Back pain when standing is one of the most common complaints amongst back pain sufferers. Sometimes the pain is present at the base of the spine (SI joint), along the spine, across the spine, or in the muscles on the sides of the spine (quadratus lumborum). Common diagnoses that go along with this type of low back pain include degenerative disc disease, disc herniations, spinal arthritis, stenosis, and lower back strains.
To obtain an accurate diagnosis, an examination would be needed. Although there are differences in how you should treat each of these conditions, common limitations exist when it comes to low back pain and standing. In many cases, imbalances at the ankles, trunk, and buttock muscles may affect your posture. If you have tightness or weakness in the hip flexors, lower back, abdominals, glutes, hamstrings, and upper back, you may be standing in an overextended posture.
If you stay in an overextended posture, you may compress the facet joints of the spine and fatigue your spinal muscles. If you have weakness in the core and spinal muscles and you combine this with prolonged standing, you may experience lower back pain. Considering that back pain when standing could be due to a multitude of reasons, the best way to know what is contributing to your back pain is to have an assessment performed.
In order to have less pain when standing, you should make some modifications to your environment. Standing in one place is not the most comfortable position to be in. Moving at regular intervals can help you unload an irritated spine. In addition, investing in a simple stool or fidget bar to prop a foot can create a more comfortable standing position. These changes should help you have less pain when standing. If your back is especially irritated, receiving hands-on physical therapy can help you alleviate pain more quickly. Treatments like dry needling, joint manipulation and mobilization, and soft-tissue mobilization can help bring your pain to a more manageable level. In addition, exercises like the "Angry Cat" can provide relief to tense spinal muscles. Once your pain has subsided, you can now address the root causes of why you're experiencing back pain you experience when standing.
If you have a weakness, learning how to activate muscles that are not firing well is key. When it comes to low back pain when standing, the muscles that often need attention are the glutes, hamstrings, hip flexors, and abdominals. In some cases, endurance of spinal muscles must be developed to withstand the demands of prolonged standing. Some exercises that are effective during this stage include the bridge with adduction, hip hurdle, and prone hollow.
Once your muscles engage better, the next step is restoring movement. To be able to stand comfortably, you need to be able to extend at your hips, spine, and ankles while maintaining an upright torso. If you are missing movement at any of these regions, you may compensate with your spine and experience back pain with prolonged bouts of standing. Exercises that are effective for restoring movement as it relates to standing include tall kneeling hip extension, calf raises off a box, and prone lumbar extension/rotation.
After you have restored movement, you need to develop strength in the hip hinge pattern. Practicing the hip hinge pattern will enable you to develop the strength of your backside and the stability of your trunk. Strength and stability will enable you to keep a healthy spine for a long time. Exercises that are helpful in building strength in the hip hinge pattern include the deadlift, kettlebell swing, and bent-over rows. Resistance can be used in the forms of barbells, dumbells, or kettlebells. Being able to generate tension through your hips, thigh, and foot muscles when hip hinging is key to staying healthy and enjoying an active life.
Most of the exercises mentioned above can be found in our video library.
When addressed with a specialized physical therapy program, overcoming back pain when standing is possible. However, ignoring pain could result in a further decline in your spine health. If you're worried about your back pain, the physical therapists at Movement Solutions would be glad to help you.
We invite you to request a back consultation with one of our specialists. This is an opportunity to ask questions, obtain clarity about your back pain, and foster confidence that we can help you. If you’re certain that we’re a good fit to work together, you can decide on the next step.
If you’re in back pain but unsure about what you should do, call us at (864) 558-7346 and ask how we can help.