Your lower back is fine in the morning. By mid-afternoon it aches, and standing up from your chair takes a second longer than it should. If that pattern sounds familiar, how you sit is worth a close look. This post covers the worst sitting positions for lower back pain, what to do instead, and the signs that point to something other than your chair.
If you want the deeper explanation of what sitting does to the lower back, our longer guide on why lower back pain gets worse when you sit covers it. This post is the practical version: what to change at your desk, on your couch and in your car.
Summary
- The position you hold the longest is often the problem. MedlinePlus lists sitting in one position for a long time as a common point when back pain first shows up.
- Slumping with nothing supporting your lower back, hunching toward a screen, working from the couch, and driving with the seat pushed too far back all work against your back.
- Simple fixes help: a small pillow or rolled towel behind your lower back, a chair you can adjust, and getting up to move during the day.
- Pain that travels below the knee, numbness or weakness, fever, or loss of bladder or bowel control is not something a better chair will fix. Get those checked right away.
- If a flare-up lasts longer than four weeks, it is time for an evaluation.
- Why Sitting Can Bother Your Lower Back
- The Worst Sitting Positions for Lower Back Pain
- A Better Way to Sit
- Move More Than You Think You Need To
- If Your Back Is Already Flared Up
- Red Flags: When It's Not Just Your Chair
- When to Come See Us
- Frequently Asked Questions
Why Sitting Can Bother Your Lower Back
Your lower back supports most of your body's weight, which is one reason it is the most common place for back pain, according to MedlinePlus's guide to acute low back pain. The same source names sitting in one position for a long time as one of the moments people first feel back pain, alongside lifting something heavy or moving suddenly.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases makes a similar point about work. Its overview of back pain notes that a desk job may play a role, especially with poor posture or a full day in an uncomfortable chair, and it lists pain that gets worse with sitting among common back pain symptoms.
That gives you two things to work on: the position itself, and how long you stay in it.
The Worst Sitting Positions for Lower Back Pain
1. Whatever position you have held for hours
Even a good posture becomes a problem when you never leave it. If you sit down at 9 and look up at noon, the length of time is working against you before posture even enters the picture. This is the first thing to change, and the cheapest.
2. Slumped, with nothing behind your lower back
Sliding forward in the seat and letting your lower back round into the chair leaves it unsupported. MedlinePlus suggests placing a small pillow or rolled towel behind your lower back when you sit or drive for long periods. If your chair has a gap there, fill it.
3. Hunched forward toward a screen
Leaning toward a laptop or a monitor that sits too low pulls you away from the backrest, so your back is holding you up instead of the chair. Bring the screen up and toward you rather than bringing yourself to the screen. The same habit strains the neck too; our post on tech neck covers that side of it.
4. Working from the couch or bed
A couch rarely gives you what MedlinePlus recommends for computer work: a chair with a straight back, an adjustable seat and back, armrests, and a swivel seat. Sinking into soft cushions with a laptop on your lap tends to combine the slump and the hunch at the same time. It is fine for a movie. It is hard on your back for a workday.
5. Driving with the seat pushed too far back
If you have to reach forward for the wheel, your back is doing work the seat should be doing. MedlinePlus advises bringing your seat as far forward as possible so you are not bending forward to drive, stopping to walk around every hour on long trips, and not lifting anything heavy right after a long ride.
A Better Way to Sit
You don't need perfect posture. You need a setup that supports you without constant effort. Based on MedlinePlus's guidance on back pain and work and on preventing low back pain:
- Use a chair you can adjust. A straight back, an adjustable seat and backrest, armrests, and a swivel seat are what MedlinePlus lists for computer work.
- Support your lower back. A small pillow or rolled towel behind it, at your desk and in the car.
- Support your feet. MedlinePlus suggests a stool under your feet so your knees are higher than your hips.
- Bring your work to you. Screen up, keyboard close, so you can sit back in the chair.
- Ask about your workspace. If your back is worse at work, MedlinePlus suggests having a trained therapist look at your setup to see whether changes would help.
Move More Than You Think You Need To
The best sitting position is the next one. Changing position and getting up regularly matters as much as how the chair is set up.
- Get up and move around during the workday. MedlinePlus suggests a 10 to 15 minute walk in the morning before work and at lunchtime if you're able.
