Lumbar pain when standing can arise for many reasons. However, the most common cause is mechanical. That is, it is from a physical source involving movement between the muscles, joints and discs.
The pain that is felt is usually not discovered until many factors that affect the spine have occurred. This pain, must be resolved by uncovering each factor individually in order to attain lasting relief. Simple fixes to only one or some of these areas without addressing any remaining will only result in minor pain relief and failure to resolve the pain long term.
Although it may seem like a simple problem because the pain is local, many of us assume that the solution is also simple. We subsequently look for simple solutions only to feel disappointed or to believe that our particular solution is not available. This is simply not the case. Back pain is complex, with many factors and the process to overcome it should be viewed as a step by step and multifaceted one.
To be able to address your pain, first begin with what is required to keep your lumbar spine healthy and what causes it to suffer chronic pain.
The lumbar spine consists of your lumbar vertebrae, vertebral discs, interconnecting facet joints, a complex nervous supply that travels in between each vertebrae, soft tissue, ligaments, tendons and muscles.
In a healthy spine, the muscles of the lower back (extrinsic and intrinsic) are actively contracting and relaxing as you stand. This is natural in order to maintain your balance. When these muscles are working properly, the distribution of weight and force on your discs and facet joints are balanced and even. This produces the natural S-curve of your spine. This is the ideal curve you should have during all times of activity. This curve protects the spine from uneven pressure being exerted on the discs that can lead to disc bulge. Uncontrolled disc bulge lead to risk of rupture and herniation of the disc. Uneven contraction and relaxation of the muscles mentioned leave the discs and facet joints at risk for injury. It is important to maintain these muscles with proper conditioning in order to prevent this type of chronic pain. The muscles themselves, specifically the intrinsic muscles also become fatigued and injured. Muscles spasms, strains and tears are common.
Standing pain that is mechanical usually begins with a failure to maintain these healthy muscles groups. Over time, they become weaker, tighter, shorter and unable to perform as before. Back pain becomes more significant until these areas are corrected. Sitting is a key contributor to the worsening of standing pain. Extended periods of sitting is usually a lifestyle choice that should be carefully monitored and adjusted in order to reduce your chances of recurring pain.
The main areas of imbalance, are the: lower back muscles (usually too tight, too strong and overused), abdominals (too weak, extended and underused), hip muscles (too tight, weak and underused) and the hamstrings (too tight, shortened and underused).
If you can imagine that the muscles from behind you are tightening while those in front are loosening, then you can visualize the lumbar discs and facet joints being pinched in back causing a bulge out in front. This causes an anterior pelvic tilt and is worsening by excess weight. When this occurs over an extended period of time, the facet joints become worn and inflamed leading the facet joint inflammation, wear and pain. Chronic imbalance also leads to advanced disc degeneration, especially to the L5-S1 disc. This is the most important yet abused disc, crucial for your lumbar flexibility and protection.
It is vital to correct any muscle imbalances in these muscles groups in order to bring back much needed protection and relief to the lumbar spine. Even when, there already is significant injury such as disc wear and facet pain, lower back pain can still be reduced dramatically, long term when you recondition and exercise these areas properly and effectively.