Why does my back hurt after sitting for a long time?

Tightness between the shoulder blades or in the middle of the back that worsens with prolonged sitting for work or study and briefly eases when you get up and move may be related to reduced thoracic spine and rib-joint movement and sustained back-muscle tension.

Rather than simply concluding that pain is present based on the habit of maintaining the same posture for a long time, you should also check whether the pain actually changes when the posture shifts, and whether the pain recurs when extending your arms or rotating your torso.

• The back becomes stiff after sitting for 30 minutes to 1 hour
• Standing up and straightening the body provides temporary relief.
• Pain is reproduced when rotating the torso or extending the arm.
• Pain in the neck and shoulder may extend to the back.
• Pain persists in the lying-down position before falling asleep.
• The degree of pain changes when breathing deeply.

Pain that varies slightly with breathing and the sensation of shortness of breath or chest tightness are different signals and must be distinguished.

If you experience chest tightness, shortness of breath, cold sweats, dizziness, and back pain, do not assume it is a musculoskeletal problem; rapid evaluation is necessary. High fever, worsening pain accompanied by coughing, and unexplained weight loss are also signals that warrant investigation for other causes.

If there is unusually severe pain when pressing on the ribs or spine, or if there is a history of trauma, you should also check for fractures.

We ask about the work environment, sitting duration, positions and movements that worsen or alleviate pain, and changes in breathing and sleep. We examine the movement of the neck and back, shoulder, rib cage tenderness around the ribs, and scapular movement.

If there are signs such as chest pain, fever or trauma that are difficult to attribute to a musculoskeletal problem, we advise evaluation by another medical specialty.

Chuna manual therapy may be considered if there are no warning signs and restricted movement of the thoracic spine and rib joints and tension in the back and shoulder muscles appear related to the pain. After treatment, we check whether the time until pain appears when sitting in the same posture is delayed.

Rather than trying to maintain a perfect posture for long periods, it is a practical management method to change your posture every 30–60 minutes and incorporate torso rotation and light stretching.