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Your guide to fighting lower back pain while working at home

It's a common issue with too much screen time. These tips can alleviate it.

Causes | Prevention | Treatment | When to see a doctor

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 resulting from sitting at my computer for hours. Health professional students are told to treat school like a full-time job, which during a pandemic, often means sitting at a computer screen for hours on end—for lectures, studying, and Zoom meetings. 

While many schools and workplaces have returned to in-person, many still meet virtually. Virtual meetings have caused 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), or a spinal problem such as arthritis or sciatica. Common causes of lower back pain when sitting (but not standing) include prolonged time spent in a chair, lack of regular exercise, and poor posture.

Prolonged sitting 

Sitting for prolonged periods of time increases stress and strain on the back muscles and spinal discs. Spinal discs act like cushioning pads between your vertebral bodies, 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 kind of 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 many Americans still doing work and sometimes school from home, a lot of these small breaks have been erased. 

Inactivity

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 the COVID-19 pandemic. “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 decreased. When routines are disrupted, it is often hard to summon the motivation to exercise at home. These changes are resulting in people who never experienced back issues experiencing pain. “Many of my patients have reported new aches and pains,” comments Saiah Yates, DPT, Loch Raven Veteran Affairs Inpatient and Outpatient Physical Therapist. “The fear and very present risk of catching COVID has limited people’s outdoor and social activities.” Even though vaccines and new treatments offer protection, new variants mean continued vigilance against the virus, which  may keep people home.

Poor posture

Before the pandemic began, the average American used screens for about four hours a day. Now that number has increased 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,  causing the strain. Low back pain from sitting for extended periods is often also associated with neck pain and shoulder pain.

How can I prevent lower back pain when sitting?

There are simple steps you can take to decrease the negative impact of being glued to your seat all day (and night) long.

At-home ergonomics

Ergonomics is the study of what makes a work environment comfortable and productive.  Many companies and schools put significant attention into spacing equipment in a way that suits long-term sitting. Ergonomic design is vastly different from the common 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 put your computer atop 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, you 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, giving lower backs 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, which can be used to help restore back function.

How to relieve lower back pain from sitting

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 is usually helped with  physical therapy, over-the-counter or prescription pain medications. Uncommonly, back pain may require surgery.

RELATED: Lower back pain treatments

Regular stretching and exercise

Even the most comfy, ergonomic chair can contribute to back pain if sat in for too long. Finding ways to be more active each day is essential to preventing and alleviating pain. Most medical providers recommend taking active breaks. 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 medications

Over-the-counter (OTC) anti-inflammatory medications, such as acetaminophen 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 mild anti-inflammatory effects. 

RELATED: Non-opioid pain management

When to see a doctor for back pain

Seeking professional medical advice can help rule out red-flag signs or symptoms. Red flags are unintentional weight loss, fever, night sweats, history of cancers, neurologic symptoms (weakness, falls, numbness), bowel or bladder incontinence, use of injectable drugs, current use of corticosteroid medications, or recent spinal surgery. 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 physical medicine and rehab physician, physical therapist, or orthopaedic specialist 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 you.

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