Do you spend hours a day sitting in an office, driving a car or truck or even lounging around watching TV or playing video games? Chances are, you’ve experienced a stiff or achy back.
According to the World Health Organization, low back pain is the single most common cause of disability worldwide. Frequent sitting is a real problem: A 2021 meta-analysis of 27 studies found a sedentary lifestyle — especially prolonged chair sitting and driving — is one of the strongest risk factors for lower back pain.
Our tendency to enjoy sitting or lounging around seems to run counter to what our bodies were designed to do, according to the experts we talked to.
Your spine and the surrounding muscles aren’t meant to stay in the same position for long periods: “For most of human history, we’ve been constantly moving,” said Matt Weber, a clinical specialist in orthopedic physical therapy at Johns Hopkins Medicine. “We didn’t evolve for this level of inactivity.”
If you sit a lot, a few small routine tweaks can make a big difference. Here’s what physical therapists and orthopedic specialists want you to know about back pain from sitting, and how to improve symptoms.
Why sitting contributes to back pain
Good posture keeps your back in a neutral position, which means your spine maintains its natural, S-shaped curve. People with healthy spines have a natural inward curve in the lower back and an outer curve in the upper back, said Eseohe Edenojie, an orthopedic physician assistant with UTHealth Houston who specializes in back pain management.
Respecting these natural curves can help prevent back pain. Not sure whether you’re neutral? While sitting, try to keep your head centered over your body, with the back of your skull behind your shoulders and your chin a bit in front of your collarbone.
It’s admittedly hard to maintain this position when seated for a prolonged period. Sitting, Edenojie said, often causes the neck to curve forward, which “compromises the spine’s natural curvature.” When the lower back isn’t properly supported, it can shift extra strain onto the muscles, ligaments and discs that help stabilize the spine, resulting in pain.
Weber said keeping muscles in a contracted position for a long period can also lead to a buildup of chemicals that cause pain and stiffness.
Posture-related pain can affect any part of the back, from the neck to the lower spine, said Gina O’Brien, a physical therapist at the University of Pittsburgh Medical Center. People who sit a lot, she added, often complain of headaches, neck pain, mid-spine tightness and lower back pain that can cause pain, tingling or numbness down the glutes or legs.
If you’re mostly sedentary, Weber said, it’s also easier to hurt your back doing yard work or sports — because your muscles simply aren’t prepared for these movements.
Looking down at your phone for long periods can put additional strain on your upper back and neck, causing you to slump forward and leading to stiffness and pain — the infamous “tech neck.” Added tension in the neck area can also affect nearby nerves, resulting in referred pain in the arms and hands; cause headaches; and increase pressure on the entire spine, ultimately leading to low back pain.
The myth of ‘perfect posture’
When it comes to preventing back pain, experts said that varying the way you sit will move the needle more than trying to achieve the “correct” posture all day.
“Any posture you maintain, no matter how textbook it looks, is not going to be comfortable for a long period,” Weber said. “What tends to be healthy is changing what your spine and back muscles are doing throughout the day.”
Less sitting is definitely one part of the equation, whether that means getting up for a quick stretch break every few hours or exercising throughout the week.
One small study from 2024 compared back pain in people who reduced sitting by one hour a day to those who continued sitting for long periods. Over six months, back pain worsened in the group that continued sitting the same amount.
In an earlier study published in Preventing Chronic Disease, a journal published by the Centers for Disease Control and Prevention, people who were given a standing desk sat 66 minutes less per day and experienced a 54 percent reduction in upper-back and neck pain. When people went back to their normal sitting habits, the improvements disappeared within a few weeks. (The study was funded in part by a standing desk manufacturer.)
Adding more physical activity to your routine, Weber said, is an even better strategy. Along with giving muscles a break from being in the same position, movement helps reduce stiffness and builds strength to support your spine when you do have to sit.
How to improve back pain if you sit all day
If your back hurts from sitting a lot, here’s what experts recommend:
- Get up and move, ideally every half-hour. You don’t have to do a full workout to benefit — O’Brien said even quickly standing up or walking around for a minute or two can help reduce strain on the back. If you drive for a living, get out and stretch when you get gas or stop for a food or bathroom break.
- Change your sitting position often. Even subtle shifts in your neck, back and leg position can help. If you have a standing desk, switch between standing to sitting every hour or two. “You want to give your muscles the chance to feel new things and get into different positions,” Weber said.
- Set up your workspace ergonomically. O’Brien recommended sitting in a supportive chair with arms (your elbows should be at a 90-degree angle) and adjusting your desk or monitor so you’re looking straight ahead or slightly down. If possible, Edonojie suggested positioning your chair height so your knees are bent at 90 degrees, too.
- Work on building core strength. “Sitting involves endurance, and regular exercise can activate muscles so they can better support the spine all day,” O’Brien said. Edenojie said building core strength — whether through weight training, yoga or Pilates — can help your body better support your spine.
- Try a T-raise exercise. Lying on your stomach, extend your arms out to the sides to form a “T,” then lift them toward the ceiling, and repeat for two sets of six or eight. “This can help strengthen muscles that support you in a seated position,” O’Brien said.
If you’ve tried all of the above and your back is still bothering you, make an appointment with your doctor or a physical therapist, who can recommend specific exercises and lifestyle changes to help. “It’s never too early or late to consult with a professional,” O’Brien said.
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