4 min

Evidence-based tips to ease back pain with sitting

How to treat back pain you get from sitting.

Kim Van Deventer

Oct 21, 2024

Medically reviewed by

If you've ever been told, "don't slouch", or to "just sit up straight" to make your back pain feel better, you'll know this isn't always helpful advice.

The truth is, whether you sit with your back fully supported, slumped, or leaning back in a chair, any of these positions can make your pain feel better or worse.

According to current advice, the best sitting posture for back pain is the one that feels the easiest and most comfortable for you to maintain.

In this article, we explain why back pain often worsens with sitting, discuss the best way to sit when you have back pain (according to current research), and give tips to help you sit comfortably in different settings.

Let’s start with how sitting affects your back.

Why your back hurts from sitting

Research indicates that rather than the specific posture, sitting in uncomfortable positions for long periods can worsen existing back pain or lead to back discomfort in those without previous back issues.

Why sitting still for long periods in awkward postures may cause back pain

Reduced circulation

Movement helps to circulate nutrients and waste products in and out of your back tissues (joints, muscles, ligaments), nourishing and keeping your back healthy, supple, and strong. Sitting still for long periods reduces your circulation, starving the tissues of nutrients and allowing waste products to accumulate. If this happens too often, it can cause back pain.

Tired muscles

If you sit in a way that feels difficult to maintain, your back and trunk muscles can fatigue and become tense and painful.

Evidence-based rehab plans for lower back pain

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Woman looking at the Exakt Health app for her lower back pain from sitting.

Common beliefs and misconceptions about posture and back pain with sitting

What is posture, really?

Posture is how you hold your body while standing, sitting, or lying down. It results from the combined effort of many muscle groups working together and is linked to your overall physical and mental health and well-being.

What is “good posture”?

“Good posture” is commonly understood as sitting straight, standing tall, and aligning your body. The assumption is that in a good posture, all your tissues align optimally for their expected job.

Back pain from sitting with "good posture".

What is “bad posture”?

"Bad posture" usually refers to sitting, standing, moving, or lifting with your body not aligned, your back bent, and your shoulders hanging down.

Back pain caused by "bad sitting posture".

What do people believe about sitting posture and back pain?

Many people (including healthcare professionals) think that sitting with “good posture” helps protect your back and keeps it from hurting, and sitting with “bad posture” can injure your back and make it hurt.

What does the current evidence say about back pain and sitting posture?

Evidence shows that these beliefs about posture and back pain are widespread but unhelpful and often get in the way of people fully recovering from back pain.

The review of the science shows that:

No single “correct” posture can cause, ease, or prevent back pain.
“Good” posture doesn’t prevent back pain, and “bad posture” doesn’t cause it.
Sitting in any posture for a long period can lead to discomfort, regardless of the posture itself or whether you have back pain or not.
Your stress and anxiety levels, sleep habits, strength and fitness levels, and genetics link more strongly to developing back pain than posture.
Focusing on staying fit and active, sitting in more comfortable, relaxed positions, and regularly changing them up is more effective for reducing sitting-induced back pain than always trying to maintain one “perfect “posture.

Now let’s look at finding relief from back pain while sitting.

The research suggests that chasing the "perfect" sitting posture may be a waste of time. Achieving a comfortable sitting position and moving regularly appears to be more effective for back pain.

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How to minimize back pain when sitting in different settings

Tips for back pain when sitting in social settings

If you have a choice, it can help to...

Choose a comfortable posture

According to the research, the best posture is the one that feels the easiest and most comfortable for you to maintain. So, aim to be more relaxed, add support when necessary, and sit as effortlessly as possible.

Choose soft but firm chairs and surfaces to sit on

Too-soft surfaces (like some sofas) allow you to sink in too deeply and can increase your back pain.

Sit on chairs with backrests

Choosing a seat with backrests ensures you have the option to support your back if necessary and gives you the ability to change your position regularly.

Add extra lower back support if possible

Sitting very upright without any back support can make your muscles tired and often increases back pain; a cushion, rolled-up blanket, or towel behind your lower back can help keep you sitting comfortably for longer.

Keep your feet supported

Preferably flat on the ground, but having them supported evenly on a foot bar or footstool can also help

Perch if sitting down hurts too much

Resting your bottom on a high chair or stool can often feel more comfortable; it also helps to break up long periods of sitting.

Change position BEFORE pain increases

Changing position and moving at regular intervals help your joints stay well-nourished and stop you from overworking the same muscles all the time. Doing this before the pain starts or increases will help you to tolerate sitting for more extended periods than if you only take breaks after you start feeling pain.

Sitting on surfaces that are too soft can often worsen back pain.

Tips for when you get back pain from driving

If you get back pain when sitting in a car, the following adjustments may help.

Adjust your car seat

Set it to the appropriate height, angle, and distance from the dashboard so you can see the road easily and reach the pedals and steering wheel without straining.

Keep your back and thighs well-supported

If it feels more comfortable, consider adding back and thigh support (e.g., a seat cushion under your bottom and thighs or a rolled-up towel behind your lower back).

Position your headrest properly

Support your head, neck, and shoulders enough so your back can relax. It should not push your head forward.

Adjust your driving position so you don't have to strain to reach the steering wheel.

Tips for if you get back pain when sitting at a desk

If you regularly find yourself experiencing back pain when sitting at a desk, you can try the following...

Use a dynamic, ergonomic chair

No chair is best for back pain. However, chairs with movement mechanisms, adjustable armrests, and seat depths may be helpful to you. These can keep your back better supported, which may help you sit more comfortably for longer periods.

Assess and adjust your position regularly

Studies show comfort levels with certain positions can change when you have back pain; you may find the chair settings you found comfortable a week ago are less comfortable now

Be more active at work

A sit-to-stand desk can help you find the right balance between sitting and standing to ease your back pain at work. Also, taking active breaks (e.g. short walks) and moving regularly throughout the day can help..

If you're working from home, doing back exercises during your active breaks can help.

Start your lower back pain rehab today!

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Man using the Exakt Health app to guide his back pain recovery.

A desk that can be adjusted for sitting and standing makes it easy to change position and reduce back pain at work.

More about back pain

Final thoughts

Back pain is a complicated condition, and easing pain with sitting takes more than simply focusing on “good” or “bad” posture.

While adopting more comfortable postures and regularly adjusting them can help reduce back pain with sitting, other factors are usually also involved. These include muscle strength and endurance, pain beliefs, stress levels, sleep patterns, and more.

Taking steps to improve your physical and mental health as part of a comprehensive rehab program can reduce your back pain, making sitting easier and less of a burden.

If you would like to learn more about the different treatments for back pain, our article about non-specific back pain explains everything you need to know about it.