How your Routine Activities Are Worsening Your Back Pain

80% of people experience low back pain at some point in their lives which is a key indicator that there is more to be improved and analyzed when treating this common issue (Zhai et al., 2024). Within current research on chronic back pain, 85% of cases are unclear of reason and misunderstood, therefore it's valuable to dive deeper into this issue. Factors from our work, activity level, and mental health can all affect pain. With all to consider, it is valuable to look over some triggers for our pain and ways we can prevent it. 

Is sitting or standing better for Back pain?

A study from 2024 comparing pain levels in standing and sitting found that a lack of movement of the spine can often increase back pain symptoms (Zhai et al. 2024). The results concluded that 85 percent of participants had pain with sitting for a long period and 73 percent had pain with standing. This leads to the proposition that standing is a better alternative to sitting for pain reduction. For many people, their occupation requires a lot of desk work which can result in pain especially if someone is sitting in the same position for many hours of the day. To add evidence of standing resulting in less pain than sitting, it has been shown that there are benefits for individuals in the workplace to increase their standing time at a desk (Nelson-Wong et al., 2020). If you are worried that going from sitting to standing can cause you some discomfort, you can slowly progress over time to accommodate yourself to it. In current research published in 2020, people who were intolerant of using a standing desk were slowly able to adjust over time by replacing sitting with standing in small increments (Nelson-Wong et al., 2020). Evidence has shown after several weeks of slowly adjusting to standing that there were great reductions in pain even for individuals who have been intolerant to standing in the past. 

With standing being the better alternative, what else can you do to decrease your back pain and why?

In the research mentioned previously, participants were also monitored for their pain while doing exercise (Zhai et al. (2024). When more movement was involved, there was a significant reduction in individuals who experienced pain: only 23% of people experienced pain while walking and 15 percent of people experienced pain while cycling. So, exercise can be extremely beneficial in improving one's pain symptoms and overall well-being. 

Just because there is evidence of exercise reducing back pain this doesn't tell us why this could be the case. Searle et al. (2015) found that people with back pain have a decrease in activation of the spinal musculature in these areas which leads to a weakness and results in a decrease in support in the lumbar spine. With weaker trunk muscles, it can also put a strain on the joints and ligaments enhancing stress in these areas. This demonstrates how important and beneficial challenging the muscles in the spine can be especially for individuals who are experiencing pain. 

Types of exercises that ARE most effective for back pain

The way training protocols are defined is vital for understanding and optimizing one's recovery. It has been shown that in chronic nonspecific low back pain, there is a benefit from moderate-intensity training (MIT) and high-intensity training (HIT) (Verbrugghe et al., 2019). Moderate-intensity training can be defined as completing cardiovascular exercises and resistance training exercises with 60 percent difficulty of maximal effort, high-intensity training is close to a maximal effort between 80 percent in cardiovascular exercise and resistance training. 

An example of HIT demonstrated by Verbrugghe et al. (2019) is the cardiorespiratory exercise of biking at a near maximum effort followed by a general resistance training program of 12 repetitions at 80% of maximal effort. Exercises that were involved in the general resistance training included three upper body exercises (chest press, arm curl, and shoulder press) and three lower body exercises (leg curl, leg press, and leg extension). The MIT program was very similar to HIT except the biking was at 60% of maximal cardiovascular effort, and the general resistance training was at 15 repetitions at 60% of maximal effort completing the same resistance exercises. The results of the current study indicated that both forms of exercise were beneficial but HIT had more benefits than MIT. In other words, you can do both types of exercises and benefit from them but high intensity has been shown to relieve symptoms more effectively. 

CONCLUSION 

Back pain is an extremely common issue that affects a wide array of populations so it can be challenging at times to know how to deal with it. Studies in the last four years have evaluated sitting compared to standing in individuals who suffer from back pain and found that pain is less common in those who stand more often. To further enhance pain-free symptoms, one can incorporate exercising into their routine to increase the motion of the spine which will lessen one's pain. Specifically, it has been found that choosing exercise regimes of moderate to high-intensity appear to be most effective. Beyond the benefits in pain reduction exercise has the added benefit of improving strength and cardiovascular capacity. You can always consult with a Victoria Chiropractor and Physiotherapist to build a complete treatment plan.

References

1. Nelson-Wong, E., Gallagher, K., Johnson, E., Antonioli, C., Ferguson, A., Harris, S., Johnson, H., & Miller, J. B. (2020). Increasing standing tolerance in office workers with standing-induced back pain. Ergonomics, 63(7), 804–817. https://doi.org/10.1080/00140139.2020.1761034

2. Searle, A., Spink, M., Ho, A., & Chuter, V. (2015). Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 29(12), 1155–1167.

3. Van Deursen, L., Patijn, J., Durinck, J. R., Brouwer, R., Van Erven-Sommers, J. R., & Vortman, B. J. (1999). Sitting and low back pain: the positive effect of rotatory dynamic stimuli during prolonged sitting. European Spine Journal, 8(3), 187–193. https://doi.org/10.1007/s005860050155

4. Verbrugghe, J., Agten, A., Stevens, S., Hansen, D., Demoulin, C., O. Eljnde, B., Vanadenabeele, F., & Timmermans, A. (2019). Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Medicine & Science in Sports & Exercise, 51(12), 2434–2442. https://doi.org/10.1249/mss.0000000000002078

5. Zhai, H., Zhang, L., Xia, J., & Li, C. (2024). The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis. Journal of Sport Rehabilitation, 33(3), 189–200. https://doi.org/10.1123/jsr.2023-0207