Prolonged Standing Back Discomfort: Chiropractic Rehabilitation

Prolonged standing can cause the pelvis to push backward, increasing the curve of the lower back/lumbar region. This increased pressure on the soft tissues surrounding the spine causes the lower back muscles to tighten and/or spasm, resulting in discomfort in the joints and nerves. Weakened core muscles and unhealthy posture/postural syndrome are the most common causes, but injury, aging, congenital malformations, or a disease/condition can also contribute to the symptoms. Injury Medical Chiropractic and Functional Medicine Clinic has a top team of professional therapists to evaluate the problem, diagnose the cause/s accurately, and develop a customized treatment and rehabilitation plan.

Prolonged Standing Back Discomfort

Back Structure

The lower back is one of the most used areas of the spine, moving around and bending during a normal day. When the body stands, the spine naturally curves both in and outwards.

• The inward curve, called lordosis, curves towards the front of the body at the lower back and neck regions.
• The outward curve, called kyphosis, curves towards the back of the body at the chest.
• When bending over while standing, the five lumbar vertebrae of the lower back change position and shift from lordosis to kyphosis when bent completely.
• When standing up from bending, the lumbar vertebrae change position again and return to the lordosis position.

Causes

The facet joints allow movement between each spine level. The standing spinal curvature can increase contact between the facet joints. As the body ages, the facet joints and discs begin to wear out, which can cause the discs and facet joints to become inflamed. Prolonged standing during normal daily activity combined with inflammation in these joints can aggravate the inflammation and cause symptoms. Regular routines and habits may contribute to low back discomfort during prolonged standing. These include:

• Sleeping on a sinking or unsupportive mattress.
• Practicing unhealthy postures that cause imbalances with proper weight distribution.
• Not wearing proper footwear and/or supportive orthotics forces the lower spine into increased curvature and can compress the facet joints.
• Not getting enough physical activity that strengthens the core.
• Improperly lifting and carrying objects.
• Excess weight makes the body heavier.

Standing Recommendations

Some recommendations may help:

• Stand for shorter periods.
• When symptoms start to present, it is recommended to change position.
• A sitting-to-standing workstation or desk that adjusts could help.
• Move around and stretch out to improve circulation and decrease muscle fatigue.
• Try placing one foot on a step while standing, limiting excessive spine curvature.
• Try back and spine support footwear.

Chiropractic

Chiropractors are experts on the musculoskeletal system. They will:

• Listen to the patient about symptoms, medical history, and occupation.
• A physical examination of muscle tone, strength, and range of motion.
• Therapeutic massage, electric muscle stimulation, and ultrasound therapy can help reduce muscle inflammation and increase circulation to injured soft tissues.
• Chiropractic adjustments will reset joints, removing pressure from the surrounding muscles and nerves.
• Targeted therapeutic strength training is recommended for core and leg muscles to improve hip flexibility.
• Non-surgical decompression or traction, either with a machine or suspension, can reverse the pressure in spinal discs.

Standing Lower Back Relief Exercises

References

Hasegawa, Tetsuya, et al. “Association of low back load with low back pain during static standing.” PloS one vol. 13,12 e0208877. 18 Dec. 2018, doi:10.1371/journal.pone.0208877

Jo, Hoon, et al. “Negative Impacts of Prolonged Standing at Work on Musculoskeletal Symptoms and Physical Fatigue: The Fifth Korean Working Conditions Survey.” Yonsei medical journal vol. 62,6 (2021): 510-519. doi:10.3349/ymj.2021.62.6.510

Ognibene GT, Torres W, von Eyben R, Horst KC. Impact of a sit-stand workstation on chronic low back pain: randomized trial results. J Occup Environ Med. 2016;58(3):287-293. Abstract. www.ncbi.nlm.nih.gov/pubmed/26735316. Accessed March 2, 2017.

Parry, Sharon P et al. “Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers.” The Cochrane database of systematic reviews vol. 2019,11 CD012487. November 17, 2019, doi:10.1002/14651858.CD012487.pub2

Rodríguez-Romero, Beatriz, et al. “Thirty Minutes Identified as the Threshold for Development of Pain in Low Back and Feet Regions, and Predictors of Pain Intensity During 1-h Laboratory-Based Standing in Office Workers.” International journal of environmental research and public health vol. 19,4 2221. February 16, 2022, doi:10.3390/ijerph19042221

Smith, Michelle D et al. “The Influence of Using a Footstool during a Prolonged Standing Task on Low Back Pain in Office Workers.” International journal of environmental research and public health vol. 16,8 1405. April 18. 2019, doi:10.3390/ijerph16081405