Do you have lower back pain when standing up from a sitting position? This is a symptom that means that there are specific problems in your back. Let’s dig in.
What Are The Parts of Your Low Back?
Your low back has vertebrae (spine bones), discs, facet joints, ligaments, muscles, and nerves (1). To see how they come together and what the facet joints do, watch my video below where I build a spine from scratch:
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Why Do You Have Lower Back Pain when Standing up from a Sitting Position?
When you’re seated, the facet joints in your lower back are in an open and slightly flexed position. When you stand up, these joints compress. If they are painful or have arthritis, you’ll have pain as you stand up because this puts pressure on the painful joints. In addition, if there is any type of movement of one vertebra forward on another (called spondylolisthesis), then this shift will have occurred as you sit. This is called degenerative spondylolisthesis (2). When you get back up, the vertebrae will come back into position after a few seconds, leading to that awkward “walk it out period” that starts out painful and ends up more normal.
What is the Best Sitting Position for Lower Back Pain?
If you have a degenerative facet joint problem, the best position is to place a pillow in the small of your low back. This will maintain the normal low back curve and allow you to sit longer with less pain when getting up. At home, this can be easy to do, but when you’re out, an easy thing to use is a rolled-up jacket or sweater. In a pinch, I’ve even used my cell phone!
Is There Something That Can Help without Surgery?
First, physical therapy should be your first choice. If that fails, a new procedure that uses precise injections of your own concentrated blood platelets or bone marrow stem cells may be the answer. This is called the Percutaneous-Functional Spinal Unit procedure. The more traditional procedure that’s often used is lumbar fusion (3). This means that the spine bones are fused together using rods and screws. The problem is that not only is this a big surgery with poor outcomes, it can also lead to adjacent segment disease (4-6). To learn more about that problem, see my video below:
Is There a Better Way?
Remember, that lower back pain when standing up from a sitting position is caused by a sloppy spine. Meaning, because of degeneration, one vertebra is slipping slightly forward on another. This is causing the facet joints to get beat up and become arthritic. Hence, any treatment needs to stabilize the spine by tightening ligaments and reducing the pain in worn facet joints. In the Perc-FSU procedure, the doctor injects healing platelets or bone marrow stem cells into the ligaments and facet joints using both ultrasound and fluoroscopy guidance. To learn more, see my video below:
The upshot? Lower back pain when standing up from a sitting position is caused by a sloppy spine. Getting this treated by fusing the spine is problematic. However, non-surgical treatments are available. _
(1) Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016;5:F1000 Faculty Rev-1530. Published 2016 Jun 28. doi:10.12688/f1000research.8105.2
(2) Wang YXJ, Káplár Z, Deng M, Leung JCS. Lumbar degenerative spondylolisthesis epidemiology: A systematic review with a focus on gender-specific and age-specific prevalence. J Orthop Translat. 2016;11:39–52. Published 2016 Dec 1. doi:10.1016/j.jot.2016.11.001
(3) Yavin D1, Casha S1, Wiebe S, Feasby TE, Clark C, Isaacs A, Holroyd-Leduc J, Hurlbert RJ, Quan H, Nataraj A, Sutherland GR, Jette N. Lumbar Fusion for Degenerative Disease: A Systematic Review and Meta-Analysis. Neurosurgery. 2017 May 1;80(5):701-715. doi: 10.1093/neuros/nyw162.
(4) Ratliff JK, Lebude B, Albert T, Anene-Maidoh T, Anderson G, Dagostino P, Maltenfort M, Hilibrand A, Sharan A, Vaccaro AR. Complications in spinal surgery: comparative survey of spine surgeons and patients who underwent spinal surgery. J Neurosurg Spine. 2009 Jun;10(6):578-84. doi: 10.3171/2009.2.SPINE0935.
(5) Zaina F, Tomkins-Lane C, Carragee E, Negrini S. Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database Syst Rev. 2016;2016(1):CD010264. Published 2016 Jan 29. doi:10.1002/14651858.CD010264.pub2
(6) Saavedra-Pozo FM, Deusdara RA, Benzel EC. Adjacent segment disease perspective and review of the literature. Ochsner J. 2014;14(1):78–83.