What causes lower back pain when standing up from sitting. How can you alleviate this discomfort. What are the treatment options for chronic lower back pain. When should you see a doctor for lower back pain.

Understanding Lower Back Pain When Rising from a Seated Position

Lower back pain is a prevalent issue affecting approximately 80% of adults in the United States at some point in their lives. The sudden pressure exerted on the lower back muscles when transitioning from sitting to standing can cause tightness and discomfort. While this type of pain is more common among older individuals, it can affect people of all ages. Various factors contribute to lower back pain when standing up, including spinal stenosis, annular tears, and ligament strains.

Mild lower back pain can often be managed with home remedies, but severe cases may require professional medical intervention. Understanding the underlying causes and available treatment options is crucial for effectively managing this condition.

Common Causes of Lower Back Pain When Standing Up

The lower back contains facet joints that remain flexed and relaxed while sitting. Upon standing, these joints compress due to the sudden pressure. Individuals with arthritis or other health conditions may experience sharp pain during this transition. Here are some of the most common causes of lower back pain when rising from a seated position:

Spondylolisthesis

Spondylolisthesis occurs when one vertebra shifts forward from its original position relative to another. This displacement happens during sitting, and when standing up, the vertebrae take a few moments to realign. During this brief period, you may experience initial pain that subsides within seconds.

Annular Tear

The lumbar spine consists of five vertebral bodies separated by lumbar discs. Each disc has an outer fibrous ring called the annulus fibrosus, which encases the nucleus. The annulus provides support, absorbs shock, and ensures spinal stability. However, degeneration or trauma can damage or weaken its fibers, resulting in annular tears – a significant cause of lower back pain when standing up.

Degenerative Scoliosis

Also known as adult-onset scoliosis, degenerative scoliosis involves a sideways curvature of the spine. This bending, typically to the right or left, can range from mild to severe. The curve often forms a “C” shape and is located in the lower back. Degenerative scoliosis results from normal wear and tear on the discs, vertebral bodies, or small joints, and can lead to lower back pain when transitioning from sitting to standing.

Genetic and Post-Surgical Factors Contributing to Lower Back Pain

Ehlers-Danlos Syndrome (EDS)

EDS is a genetic disorder with varying signs and symptoms depending on its type and severity. It primarily affects blood vessels, skin, and joints. A defect in collagen formation can cause hypermobile joints, leading to sudden lower back pain when standing up. As EDS is hereditary, there is no specific cause for its occurrence.

Failed Back Surgery Syndrome (FBSS)

FBSS is a clinical condition observed in patients who have undergone low back surgery but continue to experience post-surgical pain. In these cases, the surgery failed to alleviate the patient’s discomfort and may have even exacerbated it. FBSS is one of the most common causes of lower back pain when standing up.

Musculoskeletal Factors in Lower Back Pain

Hamstrings Tendinopathy

The hamstrings are thick muscles located in the back of our thighs, controlling the movement of our thighs, hips, and knees. These muscles comprise the Semitendinosus, Semimembranosus, and Biceps Femoris. Tendons, which are thick connective tissues, attach these muscles to the bone. Any strain or injury to these tendons can result in hamstring tendinopathy. This condition is most noticeable when pressure is applied to the hamstrings during leg extension or bending. Calf strain or pain is the most common symptom of hamstring tendinopathy.

SI Joint Syndrome

The sacrum and pelvic girdle contain two sacroiliac (SI) joints, one on each side. These joints transfer forces between the spine and lower limbs. Sudden trauma or falls can lead to SI joint syndrome, causing severe pain and inflammation in the SI joints. Individuals with this condition may experience sudden lower back pain when standing up from a seated position.

Treatment Options for Lower Back Pain

If you don’t have a medical history or diagnosed condition related to lower back pain, you can try several at-home methods to alleviate the discomfort. Some conventional treatments include:

• Relaxation techniques
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
• Physical therapy exercises
• Heat or cold therapy
• Gentle stretching

For immediate relief when experiencing sudden pain while standing up, it’s advisable to sit down again to alleviate the pressure. Once the pain subsides, you can attempt to stand up again.

