can stem from an injury (muscle strain or a sprained ligament from improper lifting for example), or a spinal problem such as arthritis or sciatica. Common causes of lower back pain when sitting include prolonged time spent in a chair, lack of regular exercise, and poor posture.
Sitting for prolonged periods of time increases stress and strain on the back muscles and spinal discs. Spinal discs act like support pads in your spine, and pressure on these pads results in pain. Pressure is typically highest when sitting, and lowest when lying down.
“The walk to the water cooler is now replaced with the much shorter walk to the fridge,” Dr. Siddiqi explains. “All of that physical activity built into your day that you don’t think about has been taken away from you in these settings. All that plays into a heightened pain experience,” explains Asad Siddiqi, DO, an associate professor of clinical rehabilitation medicine at Columbia University Medical Center.
The impact of prolonged sitting typically isn’t as bad when you break up long periods of sitting to do things like traveling to and from work, getting up to go to meetings or the office kitchen, or post school/work exercising. But with most Americans doing work and school from home, a lot of these small breaks have been erased.
The pain from prolonged sitting is exacerbated by lack of physical activity, which is much more likely to be the daily experience of many since the onset of quarantine. “A lot of people have had their normal routines disrupted,” says Dr. Siddiqi. “Now the body is having to accommodate a new normal.”
The duration at which we sit at a computer for meetings, catching up with friends, and entertainment has gone up. Physical activity, along with access to gyms and workout spaces, has gone down. When routines are disrupted, it can be hard to summon the motivation to exercise at home. For people who live in cities, exercising outdoors is not risk free. These changes are resulting in people who never experienced back issues experiencing some pain. “Many of my patients have reported new aches and pains,” comments Saiah Yates, DPT, a physical therapist with Loch Raven VA Outpatient Clinic in Maryland. “The fear and very present risk of catching COVID-19 has limited people’s outdoor and social activities.”
Before the pandemic began, the average American used screens for about four hours a day. Now that number has shot up to six hours daily, according to a survey conducted by One Poll. Fifty seven percent of respondents say that has led to more “screenaches” than ever before.
Poor posture adds to this stress by overstretching the spinal ligaments and straining the spinal discs. Muscles spasm due to the increased pressure. When we sit, this portion of our body is already crunched together, and poor sitting posture magnifies this slouching and causes the strain. Low back pain from sitting for extended periods is typically associated with other symptoms of prolonged screen use, such as neck pain and shoulder pain.
How can I prevent lower back pain when sitting?
So, how do you solve these issues during the ongoing pandemic? You can’t simply start commuting again, or make your house any bigger. But there are simple steps you can take to decrease the negative impact of being glued to your desk all day (and night) long.
Ergonomics is the study of what makes a work environment as comfortable, and therefore productive, as possible. Many companies and schools put significant attention into spacing equipment in a way that suits long-term sitting. This design is pretty different from most of our kitchen counters and bedroom setups.
Where you decide to hold your Zoom calls may be a good backdrop, but not the most ergonomic, says Dr. Siddiqi. While you may not have a lot of money to put toward ergonomic design, there are some small cues we can use to make the spaces of our homes suitable for working and supportive of our bodies:
|Eye cues||Close your eyes while sitting, with your head looking straight forward. When you open them, the center of your screen or whatever the main focus of your activity should be at eye level. If not, adjust your computer height using lap desks or a pile of thick books.|
|Elbow cues||If you place your hands on your desk, your elbows should make a 90-degree angle. If not, you should adjust your chair higher or lower as needed.|
|Arm cues||Sit in a way that allows your upper arms to be parallel with your spine. Shoulders should be relaxed. Forearms should rest comfortably parallel to the floor.|
|Lower back cues||Sit with your butt pressed against the back of your chair. Place a pillow between you and the back of your chair to allow your spine to sit with its natural curve. If your chair doesn’t have a back, try sitting against a wall, and place the pillow behind you to support the lumbar area.|
|Thigh cues||Adjust your seat level so your thighs rest parallel to the floor. Try placing your hands underneath your thigh where your leg meets the chair. If it can’t fit, you may need a footrest for your feet. If there’s too much space, your may need to move your chair height up.|
If you’re already experiencing back pain while sitting, try breaking up your sitting into short intervals and changing your sitting position. Lying down is the position that has the least strain on your back. Alternate periods of sitting with standing or take breaks to lie down as possible. Standing allows for better weight distribution, which gives the lower back a much-needed break.
