Is it better to stand or sit when I have low back pain?
The load on the lumbar spine should be reduced as much as possible both during and between episodes of low back pain, and this can be achieved to a certain extent by adjusting the body position and posture. The impact of body position and posture on the lumbar spine load can be summarized as “sitting is better than standing, standing is better than upside down”, which means that the load on the lumbar spine is greatest when sitting and least when lying down.
Specifically, if the pressure in the disc in the standing position is regarded as 100%, then the pressure in the lumbar disc in the supine position, lateral position and sitting position is 25%, 75% and 140% respectively, 150% in the slightly forward leaning standing position, 185% in the slightly forward leaning sitting position, 220% in the forward leaning standing position, and 275% in the excessive forward leaning position.
Regardless of which position or posture, the duration is too long is not good. Because any position or posture will have the corresponding muscles, ligaments in a state of tension, lasting too long will cause these muscles, ligaments fatigue, thus reducing lumbar stability, eventually leading to increased load on the lumbar spine.
Therefore, in daily life or work or try to avoid maintaining a certain position or posture for a long time. If the job requires a certain position (such as a software engineer), it is best to ensure regular rest, use a small alarm clock if necessary, and get up regularly to do relaxation exercises, etc.
What do people with low back pain need to pay attention to in their daily life?
One of the characteristics of low back pain is that it is recurrent, so in a sense, prevention is more important than treatment. In daily activities, patients with low back pain have the following things to pay attention to.
1, the correct sitting posture: sitting in the lumbar spine as convex as possible on the basis of trying to keep the lumbar muscles relaxed to reduce the pressure on the lumbar intervertebral discs, if possible, with the help of lumbar cushion volume or lean back in the seat backrest to maintain the lumbar spine physiological convexity, ideally can reduce the pressure in the intervertebral discs by 300%.
But even so, prolonged sitting is still detrimental to the lumbar bones and soft tissues. It is generally recommended that about 1 hour of continuous sitting must get up for lumbar activities in all directions, so that the muscles are fully relaxed and timely rest.
2, correct standing posture: head high, waist lightly convex, abdominal, not hunched back. In the queue, waiting for the car, often people are accustomed to the weight falls on one foot, in the long run may also lead to the spine, lower limb muscle imbalance, should be consciously adjusted.
3, the correct transfer method – rolling log transfer method, meaning the so-called overall transfer, refers to turning over, moving in the bed and sitting up from a supine position to keep the trunk in a straight line.
4, the correct posture when carrying heavy objects: stand close to the heavy object, bend the knees, bend the hips, that is, keep the waist upright state squat, after using the strength of the legs to rise and lift the heavy object, stand straight, move the legs and turn around to avoid twisting the waist.
5.Posture to be avoided: avoid repeated forward bending, weight-bearing, twisting and any other posture of the lumbar spine that will cause increased pressure within the intervertebral disc, especially in the acute phase of low back pain, which is essential to reduce the symptoms. It is generally recommended to avoid lifting or carrying heavy objects over 4.5 kg during the acute phase of lumbar pain, and to gradually increase the weight bearing thereafter according to the patient’s response.
Why do patients with low back pain need to sleep on a hard bed?
It has become a common sense that patients with low back pain should sleep on a hard bed. What is the rationale? It is mainly related to the pressure load on the lumbar intervertebral disc. As mentioned earlier, the lumbar discs are subjected to the least load in the recumbent position, mainly because the weight of the upper body no longer exerts pressure on the lumbar spine. In addition, the bones, muscles, ligaments and other soft tissue tension also affects the load due to the lumbar spine to some extent.
Too soft mattress is not suitable for patients with lumbar pain, because at this time the patient’s spine is in a state of scoliosis, muscles, ligaments are also in a state of imbalance, do not get sufficient rest. Therefore, regardless of low back pain patients or healthy people, it is recommended to sleep on a soft and hard bed to reduce or prevent the occurrence of low back pain.
Can back and leg pain “lie well”?
Some young patients are very impatient during the acute phase of low back pain and always want to move around and start various functional exercises as early as possible. Unbeknownst to them, rest itself is a primary and necessary treatment for patients with low back pain. In the acute stage of low back pain, it is generally recommended that patients rest strictly in bed for 2-3 weeks, which can effectively reduce the pressure of weight on the lumbar disc, promote the absorption of local inflammation, reduce the stimulation of nerve roots, and thus reduce pain or even make the pain disappear. Therefore, low back pain patients “lie well” is not just talk.
So, is it better to “lie on your back” (supine position) or “lie on your side” (lateral position)? For the pressure on the lumbar intervertebral disc, in the hip flexion supine position, the lumbar muscles are more relaxed, can make the lumbar intervertebral disc pressure further reduced; and hip extension supine position is due to lumbar muscle tension and to a certain extent increase the local pressure; prone position, lumbar convexity increases, pulling the muscle, will also lead to increased load on the lumbar intervertebral disc.
However, for patients with low back pain, the muscles of the lumbar region are often already in a state of imbalance, and the lumbar discs may already have pathological changes such as bulging and herniation, so the general rules may not necessarily apply. At this time to decide the position according to the patient’s response, simply put, is “how comfortable how to lie down”, because “comfortable” is actually the bones, muscles, ligaments and other soft tissue is more relaxed state.
Back and leg pain can “lie well”?
In addition to lying, “lying” for low back pain patients is also a very good posture treatment.
For the general population, “lying” on the waist is also a very good health care action. The human body every day from the opening of the eyes, washing, toilets, dining, driving, sitting at a desk to work …… statistics, a day of bending actions have 3000 to 5000 times, while the spine back extension action is only 60 to 70 times, which is a set of extremely unbalanced data, is also the cause of unbalanced spinal force one of the reasons . Therefore, lying down to chat and watch TV not only can be cute, but also can effectively treat and prevent back pain!