Duration of pain | Pain while sitting

Duration of pain

Depending on the degree of severity and localization, the estimated duration of pain when sitting varies considerably. For this reason, and due to the individual differences in the healing process, it is also difficult to make general statements regarding the total duration, even if, for example, inflammatory processes often show shorter courses than those pain causes that are orthopedic in nature. In general, however, those affected should bear in mind that the duration of the complaints depends to a large extent on the discipline with which they pursue the respective therapy (even if only to a large extent).

Insufficient adherence to the therapy can considerably slow down the healing process or even lead to the chronicity of the complaints. Coccyx pain is called coccygodynia and, due to the position of the coccyx, occurs mainly when sitting. Possible causes are a contusion or even fracture caused by a fall, a coccyx fistula or a pinched nerve.

By far the most common trigger of pain in the coccyx, however, is sitting on an inappropriate seat for too long. Especially in professions with predominantly sedentary work, a significant proportion of workers complain of coccyx pain when sitting. The pain is caused by so-called micro-traumas (tiny injuries) and by the atrophy of the trunk’s supporting muscles.

If you are engaged in such a professional activity, it is recommended that you take regular “sitting breaks”, during which work is done standing or walking. Special coccyx cushions can also help to relieve the symptoms. Stabilization exercises can strengthen the trunk holding muscles and thus lead to a reduction of pain.

If knee pain occurs while sitting, it is a pain at rest (as opposed to pain under stress), which must generally be interpreted as a warning signal from the body. In older patients, pain at rest and pain under stress on the knees often occur side by side. Over a period of months and years, patients experience pain when walking and later also when sitting.

This pain when sitting is accordingly to be regarded as a sign of further progression of joint degeneration (arthrosis) and should result in the consultation of an orthopedist. An orthopedic surgeon can quantify the extent of joint degeneration by means of an x-ray and explain the treatment options available. The most common trigger for knee pain when sitting in adolescents and younger adults is Chondropathia Patellae.

This technical term in itself only describes a “cartilage disease of the kneecap“. This clinical picture is often referred to simply as anterior knee pain syndrome. It occurs after prolonged sitting with bent knees (e.g. in the cinema, car or plane) and is perceived as bilateral pain in the area of the kneecaps.

The anterior knee pain syndrome is usually triggered by a malfunction (shortening) of the thigh muscles, which produces a continuous pull on the patella, or by a malposition of the patella. However, previous knee injuries are also possible causes. Depending on the cause, the anterior knee pain syndrome can be treated effectively in most cases; however, the complaints often disappear of their own accord after a few months anyway.

Nevertheless, a visit to an orthopedic surgeon is recommended, as he or she can identify the exact causes and thus minimize the risk of long-term secondary damage.Testicular pain when sitting can have very different causes. These include, above all, a hernia, inflammation of the testicles (orchitis), or twisting of the testicles (testicular torsion). Particularly in adolescents, however, occasional moderate testicular pain also occurs in connection with puberty and is not per se to be interpreted as a symptom of the disease.

In addition, testicular pain is also more frequent after intense sexual activity, although it is usually relatively mild and disappears of its own accord after a few hours. In all cases, the pain can be position-dependent, i.e. it can disappear when standing and only occur when sitting, or it can only occur when walking and disappear at rest. For this reason, patients who complain of testicular pain only when sitting cannot easily be identified as having a specific cause.

Even if an inflammation of the testicles seems rather unlikely in this case, since the relief of the testicles achieved by sitting usually leads to an alleviation of the symptoms. For this reason a doctor should be consulted immediately in case of severe pain, or even if the pain has not subsided by itself after several days. This doctor can clarify the possible triggers with the help of an ultrasound examination and, if necessary, initiate the necessary therapeutic measures.

Although abdominal pain is generally considered to be a “woman’s pain”, it can of course also occur in men, since it can originate not only in the uterus and ovaries, but also in the bladder, urethra, genitals or the lower intestinal parts. All diseases that can cause pain in the lower abdomen can occur depending on the position – for example, especially when sitting down. For this reason, none of the possible causes can be excluded on the basis of the fact that abdominal pain occurs mainly when sitting.

Nevertheless, there are various diseases for which the occurrence of pain while sitting is particularly typical. These include, for example, varicose veins in the pelvis, which often cause a feeling of heaviness in the legs in addition to the abdominal pain when sitting. A very common disease in which the abdominal pain occurs mainly when sitting is cystitis (urinary tract infection).

The gynecological causes of abdominal pain when sitting include above all diseases of the ovaries, for example inflammation or cysts. Furthermore, an inguinal hernia can also manifest itself in the form of abdominal pain and can be particularly intense when sitting if the seat pad presses on the hernia sac or the hernia sac is pinched between the legs. The fact that the pain mainly occurs when sitting and decreases or even completely disappears in other body positions should not disguise the fact that a serious illness can be the cause, especially in the case of very intense pain or pain that lasts for several days.

In such cases, a doctor should be consulted who can quickly and effectively rule out the most urgent causes with the help of blood parameters, an ultrasound examination and, if necessary, a palpation. Two main triggers for groin pain when sitting can be identified: a hernia or hip joint arthrosis. The inguinal hernia can be felt on the spot (i.e. the groin) as pain, but sometimes it is more likely to be diffuse abdominal pain.

In this case, sitting down leads to the build-up of pressure on the hernia, which is why the discomfort often increases when sitting down. In more advanced stages of osteoarthritis of the hip joint, pain in the groin often occurs after prolonged sitting. The pain can be alleviated with some movement, which is why it is also called “starting pain”.

Typical of hip joint arthrosis is groin pain radiating into the thigh and knee. A more rare cause of groin pain when sitting is the impingement syndrome of the hip. Here, the head of the femur hits the acetabulum of the hip joint, usually due to signs of wear.

Apart from sitting, the pain typically occurs when the hip joint is bent and/or rotated. If the pain is very intense or if it lasts longer (days to weeks), a doctor should be consulted. In most cases, a palpation examination can confirm or exclude the inguinal hernia as the most common cause.If thigh pain occurs mainly when sitting, the primary cause is irritation of the sciatic nerve or the muscle tendon attachments of the rear thigh and gluteal muscles.

Irritation of the sciatic nerve caused by compression is manifested by shooting unilateral lumbar pain that radiates into the thigh. Compression is often triggered by a herniated disc in the lower part of the spine. Another, often neglected explanation is a spasm of the piriformis muscle.

This is a muscle in the lumbar region that is only about the thickness of a finger and is responsible for the external rotation of the hip joint. It can develop especially under prolonged pressure (e.g. by prolonged sitting; more common in men who carry their wallet in their back pocket) or one-sided load (e.g. heavy asymmetric lifting of weights or in runners with leg length differences).

Due to its anatomical proximity to the sciatic nerve, it can compress it when cramped, thus imitating the symptoms of a herniated disc. Since this cause requires a completely different, namely conservative therapy (sparing, heat treatment) than the herniated disc, it should be considered at least in those patients in whom no herniated disc matching the symptoms can be found on the radiological images. Irritation of the tendon insertions of the thigh and gluteal muscles occurs mainly in patients who have recently increased their sports activities.

This is because not only muscles and the cardiovascular system need time to adapt to higher performance requirements, but also the musculoskeletal system. The tendon insertions as the interface between muscle and bone are particularly susceptible to overloading reactions. A temporary reduction of the training workload followed by a moderate, gradual increase is recommended to give the tendons the time they need to adapt to the increased training workload.

Pain in the ischium naturally occurs primarily when sitting. In most cases, the cause of the complaints can be assigned to one of the two complexes of inflammation and trauma (injury). Particularly susceptible to the development of inflammatory reactions are the contact surfaces of the ischium and the points where the muscle tendons are attached.

The former are particularly affected in patients who spend several hours a day in a seated position (usually due to work). The muscle tendons become inflamed primarily in patients who make particularly intensive use of the associated gluteal and thigh muscles during sporting activities (e.g. jogging, weight training). In both cases, the most promising treatment is obvious: more frequent breaks from sitting or better padded seating surfaces on the one hand, and an at least temporarily reduced sports workload on the other, usually make the complaints disappear surprisingly quickly.

If an injury is the cause of the pain in the ischium, finding the cause is usually relatively simple. In such cases, it should be clarified whether it is only a bruise or whether a fracture is present, as the latter might require surgery in rare cases. Pain when sitting at the sacrum is in almost all cases caused by the sacroiliac joint (ISG).

The sacroiliac joint is a joint between the sacrum and the pelvic scoops, which is highly stabilized by muscles and ligaments and has very little movement. The pain that occurs when the ISG is affected manifests itself especially when bending over or sitting (here especially when the legs are crossed) and can radiate into the thigh. The possible causes of ISG pain are extremely diverse and range from injuries (fall) to incorrect weight bearing (e.g.

leg length difference) to inflammatory diseases (e.g. ankylosing spondylitis) or joint degeneration (arthrosis). Heat treatment, loosening exercises as well as strengthening of the buttock and lower trunk muscles can alleviate the complaints. Alternatively or as a supplement, an orthopedic and physiotherapeutic clarification or co-treatment is also possible.

Pelvic floor pain is usually caused by tension in the pelvic floor muscles and occurs particularly when sitting.Cycling is perceived as particularly unpleasant by those affected, since an even greater proportion of the body weight rests on the pelvic floor than when sitting on a chair or similar. The tension of the musculature mostly results from the fact that – often due to work – a large part of the day is spent in a sitting position. It can therefore be concluded that more frequent breaks from sitting and more dynamic sitting (e.g. on an ergonomic chair or a gym ball) are the most effective measures for alleviating the symptoms.

If the complaints persist, a so-called sensomotoric therapy can be considered, in which certain trigger points at the tendon attachments of the pelvic floor are treated to relieve the tension. In the course of a pregnancy, many expectant mothers complain of abdominal pain, especially when sitting. In most cases, these are due to the stretching processes caused by the growth or remodelling of the tissue, as well as to a change in blood circulation.

Physiotherapeutic treatment has proven its worth in this case. A proven supplement is the intake of magnesium, also due to the practically non-existent side effects. Due to its location in the lower abdominal cavity, pain emanating from the ovaries usually develops its strongest intensity when sitting down.

In most cases, they are to be interpreted as cycle-related complaints, especially during menstruation and at the time of ovulation, and can therefore be considered harmless. Theoretically, however, they can also indicate that pregnancy has occurred. The third group of possible triggers are inflammatory processes in the ovaries.

The most important of these is chlamydia-induced pelvic inflammatory disease (inflammation of the ovaries and fallopian tubes). The bacterial pathogens migrate upwards from the vagina towards the ovaries, where they cause severe pain, which is not only perceived, but often particularly strong, when sitting down. If the symptoms in the ovaries are particularly severe, the possibility of acute pelvic inflammatory disease should be considered and a gynecologist consulted.

The gynecologist can confirm the suspected diagnosis and initiate an adequate antibiotic therapy. Due to its anatomical position, the prostate also tends to develop pain, especially when sitting. The most frequent trigger for prostate-related pain is prostatitis, i.e. inflammation of the prostate.

A distinction must be made here between chronic (= pelvic pain syndrome) and acute prostatitis, and between bacterial (inflammatory) and abacterial, which is the most common form. In addition to the pain that occurs particularly when sitting and urinating, there is often residual urine (the person affected has an urge to urinate but cannot empty the bladder completely) and sexual dysfunction. In more advanced cases, fever can also develop.

Other diseases that can cause pain in the prostate when sitting include prostate enlargement (benign prostatic hyperplasia) and malignant diseases (prostate cancer). Accordingly, if symptoms are intense or persistent, a urologist should be consulted to identify the cause and initiate the best possible treatment. The term hemorrhoids describes a vascular complex made up of arteries and veins, which sits closely above the sphincter muscle and together with it seals the intestinal outlet.

Although everyone ultimately has hemorrhoids, the term “hemorrhoids” is commonly understood to mean an extension of this vascular complex. Especially in more advanced stages, i.e. when the hemorrhoids are already visible to the naked eye and no longer “jump” spontaneously (i.e. by themselves) back into the rectum, pain occurs when sitting.

This pain is often preceded by bleeding from the intestine or skin irritation (often with itching) due to the impaired barrier function of the vascular complex. If there is pain in the rectum when sitting or if the hemorrhoids can be seen with the naked eye, a visit to the family doctor is recommended. This doctor can either make the diagnosis himself or, depending on the degree of severity, refer the patient to a proctologist, who can then discuss the possible treatment options.

In most cases, a prolapsed uterus results from a weakening of the pelvic floor. This, in turn, is mainly based either on an age-related weakening of the muscles or a loosening of the connective tissue as a result of childbirth.In more severe cases, the uterus can even descend through the vagina, which the specialist then calls uterine prolapse. Lowering the uterus causes traction on the connective tissue structures holding it, which can cause abdominal pain.

Since this traction is relieved in a sitting position, the complaints are often reduced in a sitting position. The situation is different with the maximum variant of uterus prolapse (see above): Here, sitting triggers pressure on the uterus, which is why the complaints increase when sitting. In both cases, the pain can be accompanied by a foreign body sensation in the genital area.

A herniated disc in the lumbar spine (lumbar spine) often causes severe pain in the lower back, which can radiate from the buttocks to the thigh and up to the hollow of the knee and calf. Due to the anatomical conditions, the pain often increases when the leg is lifted towards the upper body or when the upper body is bent forward, e.g. when sitting. This circumstance represents an important possibility of differentiation from spinal stenosis, which is often accompanied by similarly localized pain.

A specialist can use X-rays to differentiate between the two conditions and discuss the necessary further steps. Pain in the abdominal region, especially when sitting, is not necessarily typical of the maternal ligaments. Although these can cause pain throughout the course of a pregnancy, this pain is most pronounced when standing, as the uterus pulls particularly hard on the maternal ligaments holding them in place.

Sitting and especially lying down usually leads to an immediate improvement in symptoms. For this reason, stretching pain of the uterine ligaments when sitting during pregnancy is considered rather unlikely. In addition or as an alternative to lying down, special support belts can also relieve the maternal ligaments.