“You can do things in the privacy of your own home that you may have otherwise been self-conscious to do,” Dr. Siddiqi says. Working and attending school from home offer a degree of flexibility, and that flexibility can be used to help restore back function.
How to treat lower back pain
Often the only symptom of lower back problems is the experienced pain. Lower back pain happens among all ages and demographics, and typically goes away on its own within two to four weeks when the cause is removed. Chronic low back pain may require physical therapy, over-the-counter or prescription pain medications, or possibly surgery.
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Regular stretching and exercise
Even the most comfy, ergonomically savvy chair can contribute to back pain if sat in for too long. Finding ways to be a little active each day is difficult, but essential to preventing and alleviating pain. Most medical providers recommend taking active breaks to stand up at least once every hour.
“Schedule time for physical activity, even if that was not something you previously did,” Dr. Siddiqi says. “Get up, stretch, do something that gets the blood pumping a little bit, and then reset your position.”
Movements that strengthen the core abdominal muscles are especially important, as our core supports the part of the body under strain while sitting. “Our core musculature may not be engaged during long-term sitting or laying, thereby decreasing the stability of the spine,” Dr. Yates notes.
When deciding what kinds of movements to do, think of what your normal activity level is so that you meet your appropriate edge. “Find ways to compete with yourself; find different ways to measure and track your success,” Dr. Siddiqi says. For some, that may look like yoga, or stretching once a day. Here are some recommended stretches that give the lower back a little extra love:
- Knee to chest: Lie down on your back, with your lower back against the floor. Lift your legs up and hug your knees into your chest. Hold for 10-15 seconds and release.
- Reclined spinal twist: Lie down, with arms extending out in a “T” formation, knees bent, and feet on the ground. Let both knees fall to the right, and gaze to the left. Hold for 5-10 seconds, then reset. Repeat, shifting both knees to the left and gazing to the right.
- Cat-cow: Start on your hands and knees in a table-top position. As you breathe in, arch your back to move your stomach down and lift your head up. As you exhale, reverse this motion and cave your back in, letting your head fall down. Repeat 5-10 times.
Over-the-counter (OTC) anti-inflammatory medications, such as aspirin or ibuprofen (along with the use of hot/cold pads), can also be used for short-term pain relief when your back hurts. Turmeric has also been proven to have anti-inflammatory effects. These effects may help with alleviating back pain, though studies are not conclusive.
When to see a doctor for back pain
Seeking professional medical advice can be helpful for distinguishing whether or not structural damage, such as a ruptured disc or spinal stenosis, is causing the pain. Get medical attention if pain lasts longer than a few weeks, or is progressively getting worse. It’s important to pay attention to what changes make the pain better or worse, and if any other symptoms are present. “Often the timing of symptom onset can give clues as to what is causing the back pain,” describes Dr. Yates.
Your primary care provider may refer you to a physiatrist or physical therapist to get a comprehensive care plan for addressing the cause of the back pain and help restore function.
Whether your pain is a result of structural damage or quarantine-related adjustments, there are resources available to help alleviate it.
- Stretches to alleviate lower back pain, Harvard
- Lower back pain: what could it be?, Johns Hopkins
- Lower back pain fact sheet, National Institutes of Neurological Disorders and Stroke
- Ergonomics, The University of North Carolina
- Amount of time Americans spend staring at screens has skyrocketed during pandemic, New York Post
- Ergonomics for prolonged sitting, UCLA
- Low back pain: Why movement is so important for back pain, Institute for Quality and Efficiency in Health Care
- When to get help for low back pain, Harvard
- Curcumin: A review of its’ effects on human health, Foods
- Ergonomic tips for working at home