There’s no way around it – we’re living increasingly sedentary lives. That should come as no surprise in a world where you can order groceries, call friends, call a cab, and get in a full day’s work, all without leaving your chair.
Sitting down for long periods of time has become virtually unavoidable. And with sitting, unfortunately, can also come back and sciatica pain. As harmless as it seems, the simple act of sitting can cause excruciating pain, and nerve pain is no fun. Let’s find out why that happens and what you can do about sciatica pain from sitting.
Why does sitting cause back pain?
In theory, sitting sounds like it should be a great way to ease pain. You’re not up and around, and your body is at rest. That’s not the case, though – our bodies are made to be up and about, and excessive sitting can put a lot of pressure on your back, hips, and tailbone.
Dr. David Petron, a sports medicine physician, noted in an interview at the University of Utah that “the most common reason [for sciatica and lower back pain] is really prolonged sitting. We’re not designed to sit for hours at length.”
Lower back pain and sciatica from sitting is due to the amount of pressure being put on your disks. Sitting puts more pressure on the discs in your back than nearly any other activity, including running, especially if you are sitting with poor posture. These discs, when compressed, can hurt and can also press on the nerves coming out of the spine and cause pain. Sitting also creates increased pressure on the sciatic nerve in your glute, which travels all the way down to your leg. If you’ve ever felt shooting pains in your leg after sitting down, the issue may actually lie in the discs and nerves in your lower back.
Difference between lower back pain and sciatica
To make it clear: sciatica and lower back pain are not the same thing. More accurately, sciatica is one of many types of lower back pain, and it involves pain in the sciatic nerve that runs from your lower back down the outside of your thigh to the outer part of your shin. So, yes, you can have either lower back pain or sciatica from sitting – or both.
Although you may be feeling pain in your back or in this nerve that travels down your leg, the most common cause of this pain actually exists on the front of your hip. The hip flexor group, made up of your iliacus and psoas, works very hard to hold you in a sitting position whenever you are seated. Unfortunately, there is no best sitting position for low back pain or sciatica. The act of sitting is the cause of the problem. Getting up, moving around, and decreasing the time you sit is the only remedy for sciatica pain.
As a result of its extended workday and the shortened position in sitting, the hip flexor group is almost always tight, holding this tension even after you’re done sitting. This tension pulls on the spine, discs, and creates tension in the glute area. Like tug of war, the hip flexor tension on the front of the hip creates tension in muscles – like the piriformis – on the back of the hip, resulting in compression of the sciatic nerve as it travels through that muscle. This chronic compression is what causes sciatica and possibly low back pain.
There are so many reasons for this nerve and the spine to be unhappy when sitting. It’s a trainwreck. But it doesn’t have to be! Keep reading for some sciatica pain relief tips.
How do I get my sciatic nerve to stop hurting from sitting?
The solutions to get rid of your sitting-induced lower back pain are wide-ranging. In some cases, simply walking around and stretching can be a quick fix for the pain. This sounds simple, but many times, sitting is simply the reason for the pain. Prevention is the key. Getting up out of your chair every 30 minutes and stretching gives these parts of us the much-needed rest and increased circulation that is necessary to keep the body healthy. Set a timer or you will forget, trust me.
Fixing your sciatica and back pain problems isn’t always that simple, though. Many times, pain in the sciatic nerve can be aggravated by sitting, when the real cause lies elsewhere. Like I mention in my book, tight iliacus and psoas muscles (your hip flexors) can put the pelvis out of alignment, putting pressure on your sciatic nerve at the spine and the glute and causing pain.
How to relieve sciatica pain
Best stretches for sciatica
If you’re able to release some of the tension in your iliacus and psoas muscles, you give the sciatic nerve an opportunity to heal. The Hip Hook is designed specifically for this purpose. This prolonged pressure technique is the golden ticket to long term change in the holding patterns of this muscle, however, stretching can be a great way to prevent and soften these effects in the moment.
Since piriformis tightness develops as a result of fighting against the tension in the iliacus and psoas, stretching this area can relieve the tension of those muscles and therefore reduce pressure on the sciatic nerve. First, you want to address the hip flexors with a lunge stretch as that is the hidden cause of sciatic tightness. Then address the effect by stretching the piriformis with a figure 4 stretch. Holding each stretch for at least 30 seconds will help soften the hold that these muscles have on you!
Self massage for sciatica
While the piriformis lies underneath the larger gluteus maximus, it is still relatively close to the surface of the body. This helps make the muscle easier to access by using something like a foam roller, lacrosse ball, or a massage therapy ball. Self massage for sciatica is more about applying prolonged pressure to release these muscles than kneading them with your hands.