NSAIDs such as ibuprofen (Motrin, Advil) and naproxen (Aleve) are commonly used to reduce inflammation and relieve lower back pain. However, it’s essential to consult with a healthcare professional before starting any medication regimen, especially if you have pre-existing medical conditions or are taking other medications.

When to Seek Medical Attention for Lower Back Pain

While many cases of lower back pain can be managed at home, there are instances where professional medical attention is necessary. You should consult a doctor if:

• The pain persists for more than a few weeks despite home treatment
• The pain is severe and doesn’t improve with rest
• The pain spreads down one or both legs, especially if it extends below the knee
• You experience weakness, numbness, or tingling in one or both legs
• You have unexplained weight loss accompanying the pain
• You develop fever along with back pain

A healthcare professional can provide a proper diagnosis and recommend appropriate treatment options, which may include physical therapy, medication, or in some cases, surgical intervention.

Preventive Measures and Lifestyle Changes

Preventing lower back pain when standing up from a seated position often involves making certain lifestyle changes and adopting good habits. Here are some preventive measures you can take:

1. Maintain good posture while sitting and standing
2. Use ergonomic furniture, especially if you spend long hours sitting
3. Take regular breaks to stand up and move around if you have a sedentary job
4. Engage in regular exercise to strengthen your core and back muscles
5. Practice proper lifting techniques to avoid straining your back
6. Maintain a healthy weight to reduce stress on your spine
7. Stay hydrated to keep your intervertebral discs well-nourished

Implementing these changes can significantly reduce your risk of developing lower back pain and improve your overall spinal health.

The Role of Physical Therapy in Managing Lower Back Pain

Physical therapy plays a crucial role in both treating and preventing lower back pain. A physical therapist can design a personalized exercise program to address your specific needs and help alleviate pain when standing up from a seated position. These programs typically focus on:

• Strengthening core muscles to support the spine
• Improving flexibility and range of motion
• Teaching proper body mechanics for daily activities
• Implementing pain relief techniques
• Providing education on ergonomics and posture

Physical therapy not only helps in managing current pain but also equips you with the knowledge and tools to prevent future occurrences of lower back pain.

Are exercises beneficial for lower back pain. Yes, targeted exercises can significantly improve lower back pain by strengthening the muscles that support the spine, increasing flexibility, and promoting better posture. However, it’s crucial to perform these exercises under the guidance of a qualified professional to ensure they are done correctly and safely.

Alternative Therapies for Lower Back Pain Management

In addition to conventional treatments, several alternative therapies have shown promise in managing lower back pain. These include:

• Acupuncture
• Chiropractic care
• Massage therapy
• Yoga and Pilates
• Mindfulness and meditation

While the effectiveness of these therapies can vary from person to person, many individuals find relief through a combination of conventional and alternative approaches. It’s important to discuss these options with your healthcare provider to ensure they are appropriate for your specific condition.

Is acupuncture effective for lower back pain. Some studies suggest that acupuncture can be beneficial in reducing lower back pain, particularly when combined with other treatments. However, results can vary, and more research is needed to fully understand its effectiveness.

The Impact of Diet and Nutrition on Lower Back Pain

While often overlooked, diet and nutrition play a significant role in managing lower back pain. Certain foods can contribute to inflammation in the body, potentially exacerbating back pain, while others can help reduce inflammation and promote healing. Consider incorporating the following into your diet:

• Anti-inflammatory foods such as fatty fish, berries, and leafy greens
• Foods rich in calcium and vitamin D for bone health
• Lean proteins to support muscle repair and growth
• Whole grains and fruits for fiber to maintain a healthy weight

Conversely, try to limit or avoid:

• Processed foods high in trans fats
• Sugary foods and beverages
• Alcohol, which can interfere with sleep and healing

Can dietary changes alleviate lower back pain. While not a cure-all, adopting an anti-inflammatory diet and maintaining a healthy weight can significantly contribute to reducing lower back pain and improving overall spine health.

Technological Advancements in Lower Back Pain Treatment

As medical technology continues to advance, new treatments for lower back pain are emerging. Some innovative approaches include:

• Radiofrequency ablation for nerve pain
• Spinal cord stimulation for chronic pain
• Regenerative medicine techniques like stem cell therapy
• Advanced imaging for more precise diagnoses
• Virtual reality for pain management and physical therapy

While many of these treatments are still being studied or are in early stages of implementation, they offer promising alternatives for individuals who haven’t found relief through traditional methods.

