Hello. I am Dr. Ahn Jae-seok, director of seoul chungdam dr ahnapa clinic, treating pain in Namyangju Dasan New Town.
When your lower back feels heavy and sore, we instinctively rub the painful area or lean backward. Shortly after stretching, it feels refreshing momentarily, but after sitting at a desk for just 1-2 hours, your lower back inevitably stiffens—I'm sure many of you have experienced this.
When I see lower back pain patients in the clinic, I don't simply focus on the painful area. I always ask questions like, "How many hours per day do you sit at your desk, and in what posture?" and "When and how do you use your lower back throughout the day?"
Because the pain will ultimately return to where it started if we don't examine both the treatment administered in the clinic and the cumulative load placed on the lower back in daily life after the patient leaves through the door.
1. The Erector Spinae Does Not Work Alone
When the lower back feels sore, it's common to hear that "the erector spinae is knotted up." The erector spinae is a group of muscles that runs lengthwise along both sides of the spine from the neck to the pelvis, serving as a key pillar that keeps the spine upright and maintains balance when the torso tilts or rotates side to side.
However, the erector spinae absolutely does not bear the weight of the spine alone. The abdominal muscles (rectus abdominis and transverse abdominis) in front, along with the glutes (buttock muscles), pelvic ligaments, and joints below, must work together in organic cooperation for the lower back to remain comfortable.
When sitting in a fixed posture for extended periods, the abdominal muscles and glutes tend to lose strength and become slack. As a result, the erector spinae alone bears excessive load, becoming stiff and entering a defensive state of tension to prevent the spine from collapsing.
2. Clinic Case: "Why Does It Hurt More When I Keep My Posture Perfectly Straight?"
Recently, a patient A, a man in his late 30s working in an office in Dasan-dong, came to see me.
Patient A's Concern
"My lower back kept feeling sore, so I watched YouTube videos and kept my spine straight, constantly tensing my abdomen and lower back. But after a few days, my lower back became stiff as if cut by a knife, and by the end of the workday, even walking was difficult."
Patient A was a typical example of falling into another trap while trying to avoid a hunched posture. In an effort to straighten his spine, he was excessively hyperextending (bending forward excessively) his spine and keeping his abdominal muscles and erector spinae tense all day long.
Through ultrasound and examination, I first confirmed whether there was nerve compression, and along with pain treatment to reduce the burden on the overly tense erector spinae, I provided corrected "criteria for sitting in a chair." When he released the posture of tensing and bracing, distributing weight through his glutes and backrest, the pain that had persisted for weeks noticeably improved.
"A tightly knotted muscle does not necessarily mean it is the root of the problem."
Just because muscles are stiff doesn't necessarily mean a disc has herniated, and conversely, even if X-rays or MRI show degenerative disc findings, the pain you're currently feeling isn't necessarily caused only by that degeneration. When the pain started, whether there is radiating pain extending to the legs, and how it changes with movement must all be examined comprehensively to reveal the true cause.
3. Three-Step Environmental Adjustment Method for Those Who Work Sitting
The real purpose of postural correction is not to rigidly lock your body into one correct shape like military drill formation. It's to create room for your joints and ligaments to comfortably distribute load.
-
Adjust so your entire sole touches the floor
If the chair is too high and your heels lift off, weight shifts to your lower back and the back of your thighs. Lower the chair height so your entire sole touches the ground, and if the desk is too high to adjust, be sure to use a 'footrest' to maintain a knee angle of 90-100 degrees.
-
Lean back against the backrest while avoiding hyperextension
Tensing your abdomen and lower back to keep your spine perfectly upright dramatically increases fatigue in the erector spinae. Place your glutes deep into the chair and lean your entire back comfortably against the backrest while distributing some of your weight to the chair.
-
Practice 'micro movements' every 50 minutes
No matter how perfect a posture is, maintaining it for more than an hour becomes poison for the spine. Before pain develops, get up once every 50 minutes and walk lightly for 1-2 minutes. Even while sitting, gradually shift your pelvic position to distribute the load.
4. One-Minute Relaxation Exercise on a Chair Recommended in the Clinic
When your lower back feels sore during work, don't force yourself to twist or bend your spine. Instead, I recommend a movement that safely releases tension in the stiffened erector spinae and pelvis.
-
Pelvic Tilt on Chair
-
Sit properly in a chair and place your hands on your hip bones.
-
Exhale and gently round your back, tilting your pelvis backward as if your tailbone touches the bottom of the chair. (Your lower back muscles stretch gently.)
-
Inhale and raise your tailbone slightly, straightening your pelvis. At this point, don't excessively bend your lower back and move only to a natural curve.
- Repeat 10 times slowly with your breath.
-
-
Seated Glute Stretch
-
Place one ankle on top of the opposite knee, creating a "4" shape with your leg.
-
Gently lean your upper body forward from the hip joint (pelvis) while keeping your spine straight and not bending at the waist.
-
Hold for 15-20 seconds at the point where the outer buttock is gently stretched. (3 times on each side)
-
5. If You Have These Symptoms, You Need Immediate Medical Consultation
Simple muscle tension and postural imbalance often improve with environmental improvement and non-surgical pain treatment. However, if the following nerve compression warning signals (Red Flags) are present, don't try to endure it with posture practice and seek medical attention promptly for precise diagnosis.
-
Radiating pain extending from the buttocks to the thighs, calves, and toes with numbness or tingling
-
Loss of strength in the ankles or toes, causing you to drag your foot or slip out of slippers when walking
-
Feeling of dulled sensation around the buttocks or perineum
-
Sudden loss of control in bowel and bladder function (urinary or fecal incontinence)
Pain is an alarm bell your body sends to warn: "The way you're currently using yourself is overloaded."
At seoul chungdam dr ahnapa clinic, we don't simply aim to alleviate symptoms in the painful area. Rather, we carefully examine imaging findings, your actual joint mobility, and postural and load habits in daily life to provide personalized management direction for each patient.
If chronic lower back pain makes your daily life uncomfortable, don't suffer alone. Please visit us for a systematic examination.
#seoul chungdam dr ahnapa clinic #dr ahnapa #namyangju pain clinic #dasan pain clinic #dasan posture correction #erector spinae #namyangju lower back pain
This post is medical information provided by seoul chungdam dr ahnapa clinic. Appropriate diagnosis and treatment methods may vary depending on individual conditions and spinal structural status.