23 Mar Low back pain positions…which are best?
For those of you with lower back pain, positioning is everything. Lets talk about the best and worst positions you can be in for your back pain.
The hierarchy of pressure on the lower spine from worst to best is this:
Most pressure = Most chance of pain
1. Bending forward with weight (lifting/carrying something) in standing (worst) or sitting **worst position
2. Sitting in poor posture/slumped
3. Sitting in good posture
4. Doing a sit up
5. Bending forward with no weight
6. Lower abdominal crunch: lowering legs while on your back
7. Standing
8. Sidelying
9. Laying flat on your back, knees supported
10. Laying flat on your back: **best position
So as you can see laying flat on your back is the best position to be in…which is why you will always see many back pain sufferers laying on their floor flat as opposed to laying on their back flat. The firm surface is best. However, while being the least pressure of this list, the important thing to remember is that ANY position for an extended period of time will still be detrimental and may cause pain…even laying on your back flat! This is because lack of movement also causes pain. (Think of how you feel in the morning after sitting still so long…its often very painful and stiff.)
So the take home message here is to change positions frequently, or maintain some movement/stretching even when on your back to keep your spine from sitting stagnant for long periods of time. Standing and walking is a great alternative. Although standing is #7 on the list and laying flat is #10, because walking also involves not sitting still and allows the muscles to warm up, it is also a great movement. Above all avoid sitting whenever possible, avoid bending forward (squat down instead of bending at the waist) and DEFINITELY avoid sitting with poor posture. Make sure you change positions frequently..you may try alternating between walking and laying flat and stretching while laying flat for instance. How long is too long to be in one position without moving? It depends on your symptoms and the intensity. The best approach is to figure out how long it takes you to stiffen up or have pain and then make sure to spend 10 minutes less that that time in one position, thus staying ahead of the pain.
Dont forget ice and heat are also great modalities to help pain. When you are laying on your back its an ideal time to ice or heat for 20 minutes. In general ice is good for pain and heat is good for stiffness so the two can be used interchangeably depending on your symptoms.