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Posture has long been a topic of conversation and a focus of treatment in the plight to improve neck pain, headaches and especially low back pain. Many of my patients hold ingrained beliefs that they need to correct their posture in order to improve their pain or focus heavily on their ‘poor posture’ as the driving factor of their problems. These beliefs are often unsupported by clinical research. How much of our aches and pains are caused by ‘poor posture’? Can we actually improve posture? These questions have been the focus of posture-related research for some time, with contrasting results and opinions across health care professionals.
The connection and history of posture and pain is strongly embedded in society and medicine. ‘Good posture’ is thought to be upright, straight and aligned, signifying health and beauty. Images of soldiers standing tall, women walking with books on their heads and beauty competitions crowning ‘Miss Correct Posture’, have contributed to this association between optimal posture, strength and beauty. It is a common belief that ‘good posture’ is important to protect the spine from damage and that postural correction is a corner stone in the treatment of back and neck pain.
‘Bad posture’ is associated with slumping, hunching, stooping and slouching. It is an indicator of disability but also moral degeneracy (think of Quasimodo, Mr Burns and Dick Dastardly). Parents or partners tell you to sit up straight and pull your shoulders back. Manual handling courses teach straight back lifting postures, instilling fear around rounding our back and bending. Ergonomic companies provide office chair and desk assessments, examining our sedentary postures to optimise them. Posture has been a cultural obsession as far back as ancient Greece and still exists today.
Poor posture
There is a common belief that back pain is linked to lifting and ‘poor posture’. Surprisingly, there is a lack of research evidence to support this relationship.
They found no differences in sitting or standing postures of adults with and without back pain.
Current research indicates that the traditional view of ‘correct’ versus ‘incorrect’ posture and its association with spinal or joint related pain is an oversimplified view. Several research studies have found no direct link between posture and pain.
They found no differences in sitting or standing postures of adults with and without back pain. Research studies examining ergonomic interventions for workers and advice on best posture for lifting had no impact on work-related back pain. Other research found little evidence in the connection between ‘poor’ sitting and standing posture in adolescents and back pain, or the prediction of future back pain. Posture, it seems, has been the target of blame for pain for some time.
Posture is influenced by a number of factors. Illness, the environment in which we live, bone health and engagement in regular exercise all play a part in how we develop our posture. Rigid or fixed postures, such as scoliosis or joint deformity, will have a direct effect on our movement and flexibility. Often, these postures cannot be corrected without surgery, but the symptoms associated with these fixed postures can be helped with regular exercise.
Postural awareness
Dynamic posture, such as how we sit, stand, walk or run can be influenced non-surgically. Postural awareness, stretching the joints and ligaments and strengthening the muscles that support us during these activities can improve dynamic posture. The new emerging view is that rather than striving for ‘correct’ posture, we should aim for postural variability. The focus has shifted to movement over sustained posture. It is important to move regularly and adapt your posture to different situations.
There is no one single posture that can protect the spine from back pain. Unfortunately, everyone can experience spine related pain regardless of posture.
Find postures that are comfortable for you rather than adopting rigid ‘good’ posture. Exercise regularly, maintain good sleep habits, focus on stress reduction and move freely with confidence.
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