You’re likely familiar with back pain caused by too much physical activity, heavy lifting, and other strenuous causes. You may be less informed about the back pain that can occur from sitting still. Lately, when I have been meeting patients for the first time, they tell me that their pain began in March, coinciding with the start of the COVID-19 pandemic.
Patients working from home are unable to maintain normal routines, which leads to increased sitting in areas of the home that are not properly designed for work. Many don’t have a dedicated space with a desk and a desk chair. As a result, they often find themselves sitting in uncomfortable chairs with poor posture for hours at a time.
Studies have shown that sitting is one of the worst positions for the discs in the low back. When sitting, there is increased pressure placed on the discs, and this can lead to the discs “herniating.”
Discs can be thought of as jelly donuts that serve as cushions between the vertebrae – they have a harder outer portion and a softer inner portion. A herniated disc occurs when a disc is damaged and some of the soft, inner portion (jelly) leaks out of the hard, outer portion (donut). When this occurs, the jelly can irritate nearby nerves, and “sciatica,” or pain, numbness, and tingling traveling from the low back or buttock down the leg, may occur.
When patients develop sciatica, pain can be debilitating. Thus, the natural tendency may be to stay in bed to avoid pain. However, studies indicate that early mobilization is important. Seeking medical advice in order to make sure that you are moving in ways that promote healing rather than aggravating symptoms is key. In the meantime, there are methods to manage your injury and relieve your pain.
Apply heat or ice.
Applying heat to the lower back area may help to relax your muscles. Applications may include dry heat products, such as heating pads and wearable heat packs, as well as moist heat methods, like pressing a warm washcloth on the area or taking a warm bath.
Icing the area by using ice packs or other cold compresses can also reduce pain and swelling. This is best utilized when you initially sense pain in the lumbar region. A combination of both is sometimes effective, as well. Treat lower back pain with ice for the first couple of days, then consider switching to heat.
Exercise.
If performing a particular exercise perpetuates your lower back or leg pain, stop this movement immediately – “let your body be the guide” is a great rule to follow. Familiarize yourself with simple back strengthening exercises and ease into a gentle routine. By doing a variety of strength and flexibility exercises, your back muscles will better adjust to movement.
Attend physical therapy.
After evaluating your back injury or condition, your physician may recommend seeing a physical therapist or researching physical therapy exercises on your own. These exercises are specifically prescribed to patients for regaining regular motion of an injury area.
Ask about medications.
Anti-inflammatory medication can be effective when you are having an acute flare of pain in the lower back. Muscle relaxers or medications that treat nerve pain may also be effective, especially if you are having trouble sleeping due to pain. However, it is imperative to only take medication with your doctor’s approval, as these medications may cause side effects or interact with other medications that you are taking. Describing your level of pain will help a doctor determine whether medication is necessary and what dosage to prescribe.
Ask about injections.
Depending on the type and duration of pain that you are having, your doctor may decide to order an MRI to get a better look at your spine. Depending on the results, you may be a candidate for an epidural steroid injection, where anti-inflammatory medication is delivered to the site of a damaged disc using x-ray guidance. The procedure typically takes less than 5 minutes and there is very little downtime afterwards. Significant relief can be seen within a few days.
Don’t panic!
Anxiety has been shown to worsen pain levels, so remember that most causes of back pain are benign and improve without the need for surgery.
Dr. Paul Kitei is a Physical Medicine & Rehabilitation specialist and sees patients in Center City and South Philadelphia. For more information or to make an appointment, click here.
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