Are new technologies effective in treating lower back pain. Emerging technologies show promise in treating lower back pain, especially for chronic cases that haven’t responded to conventional treatments. However, their effectiveness can vary, and more research is needed to fully understand their long-term benefits and potential risks.

Understanding the causes of lower back pain when standing up from a sitting position is crucial for effective management and prevention. By implementing appropriate lifestyle changes, seeking timely medical attention when necessary, and exploring various treatment options, individuals can significantly improve their quality of life and reduce the impact of this common condition. Remember, each person’s experience with lower back pain is unique, and what works for one individual may not be as effective for another. It’s essential to work closely with healthcare professionals to develop a personalized treatment plan that addresses your specific needs and circumstances.

Lower Back Pain When Standing Up From Sitting Position

Pain in the lower back is pretty common among US adults, with about 80% of the population experiencing it at any point in their life. When you stand up, your spine bears a sudden pressure on the lower back muscles. As a result, they become tight and cause pain. 

While pain is common in the elderly, it can also happen in young individuals. Many factors can cause lower back pain when standing up from a sitting position, including spinal stenosis, annular tears, ligament strains, etc. 

Mild lower back pain isn’t something to worry about, as it can be treated with some at-home remedies. However, in severe cases, you may need proper clinical treatment. 

Causes of Lower Back Pain When Standing Up

The lower back consists of facet joints that stay flexed and relaxed when sitting. But just as you stand up, these joints become compressed due to the pressure. If you have arthritis or any other health condition, you may feel a sudden, sharp pain when standing up.  

Here are some common causes of lower back pain when standing up from a sitting position:

Spondylolisthesis

Spondylolisthesis is when one vertebra moves forward from its original position on another. This shift occurs when you sit. When you stand up, the vertebrae take a few seconds to return to their original position for a few seconds. During this period, you may initially feel the pain, but it will go away in a few seconds. 

Annular Tear

The lumbar spine comprises five vertebral bodies. There are lumbar discs present between each vertebral body. Every disc has an outer fibrous ring called the annulus fibrosus, which covers the nucleus. 

The annulus provides support, absorbs sudden forces, and ensures the spine’s stability. However, its fibers can damage or weaken through degeneration or trauma, causing annular tears. It is one of the major causes of lower back pain when standing up from sitting position. 

Degenerative Scoliosis

Degenerative scoliosis, or adult-onset scoliosis, is when the spine bends sideways. This bending is usually toward the right or left and can be severe, mild, or moderate. The curve is often in a “C” shape and is located in the lower back. 

Degenerative scoliosis results from the usual wear and tear of the discs, vertebral bodies, or small joints. In this condition, you may feel lower back pain when standing up from sitting position. 

Ehlers-Danlos Syndrome (EDS)

EDS is a genetic disorder with different signs and symptoms that vary depending on its type and severity. It most commonly impacts the blood vessels, skin, and joints. Your joints may feel hypermobile due to a defect in collagen formation. 

EDS is also a primary reason for sudden lower back pain when standing up from sitting position. However, since it’s hereditary, there is no particular cause for it. 

Failed Back Surgery Syndrome (FBSS)

Failed back surgery syndrome (FBSS) is a clinical condition observed in patients who have undergone low back surgery and continue to have post-surgical pain. This means the surgery failed to reduce the patient’s pain and increased it. This condition is one of the most common causes of lower back pain when standing up.

Hamstrings Tendinopathy

The hamstrings are thick muscles in the back region of our thighs. They control the movement of our thighs, hips, and knees and are made of three muscles. These include Semitendinosus, Semimembranosus, and Biceps Femoris. The muscles are connected to the bone through tendons, which are thick connective tissues. 

Any strain or injury to the tendons results in hamstring tendinopathy. It is most obvious when you put pressure on your hamstrings when extending or bending your legs. Calf strain or pain is the most common symptom of hamstring tendinopathy. 

SI Joint Syndrome

The sacrum and pelvic girdle consist of two sacroiliac (SI) joints. One is present on the right, while the other is on the left. The SI joints transfer back-and-forth forces through the spine and the lower limbs.  

