Ask a PT: How do I stand up to back pain?

Every day and every week, millions of people around the world have to stand in line for prolonged periods. In some places, people have to waited in line for several hours. It might be a queue for tickets, maybe a line at the airport, you might even by waiting to vote. Similarly, hundreds of millions of people are sitting at a desk for hours a day, staying sedentary while working at a laptop or desktop computer.

If you were one of those people, you may have noticed some pain in your low back. When we stand or sit for long periods of time without movement, our muscles are working to maintain that position.

The stress on some of our structures is particularly different when you’re standing. But what’s really to blame for the pain is the lack of movement. It’s not the fact that you’re sitting or standing that’s causing the pain. It’s the fact that you’re still.

Why does standing still cause back pain?

As we’ve talked about in other blog articles, our bodies really like variety and movement, and your brain perceives discomfort because your body is trying to tell you to move. Just like feeling your hand burn on a hot stove tells you to move your hand, feeling your back ache when you’re standing still is your body telling you to move - your tissues want more blood flow and to mix things up!

The easiest way to prevent pain from static positions is to avoid static positions. This means alternating between sitting and standing and going for frequent, short walks.

How can I stand in line without the pain?

It’s helpful to remember that standing in one place isn’t the same as standing still. Even in your position in line, you can almost always move around a little bit. Here’s how I do it:

• Start with some calf raises. Without leaving your place in line, rise up on your tiptoes, hold for two seconds, then lower your heels back down. Repeat for 30 seconds or so.
• Next, get that blood flowing by marching in place for 30 seconds.
• Then warm up those shoulders with some arm circles.
• If you dare, and you have the space (six feet of social distance is more than enough), try a set of 10-15 squats and 10-15 lunges.
• Repeat this every 10 minutes or so until you’re at the front of the line.

If you have kids with you, you can make movement into a game (think: Simon Says). Not only will it keep them entertained, you’ll get fewer strange looks if there are kids involved than if you’re moving around by yourself.

If you’re not comfortable being that active in line, simply mix up your posture. Shift your weight from leg to leg, then cross one ankle in front of the other. If there’s a wall or pole nearby, lean on a wall or a pole to change the load on your back. Rotate your torso side to side, and try gently nodding and shaking your head. Focus on taking deep breaths with long exhales (also good for helping stop impatience from building, and bringing you back to the present moment). If you can sit, whether on the ground, on a bench or in a folding chair, try to alternate between sitting and standing.

What are some other options when I have to stand still?

Whether you’re standing at the sink while washing dishes or standing in line at the grocery store, take a look around you. Is there an option to rest one of your feet on something? If yes, alternate having both feet on the ground with elevating one foot.

While washing dishes, open the cabinet under the sink. Rest one foot on the bottom shelf. Every few minutes, switch feet. Use the grocery cart the same way, resting one foot, then the other, on the bottom of it. Just remember that the cart will roll, so don’t lean into it!

Should I use a standing desk?

Variety is the spice of life and a key ingredient to keeping your musculoskeletal system happy. A standing desk can be a tool to do that. But simply replacing all of your sitting with standing is not the solution. Alternate sitting and standing throughout the day. Slowly increase the time you’re standing. Invest in a mat, and alternate resting a foot on a step or a few stacked books. Wear comfortable shoes, without heels, to help keep your feet, knees, and hips happy.

If you use a standing desk, remember that standing more does not replace exercise. People often feel a bit more fatigued after standing at work than sitting, so there’s a tendency to swap your normal post-work stroll for couch time when you start using a standing desk. Keep up your normal exercise regime. If you don’t have one, now’s a great time to start adding in daily walks. If you’re not exercising at all, build slowly until you get to 30 minutes at a time. Try to incorporate some therapeutic walking into your life. And if your back pain is more than an occasional twinge, the Sword Thrive digital physical therapy program may be able to help!

About the author: Megan Hill, PT, DPT

Megan Hill, Doctor of Physical Therapy, is a licensed physical therapist focused on musculoskeletal rehab and chronic pain management. She dropped her plans to go to law school for physical therapy after a knee injury from the Chicago Marathon left her in need of rehab, and she hasn’t looked back since. She’s on a mission to empower people to manage their health through exercise, education and coaching, rather than relying on passive approaches.

Megan earned a Doctor of Physical Therapy degree from the University of Illinois at Chicago (UIC). She also holds a Bachelor of Arts degree in psychology from Duke University and is a certified running coach.

Megan lives in Denver, Colorado, where she spends every spare second running, biking, hiking, sailing and stand up paddleboarding with her husband, Layton, and dog, Ollie.