We examine the habit of leaning on one buttock and the burden on the erector spinae muscles together
Written by Jae-seok Ahn | Director, seoul chungdam dr ahnapa clinic
When working while sitting, does one side of your lower back feel particularly heavy? You may feel a little better if you rub your lower back or stand and walk, but the discomfort returns when you sit back in the chair.
When this happens, I check which part of your lower back hurts and ask you one more thing.
"How do you typically sit in your chair?"
I ask this to check whether you have a habit of leaning on one armrest or putting your weight on one buttock, or if your desk or screen is shifted to one side.
Of course, having these habits does not necessarily cause pain. However, if the same area hurts repeatedly in the same posture, the way your body is supported also becomes an important clue to confirm during treatment.
What happens to your lower back when you lean on one buttock while sitting?
Your lower back and torso rest on your pelvis. When you lean to one side or sit with your torso twisted, the way surrounding muscles work also changes to maintain balance.
The muscle we examine together at this point is the erector spinae.
The erector spinae is a group of muscles that runs along the back of the spine and is involved in holding the torso upright and controlling movement. It supports your body along with muscles of the abdomen and buttocks.
For example, if you work for a long time leaning your body on one armrest while only turning your head toward the screen, discomfort can accumulate not only in your lower back but also in your upper back, neck, and shoulders.
In such cases, while checking the painful muscles, I also examine how long you stay in that posture and whether symptoms change if you shift your support position.
You must distinguish whether posture is the cause or if your posture changed because of pain
I do not immediately say "your pelvis is misaligned, which is why it hurts" just by seeing how you sit to one side.
While some people are naturally comfortable with that posture, others shift their body to the opposite side because their lower back or buttock hurts. If the posture is to avoid pain, forcing left and right alignment may be even more uncomfortable.
Additionally, lower back pain can involve multiple factors: muscles, joints, discs, and nerves.
Examining posture and examining lower back conditions should be done together.
More important than the left-right differences visible in a photo is what movements are actually difficult and in what situations pain changes.
This is how seoul chungdam dr ahnapa clinic examines it
Based on approximately 25 years of pain treatment experience, I believe it is important to listen specifically to the discomfort patients experience in their daily lives.
First, we confirm the pattern of pain.
I ask whether pain occurs only when sitting, or also when standing or walking, and whether pain or numbness extends into the buttocks or legs. I also check when it started and how you responded to previous treatments.
Second, we examine the condition of your lower back and nerves.
We check the movement and tenderness of your lower back, and if necessary, confirm sensation and muscle strength in your legs. The need for further testing is determined based on symptoms and examination findings.
Third, we examine your posture and loading habits in daily life.
We check whether your feet touch the ground when sitting, which side you put your weight on, and whether you work with your torso or shoulders twisted.
Based on this, along with treatment needed for your current condition, we explain specific actions you can try at home and at work.
Just saying "sit up straight" makes it difficult to understand what needs to change. An explanation tailored to your chair, desk, and the way you work is necessary.
Four things to check in your chair today
1. Remove thick items from your back pocket
If a wallet or mobile phone is placed under your buttocks, the support sensation on both sides can differ. After removing the item, check if sitting feels more comfortable.
2. Support both feet comfortably
If your feet are floating, you can adjust the chair height or use a footrest. Rather than forcing your lower back straight, check if your feet, buttocks, and backrest comfortably support your body.
3. Keep your screen and frequently used items close
If the screen is off to the side or the mouse is far away, you may twist your torso or reach your arm while bracing. After bringing your work closer to your body, check if tension in your lower back and shoulders decreases.
4. Change your posture before discomfort sets in
Once you find a good posture, you don't need to keep it fixed all day. Stand briefly during work breaks or try changing your sitting position.
The goal is not to maintain rigidity all day long, but to manage your posture so that burden does not concentrate on one area for extended periods.
Don't just change your posture and wait in these cases
If pain persists even after adjusting your lifestyle habits, or if sitting at work, walking, or sleeping becomes difficult, you should have an examination.
Especially if you continue to experience leg numbness or notice changes in strength, you should have your nerve condition checked.
If you newly experience difficulty urinating, problems with bowel or bladder control, numbness in the genital area, or rapid loss of leg strength, immediate emergency evaluation is necessary.
Frequently asked questions
Q. Will my lower back pain go away if I just fix my habit of sitting to one side?
It can help reduce stress, but lower back pain cannot be completely resolved by that alone. Depending on the cause and examination findings, treatment, exercise, and lifestyle adjustments should be considered together.
Q. My lower back hurts even more when I sit up straight—should I continue?
Do not force it. If you are excessively arching your lower back or continuously tensing your muscles, it may become more uncomfortable. Find a position in which you can rest comfortably, and let us know during your visit which postures change your symptoms.
Q. What should I prepare before my appointment?
Please organize information about where it hurts, how long after sitting down you feel discomfort, and whether it changes when you stand and walk. If you have previous test results and a list of medications, please bring them as they can be helpful.
For recurring lower back pain, please also show us your typical sitting posture
If you are considering treatment for recurring lower back pain in Dasan or Namyangju, please examine not only the painful area but also how you typically use your body.
If possible, prepare photos showing the chair, desk, and working posture you typically use. These can be helpful reference materials for understanding daily stress on your body.
seoul chungdam dr ahnapa clinic
Pain and posture correction treatment inquiries: 031-8088-8030
When you call, please say: "I experience lower back pain on one side when sitting and would like to receive treatment."
Director Jae-seok Ahn
Specialist in Anesthesiology and Pain Medicine, Seoul National University Hospital, 2000
Completed Fellowship in Pain Medicine, 2001
Served as Department Chair of Pain Medicine at a General Hospital for 4 years
This article provides general medical information. Diagnosis, treatment methods, and outcomes may vary depending on individual conditions and diseases.
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