719-359-9169 DrBen@cosmovement.com

Movement is Medicine: Being sedentary causes more flare-ups than physical activity in low back pain.

Key points

1. Based on a recent study looking at flare-ups with acute low back pain, researchers found a 4.4x increase in flare-ups with prolonged sitting (over six hours).

2. Heavy lifting, repeated lifting, running/jogging, and non-contact sports were not associated with flare-ups.

3. Physical therapy was associated with decreased flare-ups, meaning if you don’t have the time for flare-ups, or would like specific advice on how to handle your pain, make an appointment!

As I discussed in the previous blog post “Hanging out in Relief Valley,” many people who are dealing with pain feel a spike in the pain experience when they go from sitting to standing, waking up in the morning, or other times when they begin to move after being sedentary for a while. The important thing is to remember that pain is best understood as an alarm system, and you can think of this increase as reminding you to take it slow. As long as the pain remains steady at low levels or decreases, it is advisable to remain active.

A study published recently in the journal Spine lends further proof of this concept. Researchers set out to examine the activities that cause flare-ups during an episode of acute back pain, looking at things like physical activities as well as stress and depression. They had some interesting findings.

The clearest result of the study showed that the only activity that resulted in increased risk of flare-up was…. PROLONGED SITTING (over six hours)! Sitting for over six hours was associated with a 4.4 times increased risk of a flare-up. The coincides with the previous blog advice: Frequently moving is necessary to increase healing rate, and Hanging out in Relief Valley with help you avoid flare-ups, even if there is some discomfort involved.

They also found an increased risk (2.5 times higher) of flare ups with reported stress or depression. This will be discussed in future posts.

However, the results about what did NOT cause an increase in flare-ups were just as revealing. There was no associating with flare-ups with the following activities: any heavy lifting (over 35lbs), repeated heavy lifting, running/jogging, and non-contact sports. Prolonged standing had no clear effect. This is supported by other studies, including Gonge et al. (2001) that showed a decrease in pain in the 24 hours following physical exertion, possibly pointing to a deterrent effect of exercise.

Lastly, they found that physical therapy was associated with a protective effect, meaning those that received physical therapy had a decreased risk of a flare-up.

So what does this mean? Just like last week, MOVEMENT IS NECESSARY FOR HEALING! Don’t be afraid to move when you are in pain, as long as you follow the guidelines from last weeks post. If you remain confused about your pain, or would like more specific advice, or would prefer to get through the episode faster, please schedule an appointment! Many times some simple advice is all you need to get back to your life!


1.Suri, P., Rainville, J., de Schepper, E., Martha, J., Hartigan, C., & Hunter, D. J. (2018). Do Physical Activities Trigger Flare-ups During an Acute Low Back Pain Episode?. Spine, 43(6), 427-433.

2. Gonge H, Jensen LD, Bonde JP. (2001) Do psychosocial strain and physical exertion predict onset of low-back pain among nursing aides? Scand J Work Environ Health, 27:388-94.