Any sudden trauma or fall can lead to SI joint syndrome, which causes severe pain and inflammation in the SI joints. With SI joint syndrome, you may feel sudden lower back pain when standing up from sitting position. 

Treatment Options for Lower Back Pain When Standing Up From Sitting Position

If you don’t have any medical history or diagnosed condition for lower back pain, you can practice a few at-home methods to treat the pain. Some conventional treatments include:

• Relax. If you feel sudden pain in your lower back when standing up, just sit down again to relieve the pressure. Once the pain goes away, stand up and continue with your life. 
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). The most common anti-inflammatory medicines to relieve lower back pain include ibuprofen (Motrin, Advil) and naproxen (Aleve). However, it’s better to consult a doctor before taking any NSAIDs.
• Physical Exercises. Never start any exercise to treat your lower back pain without consulting a professional because some exercises can worsen your pain. For example, try hamstring stretches instead of sit-ups.
• Maintain Your Posture. Always sit and stand up straight and keep your posture balanced. It ensures proper weight distribution in your body.
• Get Orthotics. Get medicated shoes, inserts, orthotics, and a mattress that supports your feet and back.
• Avoid Heavy Lifting. If you lift weights daily, bend your legs and keep your back straight to shift the pressure on your leg muscles instead of the back.

Orthobiologic Methods for Relieving Back Pain

If your lower back pain persists when standing up, you can try orthobiologic treatments to relieve the pain in a less painful and less invasive method. They are outpatient procedures, meaning you won’t have to spend a night at the clinic. 

At CELLAXYS, we perform two types of treatments: 

Cell-based Therapies

These are also known as stem-cell therapies. The procedure includes harvesting the patient’s healthy “autologous” cells, processing them, and reinjecting them into the injury site. The doctor may opt for any of the below cell-based therapies:

• Minimally Manipulated Adipose Tissue (MMAT) Transplant. This process extracts cells from your adipose (fat) tissue.
• Bone Marrow Concentrate (BMAC). This process extracts highly-concentrated cells from your bone marrow.

Both MMAT and BMAC take about 1.5 to 2 hours to complete.

Platelet-Rich Plasma Therapy (PRP)

PRP includes taking the patient’s blood sample, isolating platelets, and reinjecting them into the injury site. Platelets are the healing elements of the human body. They release 10 Growth Factors, attract healing cells from the blood, and produce fibrin to promote the development of new tissues.

A high number of platelets in the injury site boosts healing and recovery. PRP is completed in 45 minutes.

Lower Back Pain When Standing

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:

RELATED: Sit Bones Pain

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 concentrate (containing 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.

Common Causes of Low Back Pain While Standing

Annular Tear

To understand annular tears, let us first review the anatomy of the spine.   The lumbar spine is comprised of 5 boney building blocks called vertebral bodies. Sandwiched between the vertebral bodies are the lumbar discs.  Each disc is comprised of an outer fibrous ring, the annulus fibrosis that surrounds the inner gelatinous center, which is called the nucleus. The disc absorbs the forces of daily living. The annulus has multiple layers of collagen that provide important support.  The annulus is similar to the sidewall of a tire which provides important stability for the tire. Through trauma or degeneration, the outer annular fibers can become injured and or weakened. 

Read More About Annular Tear

Bulging Disc In Thoracic Spine

A bulging disc in the thoracic spine is a serious medical condition that occurs when the outer layer of the disc weakens, causing it to bulge outward and put pressure on nerves and the spinal cord. The disc has two components, a soft center and a thick outer layer, and weakening or tears in the outer layer can lead to a bulge. Symptoms include pain, numbness, and weakness in the affected area. The thoracic spine is that portion of the spine that resides below the neck and above the low back.  It is commonly referred to as the mid-back.  A bulging…

Read More About Bulging Disc In Thoracic Spine

Degenerative Scoliosis

Degenerative Scoliosis, also known as Adult-onset Scoliosis, is a medical condition that involves a side bending in the spine. The bending can be mild, moderate, or severe with side-bending to either the right or the left. The term degenerative means generalized wear and tear and is common as we get older. Degenerative scoliosis is the curvature of the spine that occurs as a result of degeneration of the discs, small joints, and building blocks. The Degenerative Scoliosis curve is often located in the low back and forms a ‘C” shape. There is a convex and a concave side. The convex side is the open side where it curves outward.

