Expert Blog

Bert Bednar, DPT

Posture Matters: Back and Neck Pain

Remember when your mom would tell you to sit up straight or walk with your head up and shoulders back? Once again, your mother was right. Posture does matter. In fact, we all know it's better to use good posture. So why do we still slouch? Research has proven that poor posture contributes to back and neck pain. Sitting in a poor posture can contribute to other aspects of your health including eye strain, headaches, shoulder pain, and carpal tunnel syndrome.

Posture Affects Pain

Painful, and potentially disabling, conditions can insidiously develop as a direct result of poor sitting or standing posture, improper lifting mechanics and working habits, or begin with unrelated injuries that are then made worse by poor ergonomics.

When you deviate from normal anatomic posture, unnecessary stress and strain are placed on the normal curves of your spine causing these curves to slowly change. Over time these minor alternations make your spine more vulnerable to injury. For this reason, utilizing the principles of your best posture is critical to keeping stress and strain as low as possible. This will decrease injury to your spinal discs, decrease unnecessary muscle strain, prevent muscular imbalances, as well as protect small joints within your spine (facets) and supporting structures. Common outcomes of poor posture results in rounded shoulders, flat back, forward head positioning, improper muscular tension, and upper and lower back pain.

Proper posture is achieved by understanding the principles of appropriate seated and standing positioning along with proper flexibility, muscle strength and self-discipline. Let's discuss the best posture for standing, sitting, lying down and the importance of positional changes.

Standing Posture

Did you know that a bending forward posture can contribute to increased degenerative disc wear? To protect from disc wear and tear, it's best to utilize proper standing posture as much as your own body stance will allow. Although pathology can prevent you from achieving ideal alignment, adhering to the principles of proper posture can still help you attain your best and prevent the worsening of many conditions.

Picture an imaginary line from your ear to your shoulder to your hip to your ankle. With perfect posture, this imaginary line would align perfectly with these joints. Proper standing posture also includes holding your head up, looking forward with your shoulders held back and your chest out. Maintaining this posture provides for equal and well-distributed weight-bearing on the spinal discs, which allows the back muscles to be in a balanced position and decrease undue stress on the small facet joints and ligaments of the spine. Reducing these stresses will decrease pain and help to prevent injury.

To maintain your best posture, it's important to check yourself periodically as to how you are standing. Initially it will seem awkward; however, it becomes easier as your muscles get used to your new posture.

Sitting Posture

Slumping in a chair will overstretch and fatigue muscles. This posture can lead to injury resulting in severe neck and back pain.

When seated, sit back in your chair as far as possible. Your buttocks should be at the end of the chair to maintain a straight back with a normal low back (lumbar) curve. While seated, good posture is achieved by looking forward, keeping your shoulders pulled back and your spine up against the back of your chair. Select your chair height so your feet can be placed flat on the floor. If your chair is too high for your feet to reach the ground, use a small foot stool.

Keep your work close to you. Whenever possible, position your work so your arms do not extend past your chest. Adjust your chair's arm rests so that your elbows can be supported. Get in the habit of working while your elbows are on your arm rests. If you are able to implement these principles correctly your body position should promote a right angle at your elbows, hips, and knees.

It is important to take frequent breaks from sitting. Even maintaining proper seated posture can eventually be hard on spinal structures. Getting up and stretching periodically will help to keep tension from mounting to an unsafe level in your spinal muscles. Proper upper back and core strength will make achieving proper posture feel more natural.

Lying Posture

Proper lying posture varies far more than seated and standing postures. Generally accepted guidelines include a mattress which supports bony prominences and keeps you in proper alignment whether you are lying on your back, side or abdomen. If you rest on your side, a pillow placed between your knees will decrease strain on your lower back. Supporting the natural spinal curve of your neck is also important. A good rule of thumb is to find a position that is comfortable. If you are lying in a position resulting in unnecessary strain on your muscles and joints you will have difficulty sleeping and typically awaken stiff or sore. Remember good alignment is hardly ever achieved when reading in bed. Comfort should be your guide when you select an appropriate mattress or pillow. Getting restful sleep can depend on using appropriate principles for lying on your back, side or abdomen.

Changing Positions

Change your position frequently during prolonged activities. If you have been sitting for awhile, stand and stretch your back into a straight or neutral position. If you are standing and working overhead, bend your back forward periodically to give your back a break.

Most of us can relate to having a work day that involves lifting, reaching, typing, or driving. Most of us maintain a forward rounded position while performing many of these tasks. After keeping this posture for hours per day, over the span of weeks, months and years, our body tends to adapt to this sustained position. This results in a flexed forward or rounded shoulder position. Incorporating proper postural and core strengthening as well as neck, trunk, arm and leg stretches into your daily schedule can help to prevent you from developing a rounded posture and resulting pain.

Posture is Only One Aspect of Maintaining Functionality as We Age

Everyone performs "work" or tasks daily and many believe the work or task is sufficient to sustain musculoskeletal health. Unfortunately as we grow older, this is less often the case. To insure continued strength, flexibility and endurance, it is best to incorporate activities that accomplish three important exercise types: 1) Stretch muscle groups to reduce risk of injury and maintain flexibility, 2) Perform strengthening exercises for shoulders, upper back, low back, abdomen and legs to help decrease stress and protect your joints 3) Engage in endurance activities to maintain a healthy heart muscle and pulmonary function. Regularly-scheduled exercises that address these important aspects of body maintenance become more critical as we age. Since our body eventually will break down when not supported and maintained properly, use exercise, posture and ergonomic principles to maintain and enjoy body health for life.