The best and worst sitting positions for lower back pain

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Below we discuss the best sitting position for lower back pain.

Upright with lumbar support

Research from 2015 suggests that sitting on a chair with lumbar support or with knees at a 90-degree angle results in a relatively low reduction in spinal curvature. This position places less pressure on the spine, back muscles, and shoulders.

However, discussing the ideal recommended position and posture to help reduce pain and fatigue with a medical professional is best.

The worst sitting positions for lower back pain include:

Sitting without support

Sitting upright for a prolonged period without support can be difficult. Experts advise people to support their back or not sit in this position for a long time.

Slumped positions

Sitting in a slumped-over position for more extended periods does not adequately support the back, which can lead it to develop an excessive curvature, also known as kyphosis. This position can also contribute to lower back discomfort in the long term.

Read more about lower back pain when sitting.

Cross-legged sitting

Although cross-legged sitting may reduce muscle fatigue in the short term, it carries more risks than benefits.

A 2015 study evaluating different sitting positions and back pain found that sitting cross-legged for long periods can elongate the piriformis muscle, which runs from the lower spine to the top of the thighs. This contributes to the following:

• sacroiliac joint instability
• back pain due to increased pressure on the gluteus muscles
• pelvic misalignment

The research from 2020 found that a person with lower back pain who remained cross-legged for longer periods was more slumped.

It may therefore be best to consider reducing the time spent in a crossed-legged position or discussing alternatives with a doctor.

One leg crossed over the other on a chair

Crossing one leg over the other could also help with muscle fatigue in the short term. People often cross a leg while sitting because it feels more comfortable or has become a habit.

However, this causes left-right asymmetry in the body and increases the rotation of the lumbar spine by rotating the pelvis following the bending of the hip joint. Individuals with a limited range of hip joint motion will increase pelvic rotation.

Research findings suggest that crossing a leg while sitting can cause scoliosis and spinal deformities.

There are several treatment options for lower back pain. The best choice will depend on the cause and associated diagnosis.

Treatments include:

• medications, such as:
  • nonsteroidal anti-inflammatory drugs for pain and swelling
  • acetaminophen
  • steroids
  • muscle relaxants
• physical treatments, such as:
  • physical therapy
  • back braces
  • an exercise-based program such as yoga or pilates
• surgical interventions, including disk replacement and spinal fusion

There are also several lifestyle measures an individual can take to alleviate or prevent lower back pain, including:

• exercising regularly
• maintaining a moderate weight
• developing or maintaining a supportive posture
• using the correct technique when exercising or lifting weights

If lower back pain persists for a few weeks with little to no relief from at-home treatment, it is best to seek medical help.

Similarly, a person will need to consult a doctor if they experience one or more of the following symptoms associated with back pain:

• numbness or tingling
• weakness
• changes in bladder or bowel function
• pain that prevents them from doing day-to-day activities

A doctor can carry out assessments to determine the underlying cause and provide the necessary treatment.

Below are answers to some commonly asked questions about the best and worst positions for back pain.

Is lying down good for lower back pain?

Medical professionals do not recommend lying down for prolonged periods for lower back pain. While it may make the back feel slightly better in the short term, too much time in bed can trigger other health issues, such as:

• a loss of conditioning and tone of muscles
• digestive issues such as constipation
• the risk of blood clots developing in the veins of the pelvis and legs

Which sitting position puts the least pressure on the back?

Research suggests that sitting up with both feet flat on the ground and something to support the back reduces pressure on the back and shoulders, helping alleviate pain.

However, it is best for a person to speak with a medical professional about the best positions to help with their specific case of back pain.

Does sitting make lower back pain worse?

Sitting for long periods with little to no movement can cause lower back pain, especially when a person sits hunched over, cross-legged, and without lumbar support.

Generally, the sitting position that puts the least pressure on the back and shoulders is best for lower back pain. Typically, this involves placing the feet on the ground and using back support.

Other ways to help manage and treat lower back pain include medication and physical interventions. An individual can also make lifestyle changes to try and prevent pain from occurring, such as doing sufficient exercise and maintaining a moderate weight.