Does my posture cause me pain?
Perhaps at some point, our well-intended family members, friends or colleagues have told us to ‘sit up straight’ in an effort to protect us from becoming permanently fixed or contorted in some awkward posture. This advice usually comes when we’re caught leaning towards the television or at the end of a long working day. Many believe that we always need to have ‘perfect posture’ lest we wind up in pain and disfigured. You may be wondering if there is science backing up these claims, and if we should in fact always sit up straight.
First, what defines good posture?
The general consensus is sitting up straight, shoulders back, and the chin tucked in will reduce the risk of experiencing pain.
But what does the evidence have to say about posture and pain?
In a recent systematic review published in the British Journal of Sports Medicine, the authors were unable to find any link between shoulder position and shoulder pain, concluding that deviation from a ‘normal’ shoulder blade position may not cause pain, but rather is part of normal variations.
With emerging evidence such as this, this begs the question: is a ‘rolled-forward/slouched shoulder’ such a bad thing? If there is not a clear link between shoulder position and pain, could posture of the mid-back and head/neck position affect rates of pain?
A recent study looked at 1,100 pain-free adolescents and took pictures of their sitting posture. Based on the pictures, subjects were then clustered into one of four postural groups: (1) upright, (2) intermediate, (3) slumped back/forward head and (4) erect trunk/forward head posture. After some analysis, there was found to be NO link found between posture and neck pain/headaches. Interestingly, the authors found that the subjects with the slumped back/forward head posture, the posture we typically label as ‘bad’, was strongly associated with depression. So perhaps instead of posture being solely responsible for pain, we may view general posture as a window or insight into the general well-being of a person.
Does all this information mean that I can just sit in any position for as long as I want?
The short and simple answer is no. It's good to get variety in your body so exploring different postures throughout the day is likely best: think ‘the next posture is your best posture.’ With our modern understanding of pain science, we know many different factors could contribute to someone’s pain experience beyond just posture. Consider this scenario: if someone is exposed to a prolonged period of increased stress at work, is working longer hours sitting at a desk, is having difficulty finding time to eat healthy meals, is not sleeping well and starts to experience back pain, can we simply say change your posture and things should clear up? That would be a stretch.
Posture at times could play a role in the development of an ache or pain, but it's way too simplistic to conclude that bad posture on its own causes pain. That all said, the real take away here is that your ‘next posture is your best posture,’ so move often, but also find time to manage stress, sleep well, and eat well.
By Sean Overin, Physiotherapist