The biomechanics of commuter back pain

With an average commute time of 32 minutes, many New Jerseyians are spending more than an hour on public transportation each day. Whether you take the NJ Transit bus to Hackensack or an NJ Transit train into Manhattan, that’s a lot of time spent sitting down.

Dr. Saurabh Dang is a double board-certified pain management specialist who frequently treats daily commuters at Hudson Paine and Spine. Dr. Dang sees first-hand the pain and discomfort caused by a daily routine that depends on long periods of sitting.

Sitting rocks. Sitting sucks. (The pelvis)

Your first clue to why sitting is bad for you is found in the pelvic tilt, a small rocking motion with outsized importance. The pelvis - the bone structure at the base of the spine connecting the trunk to the lower limbs - is the foundation of your sitting posture.

The ideal sitting position accentuates rather than diminishes the body’s natural movements, starting with the pelvis tilting slightly forward. What typically happens when you sit is your body weight collapses onto your pelvis and spine, which causes an unnatural backward pelvic rotation. Instead of the more natural slight anterior pelvic tilt, we see a posterior tilt. This subtle move adds a roughly 40% higher pressure load to your lumbar discs. A recipe for pain, clearly.

Can’t you C? (The spine)

The spine also takes some abuse from prolonged, improper sitting. Any time the spine’s natural curvature is disrupted, you’re putting your ligaments under constant tension. This can lead to tissue creep (gradual elongation or deformation of connective tissues) and higher levels of muscle strain.

What does it look like? Your neutral double-curved ‘S’ shape collapses into a lazy single lateral ‘C’ curve. In other words, a slouch. This position leads to uneven loading on discs and throws surrounding ligaments, joints, and muscles into imbalance.

Use it or lose it (The muscles)

Pain and strain aren’t the only downsides to all that sitting. Long periods of physical inactivity can slowly degrade your muscles into a weaker and less stable condition. Your glutes and core - key stabilizing muscles for the body - are lulled into a sleepy state.

Disuse atrophy happens when your muscles go long stretches without engagement. Sitting on buses and trains (and at your desk) for hours on end - and repeating that daily routine for months and years - encourages your muscle fibers to shrink and weaken. When you pick up weights at the gym, you’re working to strengthen your muscles. If you do nothing, it’s not just status quo; your muscles actually weaken over time without any prompting.

When to see a specialist

Chronic pain is not normal. You should not have to organize your life around pain, avoid normal activities, or silently tolerate symptoms for months or years.

Rather than silently tolerating your pain for months or years, visit Dr. Dang to identify and treat your condition once and for all.

The good news? Most chronic pain can be treated without surgery. Dr. Dang and his team use advanced, minimally invasive treatment strategies based on a deep understanding of commute-related pain and backed by scientific evidence.

Related resources

• Back pain treatment
• Chronic pain treatment
• Dr. Saurabh Dang
• Contact Hudson Pain and Spine