Read More About Degenerative Scoliosis

Ehlers-Danlos Syndrome (EDS)

Disorders that affect and weaken the connective tissues such as tendons and ligaments. It is a hereditary disorder which means you are born with it.  EDS has many different signs and symptoms which can vary significantly depending upon the type of EDS and its severity.   It most commonly affects the skin, joints, and blood vessels.  Joints are typically hypermobile with excessive joint range of motion because of a defect in collagen formation. In most cases Ehlers-Danlos syndrome is inherited. That is to say that you are born with it. The two main ways EDS is inherited are: autosomal dominant inheritance and autosomal recessive inheritance…

Read More About Ehlers-Danlos Syndrome (EDS)

Failed Back Surgery Syndrome

Failed Back Surgery Syndrome also called failed back is a clinical condition in which patients who have undergone low back surgery continue to have pain and dysfunction.  Said another way the surgery that was intended to reduce pain and increase function FAILED. That is right, the surgery failed. You had the surgery, struggled with the pain postoperatively, diligently participated in physical therapy and yet the pain and limitation are still there.   Unfortunately, this occurs frequently.   Estimates range from 20-40% of patients who undergo low back surgery will develop Failed Back Surgery Syndrome. Pain is the most common symptom of Failed Back Surgery Syndrome…

Read More About Failed Back Surgery Syndrome

Hamstrings Tendinopathy

Your hamstrings are the thick muscles in the back of your thigh that are responsible for the movement of your hip, thigh, and knee. The hamstrings are made of three distinct muscles: Semitendinosus, Semimembranosus, and Biceps Femoris.
What is Hamstrings Tendinopathy?
Tendons are thick pieces of connective tissue that connect muscle to bone. They function to transfer the force generated by muscle contraction into movement.
Hamstring tendinopathy, also known as a “calf strain,” is an injury to the affected tendon. It usually occurs when you bend your knee or extend your leg, putting too much force on the hamstring tendon….

Read More About Hamstrings Tendinopathy

SI Joint Syndrome

The sacroiliac joints reside between the sacrum (the tailbone segment of the spinal column) and the prominent wing-like iliac bones that form the pelvic girdle. There are two SI joints, one on the left and one on the right (highlighted in red in the image above), and along with the symphysis pubis joint at the front of the structure, they are critical for transferring forces and energy back and forth between the spine and the lower limbs. There are a number of reasons that an SI joint can become painful and inflamed, leading to SI joint syndrome. Trauma, such as a fall injury to the tail bone or a forced injury from a car accident for example, obviously can create problems in the SI joint…

Read More About SI Joint Syndrome

Spinal Instability

Spinal instability is a condition that occurs when the spinal column is not able to maintain its normal alignment and function under normal loads. It can be caused by various factors such as trauma, degenerative changes, infections, tumors, or congenital abnormalities. In a stable spine, the bones, discs, ligaments, and muscles work together to support and protect the spinal cord and nerve roots. However, in an unstable spine, the structures that support the spine may be damaged or weakened. This can lead to abnormal movement and excessive stress on the spinal cord and nerves. In most cases, bone and joint problems…

Read More About Spinal Instability

Spondylolisthesis

Spondylolisthesis means that one vertebra is slipping forward or backwards on another. This causes the hole where the nerve exits (foramen) to get smaller (also called foraminal stenosis). It also causes more wear and tear on the facet joint which can lead to arthritis or what’s called “facet hypertrophy”.
spondylolisthesis recovery
The amount of slippage is graded 1-4, with grade 1 meaning that the one vertebra has slipped up to 25% on the other vertebra. Grade 2 means that one bone has slipped from 25-50% with higher grades indicating more slippage. The vast majority of patients are grade 1 to 2.

Read More About Spondylolisthesis

Torn Discs

The spinal discs are shock absorbers that live at each level between the vertebral bones (1). They have a tough outer annulus part and a soft inner gel part (nucleus pulposis). The outer covering can get damaged which can sometimes be seen on MRI and other times requires additional testing to identify. These tears are called: a torn disc, a disc tear, an annular tear, and when seen on MRI a “High-Intensity Zone” or HIZ. They can cause pain, mostly through ingrown nerves. There are torn disc findings that can be seen on MRI (HIZ) and these can be either asymptomatic (i.e. not painful) or…

Read More About Torn Discs

Show More

Meet the Perc-FSU Procedure

In the Perc-FSU procedure, the doctor injects healing platelets or bone marrow concentrate (containing 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. _

References:

(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.

