What exercises to alleviate low low back & sacrum pain when sitting?

September 4, 2023 12:01 PM

Physical therapy is not an option at this time. I have a lot of discomfort in the sacrum and low low back when sitting. This worsens considerably with harder sitting surfaces, but does also happen in my fancy ergonomic desk chair. I suspect it has something to do with lack of strength or muscle mass in the glutes and legs, and perhaps with the lower spine and tailbone bending when sitting.

I was told by a chiropractor many years ago that some imaging showed i have an unusually long tailbone ; and a couple years ago a physical therapist suspected my tailbone was shifted off to one side.

It's likely accurate to say I'm physically de-conditioned; though I have been more actively lately (more below) I (49M) have gone through long periods of little-to-no physical activity, while spending long hours at a desk.

Lately I've been doing more core work, and am also focusing on re-engaging and strengthening glutes (one-legged bridges ; squats ; swimming-pilates aka "supermans" ; etc. ). My back and abdominals feel pretty strong, and the sacrum isn't a problem until/unless I sit down, and then immediately there is pain (not sharp; dull, but intense). If I put my hands on the armrests and lift my butt up off the sitting surface, there's an immediate sense of relief, and sometimes some popping. I've tried so many cushions of different amounts of ... cushioning ... and either they don't work or they just trade one set of pain problems for another.

Thank you.

posted by jerome powell buys his sweatbands in bulk only to Health & Fitness (12 answers total)

I found a heating pad helped a lot, as did stretching while lying down and doing a sort of reverse plank while lying on my back.
posted by Rhedyn at 12:07 PM on September 4, 2023

Yup! It's the sedentary positioning that'll do that to you.
My friend (and physiotherapist) recommends the McKenzie Back Protocol to help with this (pdf).
posted by HarrysDad at 12:09 PM on September 4, 2023

This isn't an exercise, but since you mentioned that raising yourself off your tailbone helps: have you tried a Backjoy seat? It's not a cushion. It's sort of like an orthotic for your butt. It takes pressure off your tailbone and corrects your posture to reduce back pain.
posted by theotherdurassister at 12:10 PM on September 4, 2023

Similar problems as you, eventually occasionally causing significant lower back pain.

Similar to the mentioned Backjoy, I've been using the MEDesign Backfriend in the car and when I have to sit for a while. This helps.

A standing desk (or alternately a standing desk riser) will also help.

Modified Pigeon stretch helps me a lot.

And I know you said you can do PT, but honestly, a good sports PT will be able to identify and help you fix this issue.
posted by pyro979 at 2:00 PM on September 4, 2023

I think I have something very similar, based on your description of lifting your butt and feeling relief/sense of realignment in the tailbone area. When I was in a lot of pain, I had two months with weekly (or every two weeks by the end I can't remember) Rolfing sessions and that seemed to help my butt get realigned semi-permanently.

I like the Viniyoga series for lower back (so much so I bought a physical dvd!) Some of it you are already doing, but I think the whole sequence is better than the sum of its part.

I think what has helped me to keep up with a mini home Rolfing practice is to lie on my back and put a tennis ball underneath my butt. Usually there is a place or two that feels especially tender/tense. You can do this while seated too.

I find I need the cut-out coccyx cushions in basically every chair, including when riding in a car. Airplane seats are a special misery.

When I'm really in bad shape I just skip sitting in chairs entirely and sit on the floor (usually with my sit bones atop a folded blanket so my hips are elevated a bit.
posted by spamandkimchi at 2:11 PM on September 4, 2023

It's been recommended on here before but I definitely recommend The Back Mechanic by Stuart McGill. I bought it after reading a back pain AskMe and it's been really helpful.
posted by kbanas at 2:28 PM on September 4, 2023

If you have a fancy economic chair, there’s probably lots of adjustments you could make. It’s amazing how having it set up just right makes a difference.
posted by gryphonlover at 2:59 PM on September 4, 2023

It's been recommended on here before but I definitely recommend The Back Mechanic by Stuart McGill. I bought it after reading a back pain AskMe and it's been really helpful.

You can see a video here of Stuart McGill with several walk-throughs for the stretches. I use these as office breaks, can vouch that they have helped me although I am mostly relieving pressure from overuse/bad form rather than deconditioning.
posted by migrantology at 3:47 PM on September 4, 2023

I would search youtube for your specific problem under Bob and Brad's channel. If they're too cheesy for you, you can also search for other physical therapy practitioners + your problem.
posted by Issithe at 5:25 PM on September 4, 2023

I learned about Foundation back exercises through a coach who also trains at my gym. I have done the 12-min sequence (on YouTube here) on and off for lower back pain and it has made my back feel good.
posted by virve at 6:16 PM on September 4, 2023

That Foundation 12 Minute is a killer. Back pain seems to be his main thing, and he has other, less strenuous exercises. They're my favorites.
posted by rhizome at 12:36 AM on September 5, 2023

Try doing the reclining pigeon - Lie on your back, knees bent. Put the right ankle on left knee, gently pull that knee towards your chest. Hold. Do both sides. If that's too difficult, keep the position and gently push the right knee away from you. Work towards pulling the the thigh close to your chest, keeping the ankle on the knee.
This stretches all the groin muscles. It really helped my coxydynia.
Eventually I started doing the full pigeon.
posted by Enid Lareg at 9:12 AM on September 5, 2023