Back pain and stiffness with prolonged standing is one of the most common issues that we treat at our physical therapy office. Sometimes the pain and stiffness is 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 associated with back pain/tightness with standing 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 we treat each of these conditions, we’ve found that common limitations exist when it comes to prolonged standing, back pain, and stiffness.
In many cases, imbalances at the ankle, trunk, and buttock muscles can result in an overextended posture.
Being stuck in an overextended posture for long periods of time can cause compression of the facet joints of the spine and fatigue of the spinal erector muscles. If this is combined with weakness of the core and spinal muscles, back pain and stiffness may result.
Considering that back pain and stiffness is multifactorial, the only way to know what is contributing to these symptoms is to perform a full body assessment.
Once we know what the specific limitations are, our first recommendation is to make some modifications to the environment. Static standing is not the most comfortable position to be in. Moving at regular intervals can help unload irritated or sensitized tissues. In addition, investing in a simple stool or fidget bar to prop a foot on can create a more comfortable standing position. These changes create an environment for irritation to subside. While moving and optimizing ergonomics can help with pain, we know for our patients to stand comfortably, we have to address the root of the issue.
When pain and stiffness is found via our assessment, our approach includes manual mobilization to alleviate pain and improve mobility. Pain improvements can be made very quickly with soft tissue mobilization and/or dry needling of the thoracolumbar, lower back, and quadratus lumborum muscles. Flexion oriented exercises can provide relief to tense spinal muscles.
If weakness is found, we teach activation exercises to help our clients better engage muscles that are not firing well. In some cases, endurance of spinal muscles must be developed to withstand the demands of prolonged standing.
Once pain is controlled and muscles engage better, our next step is developing strength and durability with load. When performed with the right technique, deadlifts, kettlebell swings, and other hinge movements can develop strength and durability of the posterior chain (lats, lower back, glutes, hammies).
When addressed with a thorough physical therapy assessment and plan of care, prolonged standing without back pain is possible. Ignoring symptoms, on the other hand, may lead to strength and muscle loss from activity avoidance and pain that takes longer to resolve. If you have back pain and stiffness with standing, the physical therapists at Movement Solutions would be glad to be a resource for you.
We have a free guide on relieving back pain and stiffness that can give you further insight into back problems and help kickstart your recovery. We are available for a free 15-minute phone consultation to talk about how your pain is affecting you and discuss your treatment options.
If your concerns warrant an in-person consultation, we offer a limited number of free Discovery Visits at our office. This type of appointment of for those who are interested in working with us and resolving their back pain and stiffness. It is an opportunity to ask questions, obtain clarity, and develop confidence that we can help. If you have back pain and stiffness and unsure about what your next steps should be, call us at (864) 558-7346 and ask how we can help.