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Tailbone hurts when you sit. Coccyx hurts after training: what to do and how to treat

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Tailbone pain is a pathological process that is not intense. The pain can be given to the sacrum, buttocks and genitals. This syndrome is familiar to many representatives of “sedentary” professions. Pain may increase with a change in body position or movement. These pains can disturb a person throughout life, temporarily disappear and return again.

In this article, we will tell you why the tailbone can hurt when you sit or stand up and how to alleviate the condition.

This article is advisory in nature. Treatment is prescribed by a specialist after consultation.

Causes of pain in the coccyx

The coccyx is a rudiment. It represents 4-5 vertebrae fused together, which have lost their main significance in the course of evolution. Bundles of some muscles, ligaments from the pelvic organs are attached to the coccygeal bones. Therefore, the coccygeal part of the spine is closely interconnected with these organs and can respond to the slightest deviations in them.

Removal of the coccyx does not entail serious consequences, but patients who have undergone such an operation are more likely than others to form hernias of the perineum.

Coccyx is a vulnerable part of the spinal column. The most common cause of pain in the coccyx when sitting and getting up is its traumatization. For example:

• Coccyx injury . In this case, there is severe, but usually tolerable pain, sometimes small or moderate local swelling is possible.

• Tailbone fracture . The symptoms are similar to a bruise, but more pronounced. Because of the pain, the victim cannot sit, walk, bend over and turn slowly and carefully.

• Tailbone dislocation . The same symptoms are noted as with a fracture.

Another cause of pain is inflammatory changes of an infectious nature. More often, pathogenic microorganisms penetrate through a defect in the skin, less often through the blood (retrorectal paraproctitis, festering epithelial coccygeal passage, osteomyelitis).

Pain in the coccyx can also be caused by cysts, benign and malignant tumors of the coccyx, developmental anomalies.

Sometimes during the initial examination, the cause of pain in the coccyx cannot be identified, this may indicate a psychogenic factor. If the patient is fully examined and there is no data for any disease, then we are talking about chronic pelvic pain syndrome. The patient needs not only medication, but also psychotherapy.

Diagnosis

In order to establish a preliminary diagnosis, the doctor collects an anamnesis, clarifies complaints: when the first pains appeared, how they changed over time, which affects their intensity. These data are very important, as they allow us to suggest the pathogenesis of the process and further develop effective therapy.

The mandatory list of examinations includes a rectal digital examination. This study allows you to assess the condition of the muscles of the small pelvis, the presence of hypertonicity in them – overstrain.

The cause of pain is determined by external and rectal examination, instrumental studies: X-ray, CT, MRI, ultrasound.

Until the diagnosis is clarified, the patient is recommended to rest, limit physical activity, sit on a hard surface, analgesics.

Also, everyone is prescribed sigmoidoscopy – examination of the mucous membrane of the rectum and sometimes part of the sigmoid colon using a sigmoidoscope. The study allows you to exclude the pathology of the rectum, as well as check for the presence of tumors. Sigmoidoscopy is performed after bowel cleansing: an enema is done before the study.

Patients are prescribed x-ray of the sacrococcygeal spine in two projections, which allows to identify pathologies and injuries of the coccyx.

For a more accurate diagnosis, CT or MRI of the small pelvis is performed, which can reveal cysts, fistulous tracts, suppuration of soft tissues near the coccyx.

If a pathology of the pelvic organs is suspected, ultrasound is performed. This is the safest diagnostic procedure that allows you to accurately detect tumors and inflammation in the abdominal cavity.

Additionally, other diagnostic methods may be prescribed. These include:

• irrigography – x-ray examination of the intestine with a preliminary introduction of a contrast agent – barium sulfate;
• defecography — an x-ray examination that can be used to assess the process of defecation by introducing a contrast agent into the intestine;
• manometry – measurement of pressure in the studied organs of the digestive tract.

