Sitting down – Why does it hurt?

 

By Virginia Nsitem

Do you have difficulty sitting down comfortably because of low back and pelvic pain? Do you use a soft cushion to relieve pain when sitting down? Do you shift your position frequently or are you restless when sitting down for a long time? Do you have difficulty sitting on hard or very soft chairs? This article will discuss the causes of pain that interfere with sitting.

Lumbar Spine and Pelvis Anatomy

The lumbar spine has five vertebral bones separated by vertebral discs (shock absorbers of the spine). The spinal bones are connected to one another by ligaments, tendons, and muscles. The low back provides flexibility and strength to the body. The lumbar spine attaches to the sacrum bone and the sacrum bone attaches to the coccyx (also called the tailbone).

The pelvis is made up of two hip bones connected at the back by the sacrum bone (forming the sacroiliac joints) and in the front by a cartilage joint. The hip bones actually have three parts – the large ilium bone that gives us the shape of our hips, the ischium which is the bony part of the buttocks that we sit on, and the pubis which is the bone below the abdomen. The pelvis is a strong structure that helps to hold the weight of the upper body when we sit and stand. There are many muscles and ligaments in the pelvis, and some important pelvic muscles include the hip flexors, piriformis, and the gluteal muscles.

What happens to our body when we sit down for long periods of time?

  1. The discs in the spine compress, especially between the fourth and fifth vertebral bones in the lumbar spine (L4-L5).
  2. The hip muscles tighten and shorten.
  3. The body tends to slouch, causing muscle imbalance and increased pressure on the joints of the spine.
  4. Reduced blood flow to the buttock muscles.
  5. Pressure on the buttock muscles and nerves.
  6. Pressure on the “sitting bones” in the buttock (called ischial tuberosity).
  7. Pressure on the bursa in the pelvis causing bursitis.

Symptoms of back and pelvic pain caused by sitting

Pain when sitting usually occurs after sitting for an extended period of time, and with poor posture. Common symptoms include:

  • Achy and stiff back muscles
  • Tender and achy buttock muscles
  • Buttock pain at the “sit bones” or the tailbone
  • Pain that radiates from the back to the buttock
  • Numbness and tingling in the buttock region
  • Pain the radiates to the groin region
  • Difficulty sitting on one side of the buttock
  • Difficulty rising from a seated position

As the pain worsens, it may interfere with other activities, such as walking and standing.

Relief of Back and pelvic pain caused by sitting

Before treatment and rehabilitation can begin, it is important to get an accurate diagnosis. In addition to a physical examination and a thorough understanding of your symptoms, you may be referred for additional tests such as x-rays, CT scans, or MRI studies. Chiropractors specialize in diagnosing, treating, and rehabilitating injuries of the spine, muscles, ligaments, tendons, joints, and nerves.  A correct diagnosis is important to rule out more serious conditions that may be causing your pain and symptoms. The focus of the treatment is to reduce pain, restore flexibility and strength, return you to regular activities, and prevent a reoccurrence of the injury.

 

Your treatment by a chiropractor may also include:

  • An ergonomic assessment of how you sit, and tips to improve your sitting posture.
  • Chiropractic treatments for the spine and pelvis to improve flexibility, balance, and strength of the muscles and ligaments, and restore proper movement to the joints.
  • The addition of massage therapy and acupuncture to your rehab program may aid in pain relief.
  • Advice on how to include “micro” breaks throughout your day to stretch tight muscles, improve circulation, and change your posture.
  • Advice on how to choose the proper supportive chair, and a reminder to avoid the common mistake of sitting on your bed to do work, read, or watch TV.

Stop the Pain … Before the Pain Stops You!

 

(Dr. Virginia Nsitem is a chiropractor specializing in laser therapy for spine, muscle, joint, and nerve injuries, and is a Fellow of the Royal College of Chiropractic Sports Sciences in Canada. She may be reached at (905) 275-4993, or by email at totalhealth@bellnet.ca )