- Stand up when you take a phone call, or walk to a coworker instead of messaging.
- Avoid trading one extreme for another. MedlinePlus also advises against standing for long periods, so a standing desk works best as something you alternate with, not a full-day replacement.
- Keep up regular exercise. MedlinePlus recommends regular exercises that strengthen your abdominal and core muscles to lower your risk of further injury.
If Your Back Is Already Flared Up
For a fresh flare-up with no warning signs, MedlinePlus's guidance on acute low back pain is:
- Reduce your normal physical activity for the first couple of days, then slowly return to your usual activities.
- Use ice for the first 48 to 72 hours, then switch to heat.
- Consider an over-the-counter pain reliever if you have no medical reason to avoid one, following the label.
- Skip bed rest. MedlinePlus is clear that long rest is not recommended, and staying as active as you can helps keep your back and stomach muscles from getting weaker.
- Avoid heavy lifting and twisting for the first six weeks after the pain began.
Red Flags: When It's Not Just Your Chair
An achy back after a long day at a desk is one thing. The signs below are different and need prompt medical attention. This list follows MedlinePlus's guidance on low back pain.
Contact a health care provider right away if you have:
- Back pain after a severe blow or fall
- Loss of control over urine or stool
- Weakness or numbness in your buttocks, thigh, leg or pelvis
- Pain traveling down your leg below the knee
- Unexplained fever with back pain
- Burning with urination or blood in your urine
- Pain that is worse when you lie down or wakes you up at night
- Severe pain that does not let you get comfortable
- Difficulty walking or keeping your balance
- Redness or swelling on the back or spine
- A history of cancer
Also contact a provider if:
- You have been losing weight without trying
- You have had back pain before, but this episode is different and feels worse
- This episode has lasted longer than four weeks
Pain that runs down the leg can involve the sciatic nerve. Our post on sciatica and leg pain explains what that can mean.
When to Come See Us
If better sitting habits settle your back within a few days, you may not need anyone. An evaluation is worth it when:
- The pain keeps coming back even after you've changed your setup
- A flare-up hasn't cleared after about four weeks
- Sitting has started to limit your workday, your commute or your sleep
- You want a clear answer on what is actually driving the pain
MedlinePlus notes that chiropractic care for back pain is most effective for back pain present for three months or less and for flare-ups of chronic back pain. It also describes the screening a chiropractor does at the first visit to make sure care is a safe fit. If you're curious what that looks like here, see what to expect at your first chiropractic visit.
Dr. Jeff Haynes brings more than 20 years of clinical experience and certifications in Active Release Technique and functional movement screening. Our job is to find the root cause, treat what needs treating, and give you an honest assessment. We don't believe in unnecessary treatment plans or keeping patients dependent on care they don't need.
Frequently Asked Questions
Is there one worst sitting position for lower back pain?
The position you stay in the longest is usually the one causing trouble. After that, slumping with no lower back support, hunching toward a screen, working from a soft couch, and driving with the seat too far back are the common ones to fix.
Does a pillow or rolled towel behind my back actually help?
It's one of MedlinePlus's own suggestions for sitting or driving for long periods. It fills the gap between your lower back and the chair so you aren't holding yourself up.
Is a standing desk better than sitting?
Alternating is the goal. MedlinePlus advises against standing for long periods, and it names sitting in one position for a long time as a common point when back pain starts, so switching between the two and taking walking breaks beats picking one for the whole day.
Can a chiropractor help with lower back pain from sitting?
Chiropractic care is commonly used for back pain, and MedlinePlus lists recent back pain and flare-ups of chronic back pain as where it tends to work best. A first visit includes an exam to confirm it's the right approach for you, and if it isn't, we'll tell you.
What should I do if my back flares up and isn't getting better?
Call the office. If you're not improving, or you just want to know what you're dealing with, we'll find the earliest time that works for you.
Small changes to how you sit can make a real difference by the end of a workday. Support your lower back, bring your work to you, and get up often. If the pain keeps coming back or won't settle, Dr. Jeff Haynes at Comprehensive Chiropractic & Wellness in Lincoln Square will give you an honest assessment. Call (312) 658-0658 or visit us at 4526 N. Lincoln Ave.