Which doctor to contact

If you notice constant or intermittent pain in the coccyx with high intensity, you should consult a specialist. This is a very ambiguous symptom, under which serious diseases can be hidden that require special studies and specific treatment. In addition to a general practitioner, neurologist, orthopedic traumatologist, sometimes you need to consult other specialists: a urologist, gynecologist, proctologist, in order to exclude diseases of the pelvic organs.

You can first make an appointment with a therapist, who will refer you to the right specialist and prescribe an additional examination, or call the Temed Clinic and we will advise you on all issues.

Make an appointment with a neurologist

Appointment lasts 60 minutes, includes diagnostics, analysis of your MRI and preparation of a treatment plan, takes place both in person and online.

Treatment of pain in the coccyx

After the doctor has made a diagnosis, he prescribes a complex treatment. It is individual and may include different methods.

• Drug treatment:
  

• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation;

• Muscle relaxants to reduce skeletal muscle tone;

• Local anti-inflammatory agents in the form of creams, ointments, gels;

• Microclysters and rectal suppositories to normalize bowel function;

• Antibiotics in the presence of an infectious process;

• Antidepressants for the normalization of the psycho-emotional state in case of chronic pelvic pain without objective pathological causes.

• Physiotherapy reduces inflammation, soft tissue swelling and speeds up recovery. Our clinic uses the following methods:

• Laser therapy is a biological catalyst for recovery and healing. The laser eliminates inflammation, accelerates regeneration. The procedure is painless and is not felt by the patient;

• Acupuncture – stimulates biologically active points, which are connected by nerve fibers with the pathological focus, this helps to reduce pain and speed up recovery;

• Complementary therapies – innovative BTL SIS magnetotherapy, shock wave therapy and massage – are prescribed at the discretion of the attending physician after examining the patient. Magnetotherapy reduces pain and local swelling. Massage improves the mobility of the spinal column, reduces chronic pain;

• Exercise therapy – not only improves the patient’s condition, but also helps to prevent the recurrence of the disease for many years.

Our doctor will tell you more about all treatment options at the initial appointment.

The operation is carried out only in extreme cases, when other methods of treatment have not brought the expected result for a long time. It involves the complete or partial removal of the coccyx.

If the coccyx hurts especially hard when sitting and getting up, and the disease is in the acute phase, some treatments are contraindicated. Therefore, they cannot be used without the knowledge and consent of the doctor.

Consequences

If timely treatment of any pathology that provokes pain in the coccyx when standing up and sitting is started, the prognosis for a complete recovery is favorable.

If left untreated, the symptoms become more intense as the disease progresses, indicating that the disease is progressing. There are shootings near the sacrum, while it hurts not only to sit, but also to get up.

The advanced stage of the disease leads to problems with the mobility of the spine and limbs, and in the future – to severe disability.

In the later stages of the development of pathology, effective therapy will be long and expensive, surgical interventions are possible. Therefore, do not delay going to a specialist if pain appears.

Trauma to the coccyx is an insidious injury and its consequences can be very diverse. One of the most dangerous is damage to other parts of the spine with spinal cord injury. This manifests itself as pronounced motor, sensory disorders in the limbs, as well as a violation of the functions of urination and defecation.

Prevention

To avoid a relapse, do not ignore the symptoms – make an appointment with a doctor. You can avoid severe complications and painful relapses if you follow all the doctor’s recommendations during treatment and during the recovery period.

It is necessary to systematically observe and examine such specialists as a proctologist, neuropathologist and osteopath. It is important for women to be regularly examined and treated in a timely manner by a gynecologist, since many diseases of the female reproductive system lead to pain in the coccyx.

Rethink your lifestyle: include physical education after 30-40 minutes of sitting on a hard chair, as well as morning exercises and regular physical exercises to strengthen the muscles of the spine.

Equally important is the ergonomics of the workplace. Maintain the correct body position during work and rest. If there is pain, use special seat cushions, they will reduce pressure on the coccyx.

Include a variety of fiber foods in your daily menu to help prevent constipation. Take vitamins and minerals regularly.

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Square lumbar syndrome – treatment, symptoms, causes, diagnosis and worried about back pain, especially in the lower back. Low back pain may be due to poor posture, poor posture, physical inactivity, or other factors, and may be in the form of discomfort or quite severe.

