Many patients with low back pain, hip pain and sciatica will develop a sharp exacerbation of pain as they get up off a chair. This can be even more severe when they get out of bed or out of the car. It is also worse the lower the seat is. Some people may have difficulty walking or walk with a limp after getting up from a chair. What is occuring is that as most people would bend forward as they get up from a seat and cause instant and severe Hip Rib Impingement ( HRI ) which then causes a flare up of their pain. HRI may well be the cause of  #NoF as it may trigger a sudden loss of power in the hip muscles causing the neck of femur to fracture.

Ideally, at home, patients should choose to sit on seats that are firm, not too low and easy to get up from. Dining chairs and office chairs are preferable although a fit ball would be best as it stimulates muscle contractions when sitting. The worse seat is a sofa or couch which is too soft or too low. If the patient insists on sitting on a low or soft sofa then they should make modifications such as to put plywood under the cushions if they come off. They could also add a wedge cushion on top of the sofa to further elevate their hips and reduce HRI while seated and when they get up.

In the workplace, they should adjust the seat tilt and height so that their knees are lower than their hips as this would reduce the chances of HRI while working. They should also get up every 20 minutes to reduce muscle and mental fatigue. They should avoid crossing their legs and sit with their legs a bit apart for stability. I find that foot stools usually make their problems worse as it reduces the hip Rib Gap ( HRG )I reviewed an excellent office and therapy chair called Saiza produced by Smirthwaithe in UK a few years ago.

Finally, patients should be reminded to perform the Air Bag Technique when they get on and off the seat and to continue with posture breathing while they are seated.