Back Pain with Sitting after an Auto Accident

Back pain is a common problem following auto accidents.  Many people sit for prolonged periods at work.  An issue that many encounter is that this back pain becomes worse when sitting.  There are options available to manage back pain with sitting. 

One of the better options is to stand rather than sit.  Standing takes pressure off the back and helps decrease shearing force on the back as well.  Shear forces are translational forces that in the spine are controlled by the vertebral facets and ligaments.  The ligaments help control posterior movement of the low back vertebra.  These ligaments are frequently injured in auto collision.  When injured, these ligaments become stretched and normal ligament strength is reduced, at which point they are unable to properly control joint movement.  

Standing also helps decrease the chances of a variety of other health issues.  Prolonged sitting is associated with weight gain, hemorrhoids, and back pain regardless of previous injury.  

Standing desks and standing desk retrofits are available and can help reduce strain on the back.

The seated position tends to place the low back into a flexed position.  Often the head moves forward with the shoulders rolling forward as well.  In this position the weight of the body is redirected from vertical compression into rearward shear force, placing pressure on the joints and ligaments and promoting rearward sliding of the discs and vertebra.  Many people sit to use computers for work.  It is often the case that a computer workstation and accessories are not well ergonomically positioned.  Adjustments to monitor, keyboard, mouse, and chair height and positioning can help reduce strain on the body, but many of the problems with sitting remain.

When standing, the weight of the upper body centers closer to the lumbar portion of the spine, which results in a shift in the ratio of forces away from shear and towards compressive.  Compressive forces are well handled by the bone of the spine, and easier on the body than shear forces.  Additionally, overall force on the spine is reduced when standing straight as the muscles of the back don’t have to work as hard to balance the upper body and maintain posture.

Lumbar support pillows and cushions can help limit flexion of the low back and promote a good lumbar back lordotic curve.  This reduces both shear force and overall force placed on the back compared to sitting with the low back in flexion, but force on the back is still increased compared to standing.  When using a lumbar support cushion, it is important to make sure that it is correctly positioned.  It is easy for these cushions to slide down and leave you with your back unsupported.  A lumbar support cushion should be placed at the small of the back.  It is important that the cushion be placed flush and against the back in order to provide support.  

Back braces can help manage low back pain.  Back braces provide support for the back and help manage shear force, which produce much of the strain on the ligaments.  Back braces can also help limit excessive flexion and extension in the low back.  However, back braces do have limitations.  They can be difficult to wear for extended periods.  Additionally, you can become dependent on a back brace.  The weight that back braces help manage is normally taken care of by the muscles, and these muscles can become accustomed to this and contribute less to postural control.  In more extreme cases, these postural muscles can weaken or atrophy.  

Replacing a chair with a stability ball can be helpful in managing low back pain.  The stability ball presents an unstable surface for sitting, and activation of the core muscles is necessary in order to maintain the seated position.  These core muscles help stabilize the joints of the back, which can help prevent and manage low back pain.  However, the correct stability ball size needs to be selected.  Many people sit incorrectly on stability balls as well, slouching their backs while on the ball instead of sitting upright and activating the core muscles.  Instruction in the use of a stability ball may be necessary.  After a motor vehicle accident, the muscles of the core may be injured, and can tire with extended use of a stability ball, leading to slouching.   

Exercises and stretches are beneficial for low back pain as well.  Exercises and stretches can provide relief of low back pain and improve healing.  Seating modifications are often necessary to manage low back pain after a car accident.  

Your Chiropractor will be able to instruct you in exercises and stretches as well as seating modifications to help you heal.  Most of all, a chiropractic physician can perform spinal manipulation to improve spinal motion and improve your body's physical function.   Contact our chiropractic office in SE Portland, or Aloha-Beaverton, OR if you are suffering from low back pain or have been involved in an auto accident.