One of the most common causes of low back pain is quadratus lumborum syndrome. The quadratus lumborum is located in the lower back. It connects the ribs, spine, and pelvic bones, and when it contracts too much or too often, it causes hip elevation, and pain in the back, hips, and buttocks. The quadratus lumborum is responsible for tilting the torso, straightening the torso, and stability of the lower back. Since the quadratus lumborum is part of the muscles responsible for the movement of the spine, damage to this muscle can lead to limited mobility and pain when performing various movements.

It is often difficult to determine when a muscle strain has occurred. Sometimes, the pain can be sharp and quite severe, and in such cases, the patient notes a clear connection with a specific injury. In other cases, there may be persistent pain for several days, with no apparent external cause. In cases where there is tension in the square muscle of the lower back, patients may have spasms or cramps and, despite the fact that these are unpleasant sensations, they indicate that the body turns on self-regulatory mechanisms.

As with any muscle injury, damage to the quadratus lumborum causes inflammation and a feeling of warmth in the area of ​​the muscle. This is explained by the fact that when the muscle is tense, the body reacts by increasing blood flow, thereby accelerating the healing process.

Swelling in the muscle area is a sign that there is fluid accumulation in the tissues surrounding the muscle, which further exposes the muscle to damage and therefore any muscle injury that is accompanied by swelling requires a careful approach to treatment.

Causes

Square muscle syndrome can be caused by acute injuries such as heavy lifting, twisting of the body when lifting. Pain can also appear when the back is in a bent position for a long time (for example, when working in the garden). The cause of the syndrome can also be a difference in the length of the limbs (when one leg is shorter than the other), which can be either congenital or acquired. But most often, square muscle syndrome occurs as a result of prolonged static loads. It is very typical in this case that this syndrome develops in people who spend most of their time at the computer, since the square muscle of the lower back is one of several muscles that are overloaded during normal sitting.

Symptoms

Quadrus lumborum pain is usually felt in the iliac crest and sacroiliac joints, as well as deep in the upper buttocks. The pain may also radiate to the lower buttock and the greater trochanter. The pain may worsen after sleep when the patient gets up and begins to walk. Painful muscle spasm when the body takes a vertical position is characteristic of acute overexertion. In such cases, coughing or sneezing can also be painful, as can turning in bed during sleep. Often the increase occurs in the morning hours, even with small movements, after the tense muscles have been in a contracted state all night. Patients often report that the painful spasm occurred after they got out of the shower and reached for a towel, or when they twisted, twisted, leaned over something in the kitchen during breakfast. A less acute onset, with a gradual increase in pain, occurs in patients who sit for a long time at work without getting up or moving around. Postural tension of the square muscle due to incorrect position during sleep can also be an important factor in exacerbating pain manifestations. The pain associated with the square muscle syndrome may also be in the lower back, the pain may be in the thighs and buttocks, in the groin, in the pelvic region, in the lower front of the thigh.

There are symptoms that may indicate that there is a more serious cause of pain:

• Numbness, tingling in the legs or feet.
• Constant pain that does not improve with rest.
• Gradually worsening pains.
• Bladder or bowel dysfunction.
• Pain that worsens during sleep.
• Numbness in the perineum.
• Morning stiffness lasting more than half an hour after getting up.
• Weight loss, night sweats or fever

If you have these symptoms, you should definitely seek medical attention.

Diagnosis

There are a number of conditions that can cause muscle spasms.

Symptoms similar to those of quadratus lumborum syndrome are:

• Trochanteric bursitis
• Spine compression at S1 level
• Osteochondrosis
• Stenosis of the intervertebral foramina
• Sciatica
• Cauda equina syndrome
• Ankylosing spondylitis
• Scoliosis
• Arthrosis
• Rheumatoid arthritis
• Weakened abdominal muscles
• Diverticulosis
• Endometriosis
• Uterine fibroids
• Uterine prolapse
• Pelvic inflammatory disease
• Kidney infections
• Urolithiasis
• Urinary tract infections

Due to similar symptoms, it is necessary, first of all, to exclude these diseases using instrumental (X-ray, MRI or CT, pelvic ultrasound) and laboratory methods of research. After the exclusion of another possible genesis of the pain syndrome, the presence of the square muscle syndrome can be assumed.