While self massage for sciatica pain relief may hurt, it should be more of a “hurts so good” kind of feeling during and after the release. The pain should start decreasing after 30 seconds; if it doesn’t, move the tool to a different spot. If at any point you feel a large increase in pain that lingers after the release, you may want to reduce the intensity of the pressure and/or explore a different spot along the muscle. If that increased pain does not go away, please stop and consult your healthcare practitioner.
Do I need surgery for my lower back pain and sciatica?
One common issue that’s prevalent throughout our culture is that surgery is necessary – and beneficial – in cases where there’s significant pain. While this is true in some cases and you should always consult with your doctor, sciatica and lower back pain typically does not require surgery. The key to determining if you need surgery is to first determine the actual cause of your pain. Just because you have a herniated disc, doesn’t mean that it is the source of your pain. There are many people, young and old, that have herniated discs with no pain.
Sitting and Sciatica Pain Relief
Instead, physical therapy is normally the best way to treat the lower back pain and sciatic problems that you’re having. Whether you simply need to get in a yoga routine, specific stretches, or to release tension in your hip flexors, physical therapy can offer a lot of solutions that surgery cannot – with the added benefit of being much less risky and more beneficial overall. Try PT first!
Back pain and sciatica issues from sitting are quite common, and they’re continually becoming more commonplace as so many jobs and lifestyles involve sitting for long periods of time. If you’re able to, try to get up and be active as much as you can, and simply taking a walk around the block can make all the difference! This will help to prevent these issues from occurring in the first place.
Best Sitting Positions for Sciatica
In addition to getting up more frequently to move around, try mixing in some different positions to figure out what the best sitting position is for YOUR body to relieve your sciatica pain. We'll share some ideas on how to sit with sciatica below, which you may use to get some short-term relief as you keep working towards addressing the root cause of your pain for long-term results.
1. Sitting with a more open hip angle
A common sitting position for many people is where the height of the seat allows for their feet to be flat on the ground and also have the knees and hips at about a 90-degree angle. This places the hip flexors into a shortened position (compared to a 180-degree angle when standing) and increases the chances for tightness that ultimately contributes to sciatica.
Assuming that a standing desk isn't available or you aren't able to stand for 8+ hours straight during the day, the next best option would be to sit with a more open hip angle. This could be achieved by raising the height of your chair, placing a cushion on top of your chair, tucking your feet underneath your chair, or even utilizing a kneeling chair (if you have one).
Each of these positions opens the hip angle to more than 90 degrees and helps to lengthen the hip flexors, giving them a chance to relax a little more and hopefully take some pressure off of the sciatic nerve being irritated. If you have a soft mat that you can lay on the floor and if the height of your desk allows for it, you could take this one step further and take a kneeling position or half-kneeling position (like a kneeling hip flexor stretch) while you sit to open up both (or just one) of your hips to a 180-degree angle.
2. Sitting cross-legged or with one leg crossed over the other knee
Whether you find yourself seated in a chair, car, couch, or even on the ground, a possible way to sit with sciatica and get some relief would be to sit cross-legged or have one leg crossed over the other knee (very similar to the Figure 4 stretch). Doing so will stretch the piriformis muscle which, when tight, can irritate the sciatic nerve that runs directly underneath it. Sitting this way may help lengthen that muscle, reduce the compression on the nerve, and provide you with some relief.
3. Sitting with some lower back support
Giving the lower back some support, whether it is by using a lumbar roll cushion or sitting in a chair with built-in lumbar support, can help provide your muscles with enough help to let them relax a little more to take enough pressure off of the sciatic nerve so that you can experience some relief.
Frequently asked questions on sciatica while sitting
Does sitting make sciatica worse?
Sitting too much, especially for longer periods of time, can be something that triggers or worsens your sciatic pain. When sitting, the muscles that support the alignment of your pelvis and lower back can become tighter and compress on the sciatic nerve. Taking frequent breaks to move around or stretch may help to relieve the tightness in this area and reduce the pain.
Where does the sciatic nerve run?
The sciatic nerve starts in the lower back and runs through the hips and buttocks (underneath the piriformis muscle) all the way down the legs.
What causes sciatica?
Sciatica is caused by a compression on the sciatic nerve, which branches through the lumbar spine and runs through the glutes and all the way down the legs. Compression on the nerve can happen in several ways, such as a bulging or herniated disc, pinching of the nerve by decreased space in the lumbar spine, or from tight muscles (like the piriformis) pressing on the nerve.
How do I get my sciatic nerve to stop hurting?
To improve your sciatica pain, it is important to first find the true root cause of your pain. Sciatica may develop over time as the result of muscle imbalances around the pelvis and lumbar spine. This impacts the alignment of the structures and function of the muscles in these areas, ultimately compressing on the sciatic nerve and causing pain. Using a combination of muscle release and corrective stretching and strengthening exercises, you may be able to improve the alignment of your body and the functioning of the supporting muscles, addressing that root cause to improve your sciatic pain.