Why does standing still make my lower back hurt?
Back pain is the leading chronic pain condition worldwide, with over 80% of us experiencing it at some time in our lives. Common medical advice for back pain is to stand for periods of the day, but for many people standing still makes their pain worse, and they don’t know why.
One cause may be in the fascial system and how it works to support your body. Fascia is a body-wide network of connective tissue, connecting everything to everything else, at every level from surface to deep inside.
When working normally, fascia provides both the support and movement for the body to act as a tensegrity structure. Taken from architecture, tensegrity structures are self-supporting with a synergy between tension and compression that produces a perfectly balanced and incredibly strong structure. It is tensegrity that allows bridges and buildings to move with the forces of weather yet remain safe and intact.
In the body, perfectly balanced fascia provides for a structure that can self-support against the forces of gravity without any physical effort. This is contrary to traditional anatomical teaching which says that it is bones that provide the structure and muscles the movement. From a fascial perspective, this is still true to a degree, but without fascia the balance would be lost and our skeleton nothing more than a pile of bones on the floor.
The pelvis-back connection
A key balance pivot point for back pain is the pelvis. Movement originating from the pelvis is transmitted throughout the body by a combination of fascia, muscle, ligament, tendon and bone working together as a structural unit.
Working in conjunction with the pelvis is the thoracolumbar fascia (TLF) which is a large flat sheet of fascia that covers the lower back. It serves as a hub, a connection point attached to the pelvis and lumbar vertebrae (the bones of the spine), the muscles of stability (abdominal and pelvic floor), and the muscles of movement in the buttocks, legs and back.
The TLF not only provides stability, it also transmits movement between upper and lower body in vertical, diagonal and rotational directions. It is the force transmitted through the TLF that allows us to walk, swinging not only our legs, but also our arms and our hips as we move.
Causes of lower back pain
However, any change to this natural balance can have a profound effect on our whole tensegrity system. For many of us our daily lives can create imbalance.
Sitting is a key culprit, whether at a desk, driving, or sitting for prolonged periods. Sitting tightens and shortens our hip flexor muscles and associated fascia (deep in the front of your pelvis), shortens our hamstrings in the back of our thighs, and weakens our gluteal muscles in our buttocks. Slumping while we sit deactivates our core abdominal muscles and pelvic floor, while staring at a computer screen pulls our head and shoulders forward.
Some of this may be sounding familiar. The combined effect is to throw our body out of balance as the body is pulled forwards and the pelvis tips forward exaggerating the curve in our lower back. At the same time, our back, buttocks and legs have to work harder to keep us upright. For many people, this pull forwards is combined with a twist in their body to one side.
Your body is now working hard to stay upright and level. And this is most exaggerated when you are standing still as the tissues have no opportunity to rest, unlike when you walk or move which spreads the load between different body areas. So it is hardly surprising that your tight and weak muscles and fascia tighten more, squashing pain sensitive structures and that your pelvis locks into uneven positions which compress the joints and bones.
Not only does this explain what a pain in the back standing still can be, but also how imbalance can contribute to long-term issues such as osteo-arthritis.
Self-help for back pain
Some simple ways to help release your back and pelvis include regular movement, whether walking or a whole body movement therapy like tai chi or qi gong. You can find out more in our Living Pain Free online programme with useful videos of fascial exercises and stretches can also help to undo some of the restrictions that are holding your body out of balance.