A Physical Therapist Explains How to Prevent Back Pain from Standing All Day

“My back pain used to affect so much of what I did,” a Hinge Health member recently told us. “I’d regularly have to support my back against my hands when I walked, and I had to turn sideways to get into my car, putting my butt in before my legs.” 

We’ve all been there: You spend a day standing in line at Disney World or are on your feet all day at the mall, and by evening your back is toast. Maybe it even affects your ability to do your normal activities for a few days to a few weeks. Lower back pain during everyday activities, like standing, can be debilitating and frustrating. But there’s a lot you can do to treat and even prevent it entirely — and it starts with movement and exercise therapy. 

In fact, the same Hinge Health member whose back pain affected their ability to do so much told us that their stretching and strengthening routine has made a big difference in their life. “Now, I can stand in a line and wait for something, whereas I used to have to sit down or have someone stand in line for me,” they said. “I can bend over to do something and actually stand back up straight without holding on to something.” 

What Causes Lower Back Pain While Standing?

There are a lot of different causes of back pain, and standing can certainly be one of them. When you stay in the same position for too long — sitting, standing, lying down, you name it — it can contribute to back pain. 

While this can happen to anyone, there are certain factors that can make it more likely that you will experience back pain while standing, or have worse symptoms. They include:

Wearing unsupportive shoes. Some people can wear any type of shoe they want and never experience back pain. Others aren’t so lucky, though. If you’re prone to back pain, you may want to avoid shoes that tip you forward. High heels are the most obvious culprit of this, but even some athletic shoes can be problematic for some. “Oftentimes, people will think they’re safe because they’re wearing running sneakers. But if it has a thicker heel than the forefoot, gravity will tip you forward and put more pressure on your back,” explains Dr. Broach.

Sciatica. This is nerve pain that travels from the buttocks down the leg. It’s due to irritation or compression of nerves in the lower back. “If you have sciatica and stand in one position for a long period of time, then your muscles get cold in that resting position,” explains Dr. Broach. “When you do switch positions or move around, those muscles can then push down on your sciatic nerve, which worsens pain.” Although movement can initially cause an uptick in sciatic pain after being still for a while, frequent movement breaks or changing positions can help prevent pain from setting in at all. 

Stress. It’s probably not news to you that stress can take a toll on health. Research suggests that stress can almost triple the risk of developing lower back pain. “I just began to work with a patient who noticed that her back pain while standing started just two weeks after her mother died,” says Dr. Broach. “We don’t know exactly how emotions related to stress, like grief, worsen back discomfort, but the thought is these negative emotions amplify pain.” Let’s face it: We all have some stress. You can’t control every stressor in your life, and you don’t have to. There is always something you can do to manage and take control of certain stressors, which can make a big difference when it comes to back pain. 

And if you have flat feet? Don’t worry — you’re far from doomed. While it’s true that almost two-thirds of people with flat feet report low back pain, especially during activities such as standing or walking, a flat foot doesn’t mean a flat outlook. One reason people with flat feet may experience back pain is that their ankles tend to roll slightly inward when they stand, which can impact knee and hip alignment and trigger lower back pain, notes Dr. Broach. But plenty of people with flat feet never experience back pain, and most people with persistent back pain have perfectly arched feet.

Flat feet may be one of many contributing factors to your low back pain, but it is not the only reason for it, and there are many ways to manage and prevent back pain, no matter what the bottoms of your feet look like. 

How to Prevent Back Pain While Standing

You don’t have to learn to just live with back pain when you’re standing. There are things you can do to help prevent it, or at least make it more bearable. They include:

• Shift your weight. If you know that you’ll need to stand for an extended period of time without the ability to sit or even walk around, make an effort to shift your weight every few minutes from your toes to your heels, or from one foot to the other. “Simply changing your position frequently can help take the strain off of back muscles,” says Dr. Broach. You can also try marching in place for a few minutes. “This adjusts your hips, so it helps temporarily release back muscles that hold you upright,” she explains.

