Preventing Back Pain from Long Sitting

by Dr. Jolie Bookspan

Travel usually means long hours of sitting. Most lists of instructions for sitting without hurting your back tell you to sit in exact ways at exact angles. But you don't need to memorize strange rules and sit in uncomfortable ways. Instead, it's better to understand the concepts of how strain and injury occur so you can sit in healthy ways that are comfortable and easy.

Why Is Bad Sitting Bad?

Sitting with a rounded back does bad several things. Rounding forward (slouching) when sitting holds the muscles in a longer than normal position, which weakens them. It slowly degenerates your discs, which are the little cushions between your back bones (vertebrae), and pushes the discs outward to the back. This is how discs herniate, also called a slipped disc. A slipped disc can bulge outward enough to press on nearby nerves, sending pain down your leg. This is sciatica. This is easy to prevent.

When Do People Round Their Back?

People round their back all day standing, traveling, eating, then round to "relax." No wonder their back hurts.

Many chairs have a round (concave) back. It's common to sit in these round chairs and allow your back to round to fit the round chair back. Your body weight presses down on your low back discs.

Simple Pain Prevention

Instead of sitting forward in your chair, move your hip all the way to the back of the chair, and lean back in comfort. If the chair back is rounded, put a small cushion in the space between your low back and the chair, to preserve healthy normal back posture.

Cartoon on proper sitting with a back roll

Making a Lumbar Roll

When traveling you can use many common soft items to make a lumbar roll. Try a small folded towel, shirt, or gloves. Fold your jacket, just enough to be the size you want.

Using the Lumbar Roll - Lean Back, Not Forward

Don't use a big lumbar roll. It will be uncomfortable. If you fell like it is sticking you in the back, check that you aren't rounding against it, or that it isn't too large, or too high or low on your back. Lift your upper back against the chair instead of pressing against the roll. Rounding against the lumbar roll is as uncomfortable and just as useless as rounding without one.

Sitting on Buses and Flights

Commercial airline, bus and train seats are often rounded (concave), encouraging prolonged, forced rounding. For highly rounded seat, you may have to use two pillows, one in the natural curve of your lower back, and the second pillow behind your upper back, in the space still left by the rounded seat. Position the pillows so you can straighten up, not be made to round your back and neck forward by the hollow of the seat back.

Cartoon of proper back placement while sitting on an airplane

Flights sometimes have a video message encouraging in-seat stretching. Often the advice is forward bending. That is the last thing you need after sitting bent forward for so long. Instead, stretch your back and shoulders backward, not forward. Pull your chin in while leaning back. Breathe.

Sitting at the Internet and Restaurant

Move the seat in and sit closer to the desk so you can sit up instead of hunching forward. Use a roll if needed.

Sitting for Relaxing

Instead of sitting rounded forward in soft chairs and couches, use a pillow or other cushiony object to pad the space between the normal inward curve of your low back and the chair so that you can sit up and slightly back.

Cartoon of back roll use while reclining

Don't Forget To Get Up

No matter how well you sit, it's still a lot of bending at the hip. Stand up and straighten out. Another nice way to straighten out after long trips is to lie face down and prop up on elbows.

No Strange Rules

It is common to hear that you must sit at 90-degree angles or hold your thighs parallel to the floor, or other strange, strict rules about positioning your arms or legs. Don't worry about angles. Get the concepts, then you can keep healthy posture while you go about your life.

Watch how other people sit and send me photos of the good and the bad. There will be prizes for the best ones.

For more pain prevention and fun ways to better health, see Dr. Jolie Bookspan's web site.


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Dr. Jolie's sports medicine methods are successfully used around the world by top spine doctors. Harvard school of medicine has named her "The St. Jude of the Joints."

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