June 2012

Good Posture Helps Reduce Back Pain

John Schubbe, DC
www.spine-health.com

Correct posture is a simple but very important way to keep the many intricate structures in the back and spine healthy. It is much more than cosmetic-good posture and back support are critical to reducing the incidence and levels of back pain and neck pain. Back support is especially important for patients who spend many hours sitting in an office chair or standing throughout the day.



Problems Caused by Poor Back Support and Posture

Not maintaining good posture and adequate back support can add strain to muscles and put stress on the spine. Over time, the stress of poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs and joints. All of these can be major contributors to back and neck pain, as well as headaches, fatigue, and possibly even concerns with major organs and breathing.

Identifying Good Posture

Basically, having correct posture means keeping each part of the body in alignment with the neighbouring parts. Proper posture keeps all parts balanced and supported. With appropriate posture (when standing) it should be possible to draw a straight line from the earlobe, through the shoulder, hip, knee, and into the middle of the ankle.

Because people find themselves in several positions throughout the day (sitting, standing, bending, stooping, and lying down) it's important to learn how to attain and keep correct posture in each position for good back support, which will result in less back pain. When moving from one position to another, the ideal situation is that one’s posture is adjusted smoothly and fluidly. After initial correction of bad posture habits, these movements tend to become automatic and require very little effort to maintain.

Ergonomic Office Chairs for Back Support

Office work often results in poor posture and strain to the lower back. Many people work sitting in an office chair that is not properly fitted to their body and does not provide enough lower back support. One strategy is to choose an ergonomic office chair that often provides better support than a regular chair and may be more comfortable for the patient.

Take a Break from Sitting in an Office Chair

In addition, the spine is made for motion, and when sitting in any type of office chair (even an ergonomic office chair) for long periods of time, it is best to get up, stretch and move around regularly throughout the day to recharge stiff muscles.

Identifying Incorrect Posture

The first step in improving posture is to identify what needs improvement by examining one’s own posture throughout the day, such as sitting in an office chair, carrying objects, or standing in line. At regular intervals during the day, take a moment to make a mental note of posture and back support. This should be done through the normal course of a day to best identify which times and positions tend to result in poor posture. Some people find it easier to ask someone else to observe their posture and make comments or suggestions.

Examples of Bad Posture and Back Support:

The following are examples of common behaviour and poor ergonomics that need correction to attain good posture and back support:
• Slouching with the shoulders hunched forward
• Lordosis (also called "swayback"), which is too large of an inward curve in the lower back
• Carrying something heavy on one side of the body
• Cradling a phone receiver between the neck and shoulder
• Wearing high-heeled shoes or clothes that are too tight
• Keeping the head held too high or looking down too much
• Sleeping with a mattress or pillow that doesn't provide proper back support, or in a position that compromises posture

Examples of Bad Posture While Sitting in an Office Chair
:

The following bad habits are especially common when sitting in an office chair for long periods of time.
• Slumping forward while sitting in an office chair
• Not making use of the office chair’s lumbar back support
• Sliding forward on the seat of the office chair

Guidelines to Improve Posture

As already discussed, for correction of poor posture it is important to determine where improvement is needed, such as when sitting in an office chair. Next, patients must work on changing daily habits to correct those areas. This effort will improve back support and over time help decrease back pain and neck pain. It will take some effort and perseverance, and will seem a little unnatural at first. It is typical to feel uncomfortable, and even feel a little taller, but over time the new posture will seem natural and more comfortable.

Following are some guidelines of how to achieve good posture and ergonomics in the workplace and other situations.

Sitting Posture for Office Chairs
:

• Be sure the back is aligned against the back of the office chair. Avoid slouching or leaning forward, especially when tired from sitting in the office chair for long periods
• For long term sitting, such as in an office chair, be sure the chair is ergonomically designed to properly support the back and that it is a custom fit
• When sitting on an office chair at a desk, arms should be flexed at a 75 to 90 degree angle at the elbows. If this is not the case, the office chair should be adjusted accordingly
• Knees should be even with the hips, or slightly higher when sitting in the office chair
• Keep both feet flat on the floor. If there's a problem with feet reaching the floor comfortably, a footrest can be used along with the office chair
• Sit in the office chair with shoulders straight
• Don't sit in one place for too long, even in ergonomic office chairs that have good back support. Get up and walk around and stretch as needed

Standing Posture
:

• Stand with weight mostly on the balls of the feet, not with weight on the heels
• Keep feet slightly apart, about shoulder-width
• Let arms hang naturally down the sides of the body
• Avoid locking the knees
• Tuck the chin in a little to keep the head level
• Be sure the head is square on top of the neck and spine, not pushed out forward
• Stand straight and tall, with shoulders upright
• If standing for a long period of time, shift weight from one foot to the other, or rock from heels to toes.
• Stand against a wall with shoulders and bottom touching wall. In this position, the back of the head should also touch the wall - if it does not, the head is carried to far forward (anterior head carriage).

Walking Posture
:

• Keep the head up and eyes looking straight ahead
• Avoid pushing the head forward
• Keep shoulders properly aligned with the rest of the body

Driving Posture
:

• Sit with the back firmly against the seat for proper back support
• The seat should be a proper distance from the pedals and steering wheel to avoid leaning forward or reaching
• The headrest should support the middle of the head to keep it upright. Tilt the headrest forward if possible to make sure that the head-to-headrest distance is not more than four inches.

Posture and Ergonomics While Lifting and Carrying
:

• Always bend at the knees, not the waist
• Use the large leg and stomach muscles for lifting, not the lower back
• If necessary, get a supportive belt to help maintain good posture while lifting
• When carrying what a heavy or large object, keep it close to the chest
• If carrying something with one arm, switch arms frequently
• When carrying a backpack or purse, keep it as light as possible, and balance the weight on both sides as much as possible, or alternate from side to side
• When carrying a backpack, avoid leaning forward or rounding the shoulders. If the weight feels like too much, consider using a rolling backpack with wheels.

Sleeping Posture with Mattresses and Pillows
:

• A relatively firm mattress is generally best for proper back support, although individual preference is very important
• Sleeping on the side or back is usually more comfortable for the back than sleeping on the stomach
• Use a pillow to provide proper support and alignment for the head and shoulders
• Consider putting a rolled-up towel under the neck and a pillow under the knees to better support the spine
• If sleeping on the side, a relatively flat pillow placed between the legs will help keep the spine aligned and straight.

It is important to note that an overall cause of bad posture is tense muscles, which will pull the body out of alignment. There are a number of specific exercises that will help stretch and relax the major back muscles. Some people find that meditation or other forms of mental relaxation are effective in helping relax the back muscles. And many people find treatments and activities such as massage therapy, yoga, tai chi or other regular exercise routines, or treatments such as chiropractic or osteopathic manipulation, etc. to be helpful with both muscle relaxation and posture awareness and improvement.