• Opt for softer surfaces when possible. If you can, try not to stand on hard surfaces such as stone, asphalt, or concrete for too long, advises Dr. Broach. “They’re not very forgiving, which puts more weight on your back,” she explains. Better surfaces include grass, dirt, walking or running tracks, and even indoor carpet. If you can’t control where you stand, consider options that make hard surfaces more forgiving, such as an anti-fatigue mat.  

• Break up standing desk time. Standing desks can be a terrific tool to manage back pain. But just as sitting in front of a computer for long periods can cause an uptick in back pain, it’s possible that standing can, too. About 40% of people who use standing desks for longer than two hours at a time develop low back pain, according to a 2018 study published in the Journal of Applied Biomechanics. If you notice an increase in pain after using a standing desk for a long time, sprinkle in some time for sitting or walking to alleviate muscle tension. (This can also help to prevent pain and tension in other areas, such as knees and hips.)

• Take a deep breath. Slow, controlled breathing helps to counteract the body’s fight-or-flight response, which elevates levels of stress hormones in the body and can contribute to back pain. One good technique to try is called diaphragmatic breathing, or belly breathing. A 2017 study published in the Journal of Sports Rehabilitation found that this type of exercise helped to reduce back pain.

• Do some gentle exercises throughout your day. Targeted movements, exercises, and stretches increase the strength and flexibility of the structures in and around your back and prevent pain flares. (More information on this below). 

How to Find Back Pain Relief After Standing

Sometimes, you can’t control how long you have to stand. And after a long day of being on your feet, you probably want quick and easy ways to help your back stop hurting. Here are some safe and effective at-home treatments for lower back pain:

• Move around. You might worry it will make your back pain worse, but light exercise such as walking can stretch out muscles and increase blood flow to the area, says Dr. Broach. Studies show people with low back pain recover faster when they stay active. Good options include walking, swimming, using a stationary bike, and low-impact aerobics.

• Heating pads or wraps. Heat promotes muscle relaxation and increased blood flow, bringing nutrients to the sore area to stimulate healing.

• Over-the-counter pain relievers. Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. 

• Physical therapy. A physical therapist can work with you on exercises to strengthen and stretch out your sore back muscles so that they can better support your back. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

If you’re prone to back pain while you stand, exercises that stretch and strengthen your back and core muscles can prevent and treat pain. Here are some of the best exercises for lower back pain when standing, recommended by Hinge Health physical therapists.  

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Be Aware of How You Stand 

One of our favorite sayings at Hinge Health is, your best position is your next position. And being aware of your standing habits can be helpful in putting this into practice. Do you notice that you stand with your weight on one leg more than the other? Or with your stomach out? Slouched a little? “None of these things are bad, but if you notice that you tend to hold any of these positions for too long or too often and your back feels aggravated, you might adjust your standing habits to take pressure off your back muscles,” says Dr. Broach. It may not be a problem, but it’s worth taking note of how you tend to stand so that you can tweak your posture and change positions if low back pain is a problem for you.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Sciatica. (2020, March 25). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/12792-sciatica

2. Choi, S., Nah, S., Jang, H.-D., Moon, J. E., & Han, S. (2021). Association between chronic low back pain and degree of stress: a nationwide cross-sectional study. Scientific Reports, 11(1). doi:10.1038/s41598-021-94001-1

3. Almutairi, A. F., BaniMustafa, A., Bin Saidan, T., Alhizam, S., & Salam, M. (2021). The Prevalence and Factors Associated with Low Back Pain Among People with Flat Feet. International Journal of General Medicine, 14, 3677–3685. doi:10.2147/ijgm.s321653

4. Viggiani, D., & Callaghan, J. P. (2018). Hip Abductor Fatigability and Recovery Are Related to the Development of Low Back Pain During Prolonged Standing. Journal of Applied Biomechanics, 34(1), 39–46. doi:10.1123/jab.2017-0096

5. Anderson, B. E., & Bliven, K. C. H. (2017). The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain. Journal of Sport Rehabilitation, 26(5), 452–458. doi:10.1123/jsr.2015-0199

6. Chou, R. (2021, September 20). Low Back Pain in Adults (Beyond the Basics). UptoDate. https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics