Going From Sit to Stand with Back Pain/Sciatica

How to Safely Get Up from Sitting When You Have Back Pain or Sciatica

If you're dealing with back pain or sciatica, you've probably noticed that something as simple as getting out of bed or standing up from a chair can be excruciating. Here's the thing: the way you're doing it matters—a lot.

Bob Shrupp and Brad Heineck, the two most famous physical therapists on the internet (in their own opinion), break down exactly how to go from sit to stand without aggravating your back. And spoiler alert: it's not just about willpower or pushing through the pain.

Why Mornings Are the Worst for Your Back

Here's something most people don't realize: your discs are under extra stress first thing in the morning.

Throughout the night, your spinal discs fill with fluid—a process physical therapists call "imbibing." While that sounds like you're having a good time, it actually increases pressure in your discs and makes them more vulnerable to bulging or herniation. That's why your back feels tightest in the morning and why getting out of bed the right way is absolutely critical.

When you combine disc fluid buildup with incorrect movement patterns, you're essentially injuring your back each time you stand up. Over time, these repeated micro-injuries add up.

The Wrong Way vs. The Right Way

What NOT to do:

The most common mistake? Rounding your back and leaning forward as you get up. You know the movement—you round out your spine, get your nose over your toes, and power through. It feels natural, but it's exactly what stresses your discs the most.

When you bend this way, you're placing maximum pressure on the front of your discs, which is where bulging and herniation typically occur. And that moment when you straighten back up? That's often when people experience sharp pain.

What TO do instead:

Keep your back straight throughout the entire movement. Think of your spine as locked in position, with all the movement coming from your hips instead.

The Broomstick (or BOOYAH Stik) Trick

One of Bob and Brad's favorite teaching tools is simple: a broomstick or alignment stick. Here's why it works so well.

When you hold or imagine a straight stick along your spine, it should touch three key points of contact:

• The back of your head

• Your mid-back

• Your pelvis (sacrum)

If all three points aren't aligned, your form is off. This visual feedback makes an immediate difference—Bob's wife noticed right away once she started thinking about the stick being there.

If a physical stick feels awkward, try these mental cues instead:

• Imagine a two-by-four taped to your back

• Picture a string attached to your head, gently pulling you straight up (not forward)

The Step-by-Step Process for Getting Up Safely

Here's how to do it right, whether you're getting out of bed or standing up from a chair:

1. Position yourself correctly – Slide forward to the edge of the chair or bed. Place your feet underneath you, positioned about shoulder-width apart (or a bit wider if you can). Wider legs make it easier to get lower and maintain better control.

2. Keep your spine locked – Maintain that straight-back posture throughout. Your back shouldn't move during this entire movement.

3. Bend at the hips – Lean forward while keeping your spine straight. All the motion should come from your hips, not your lumbar spine.

4. Use your arms if available – If there's an armrest, use it to push yourself up. No armrest? Place your hands on your thighs near your knees and push off from there.

5. Stand straight up – Don't bend forward as you rise. Come straight up as if that imaginary string is pulling your head toward the ceiling.

Pro tip: If you're in pain while performing this movement, your form might be off. Try adjusting the arch in your lower back (experiment with more or less curve), or tighten your abdominal muscles while you move. To check if you're engaging your core correctly, poke your fingers into each side of your abdomen—you should feel the muscles tighten.

Avoid Low Surfaces at All Costs

When you're managing back pain or sciatica, the height of your seat makes a huge difference.

Surfaces to avoid:

• Soft couches and recliners that you sink into

• Bleachers at sporting events

• Chairs that are too low (many office chairs are adjustable—raise yours)

• Standard toilets

Better alternatives:

• Raised toilet seats (available on Amazon, inexpensive)

• Commodes with built-in armrests for pushing support

• Taller chairs or stools (half-stand, half-sit stools are ideal)

• The upper bleachers at events where you can stand without blocking views

The Toilet Game-Changer

Speaking of toilets, here's an unconventional tip that actually works: some people find it easier to straddle the toilet backward and lower onto the seat while facing the tank or wall.

Why? It forces better posture because you can't lean forward, plus you have the tank to hold onto for support as you lower yourself. That said, this isn't for everyone—if you have mobility issues or knee problems, the raised toilet seat option might work better for you.

Practice Makes Progress

Getting up correctly won't feel natural at first. Bob and Brad recommend practicing this movement before you leave a physical therapy session—or even just practicing in your living room a few times a day.

Here's the goal: when you go from sit to stand, your back pain should not increase. If it does, adjust your form. Maybe you need more or less arch in your lower back. Maybe your abdominal muscles need more engagement. Keep experimenting until you find the version that feels better.

The Bigger Picture

This isn't just about getting out of bed or avoiding the toilet. The locked-in spine position Bob and Brad describe should become part of your daily movement patterns. Every time you sit, stand, or bend throughout your day, think about maintaining that straight spine with movement coming from your hips.

Small changes in how you move can dramatically reduce your daily pain levels. And that's something worth practicing.

For more back pain and sciatica exercises and education, check out the full Sciatica Program. You can also download a printable PDF guide to keep these techniques with you.