Lower back pain when standing and walking can be caused by spinal arthritis, stenosis, disc herniation, and decreased hip extension and lumbar spine extension.
It’s worth mentioning that these are all potential causes. In most cases, it’s not possible to know the exact cause of lower back pain unless you’ve had an acute injury like a fall, car accident, or some other type of trauma.
Even if you got imaging like an x-ray or MRI on your lumbar spine, it’s often unclear as to what structures could be producing symptoms.
This is why it’s so important to not let your image dictate what your treatment should be unless you are a surgical candidate.
Allowing symptoms to guide treatment is the best approach we have to improve your overall functional status.
I created this guide to exercise and lower back pain. It’s titled degenerative disc disease but it applies to all back pain.
You can also join our free FB group for lower back pain with this link.
Table of Contents
- What are the potential causes of lower back pain when standing and walking?
- Decreased hip and lumbar spine extension
- Spinal stenosis
- Spinal arthritis
- Muscle spasm
- Sedentary lifestyle
- What Does NOT contribute to lower back pain when standing and walking
- Poor posture
- Bad Mattress
- How To Improve Lower Back Pain With Standing and Walking
- Graded walking or standing program
- Specific exercises
What are the potential causes of lower back pain when standing and walking?
If you’re having pain when standing for long periods of time, this section is going to be for you.
Decreased Hip and Lumbar Spine Extension
This finding, in my experience working with patients, can sometimes, once improved, allow for better movement at both the hip and lumbar spine and relieve some of the repetitive stress at the end of the range of motion.
While this is not a certainty that this is the cause or will be the solution it is something worth noting if there is a significant decrease of range of motion.
The logic is this. If you have diminished hip extension, that means your lower back will be forced into more lumbar extension.
Extension is not bad in itself, it’s a normal motion that the spine and most other joints go through. However, as we get older, particularly, we start to lose range of motion in all directions, including extension.
This is just something to try out and test to see if it improves symptoms.
Spinal Stenosis
If you do have spinal stenosis then it is absolutely possible that this could lead to lower back pain while standing.
With stenosis, walking or standing back be painful because there is decreased space for the spinal nerve roots to exit out of the facet joints.
These facet joints create a space called the neural foramen or foramina and if they narrow down enough, they can become even more crammed when in the position of lumbar extension, which, is what happens when you are walking or standing.
Spinal stenosis can also occur around the spinal cord itself and cause bilateral symptoms.
People with spinal stenosis often worry about back hyperextension however in this article I describe why that worry might be unfounded.
Spinal Arthritis
Spinal arthritis, also known as degenerative disc disease, is very closely related to spinal stenosis.
Spinal degenerative changes are normal as we age and some people will experience pain, while others will not.
It really depends on the person, and at this point in time, we cannot predict who will have higher or lower amounts of low back pain from this.
Later in the article i’ll discuss the best things you can do to improve symptoms and help your back hurt less.
Muscle spasm
Muscle spasms can come on for a variety of reasons.
Maybe you were lifting heavy the other day and your muscles weren’t prepared for that causing you to feel some pain in your lower spine. But honestly, this can happen with light weight just as frequently.
I can’t tell you how many times clients have told me that they feel pain in their spine and on either side of their back after picking up a sock from the ground.
So I think it just goes to show you can feel pain when lifting heavy or light. There is nothing inherently dangerous with heavy lifting.
If you were lifting the day before and tweaked your back and then you need to go stand or walk for an extended period of time, it’s possible that you may experience pain. In any case, the best treatment for this is to keep moving and try to reduce aggravating factors.
Sedentary lifestyle
Most health conditions are exacerbated by a sedentary lifestyle. If you aren’t moving around normally with basic physical activity such as walking for work, with your dog, or regularly exercising, you are at higher risk for just about every health condition that exists, physical and mental.
Being physically active cannot completely eliminate your risk of injury or pain, however it can reduce it.
Plus, it just feels good to get the blood flow going and often times just getting moving more can be a potent pain relief strategy.
Here is what likely does not contribute to low back pain when standing or walking
Poor posture
This is old news. If you are stuck in the late 90’s and the early 2000’s, poor posture and debating poor posture was all the rage.
There is a ton of new research out showing that poor posture is not really a thing.
Sure, if you stay in one posture for too long you might start to experience some pain. That’s normal.
But for one posture to cause significantly more pain in the lower back, or upper back for that matter, is nonsense.
I’ve had patients who have perfect posture (as defined by society), who have horrible pain. I’ve also had patients who have “horrible posture,” who have no symptoms whatosever.
The name of the game is changing your posture routinely as to not stay in one position longer than your body wants. Usually you’ll start to ache and get uncomfortable.
A Bad Mattress
I’m going to save you thousands of dollars right here. If you think its your mattress, its probably not.
Sure, if your mattress is really old and you can’t find a comfortable position to sleep in, make sure to get a new mattress.
But aside from that, I wouldn’t worry about it too much.
How To Improve Back Pain When Walking (and standing)
Your doctor may suggest you work with physical therapy to improve symptoms if they are severe.
At physical therapy you’ll likely work on several different exercises, including stretches.
In addition to the exercise component of physical therapy, you should also discuss your imaging findings and what they mean, the importance of regular physical activity for your overall health, other health conditions you may have, and what types of medications you’re taking.
A lot of people think that you only exercise at physical therapy. While this is true in some instances, if you are working with a good therapist, you’re not only going to be working on strengthening back muscles, but you’ll also be focused on functional goals such as setting a step goal per day.
Personally, since I am a physical therapist, I think that often times we focus on pain relief for low back pain and forget that the things people really care about is how that will actually transfer to their daily life.
The standing or walking that you might need to be able to do is at family gatherings, work events, or getting together with friends.
We uncover those deep drives and passions for you to make sure that we are focused clearly on getting you back to those things.
Graded walking or standing program
If I were your therapist, this is the first thing we would implement.
Find the duration or distance you can walk before your pain starts to get a bit worse.
Then, once we’ve found that amount of standing or walking, we can slowly increase it over time.
Eventually you’ll be able to go long periods of standing or walking without sitting and be back to your favorite functional activities.
This can take some time, though, and everyone is different.
I’ve had clients who take over 6 months or more to make real progress in their standing tolerance and/or walking distance. So, keep the faith!!
Before we get into the exercises I wrote an article about back pain in new parents that you might be interested in (if you’re a parent.) If not, move on 🙂
Specific exercises
I usually start people off on three sets of 10 for these types of exercises and then test to see whether or not they’re responding well to it (increased or decreased symptoms)