7 Reasons why bad posture DOESN’T cause back pain

You have probably stumbled upon many claims that bad posture causes back pain, or that you should work on your posture to get rid of neck and back pain. You may have even associated sitting in your office chair in a slouched position with the pain that you get. You can find this claim all over the internet - from physiotherapists, chiropractors, personal trainers and far too many shirtless insta-“gurus” (SIGs).

From our parent’s telling us to sit up straight, to our co-worker with their $325 office chair with the $125 trademarked back support attached, you will almost certainly be told sooner or later by the ”posture police” that your posture needs some work.

For example, if you have a relatively large curve in your upper back (kyphosis), you’ll be told that without correction, you’ll end up with a hump like your great-aunt Maggie, or that you need a specific number of treatments with a particular health professional to “correct this”. Other asymmetries might include one leg longer than the other, or a scoliosis, all of which aren’t proven to be linked to causing pain or disability.

These cues are based on unproven ideas, especially considering that even if you are fully bent forward touching your toes, your lower back will – at best – straighten or flatten, meaning there is nearly always a curve (lordosis) in your lower back.

Ideas like sitting or standing with perfect posture do, on the surface, seem intuitive, and are advocated by numerous health professionals and shirtless-insta-guru’s (SIGs). But, are these ideas actually supported by evidence? Should you spend time and money having your posture analyzed, your spine manipulated in many uncomfortable ways while spending hours of your precious time on “corrective” exercises?

So, what evidence do we have that posture does or doesn’t contribute to back pain? Here are some key findings:

1.       There is no association between leg length differences and back pain. (Grundy, Roberts, 1984)

2.       There is no significant difference in lumbar lordosis (curve) or leg length inequality between three groups of 321 males with severe back pain, moderate pain, or no pain. (Pope, Bevins, 1985)

3.       No association between measurements of neck curvature and neck pain. (Grob et al. 2007)

4.       No significant difference in lumbar lordosis, pelvic tilt, leg length discrepancy, and the length of abdominal, hamstring, and hip flexor muscles in 600 people with and without back pain. (Nourbakhsh, et al. 2002)

5.       Teenagers with postural asymmetry, excessive thoracic kyphosis and/or lumbar lordosis were no more likely to develop back pain in adulthood than peers with “better” posture. (Dieck et al. 1985)

6.       Pregnant women with greater increases in low back curve during pregnancy were no more likely to develop back pain. (Franklin, et al. 1988)

7.       People who work occupations involving frequent awkward postures do not have higher levels of back pain. (Lederman, 2010)

As with most topics, there is some evidence pointing to the contrary, but large analysis involving multiple studies overwhelmingly supports my point here. Posture isn’t proven to cause pain.

Here are some things that ARE proven to be linked to back pain:

·       Stress

·       Depression

·       Exercise – too much or too little

·       Job satisfaction

·       Smoking

Here is another predicament: Even if the evidence did prove that poor posture causes pain, we still have no evidence to prove that correcting/changing your posture will reduce or resolve your pain.

If you’re having a hard time understanding why bad posture doesn’t lead to pain, here are some reasons why:

1.       Our bodies are amazingly adaptable. Exposed to any stimulus – muscular load, bone stress, joint positions, our bodies – including muscles, ligaments, nerves, bones- have the ability to adapt. So, if you’ve sat hunched over since your awkward teen years, it’s likely that this is a comfortable and safe position for you to continue.

2.       People come in all shapes and sizes. We all have unique and differing builds and anatomy. Our anatomy is heavily influenced by our gender, genetics and age – all of which are out of our control. There is no “perfect” shape or posture, just a very broad scale of what is considered normal. Because we are built differently, we also move, sit stand differently

Because of these two reasons, you should understand that to assign a very narrow and rigid posture to everyone is not only impossible, but also unhelpful. Trying to make you sit like me or me to sit like you based on unfounded ideals just isn’t useful for preventing or treating pain.

So what should you do instead of worrying about your posture?

Move!

If you sit at a desk all day, get up and move every 15-20 mins. You don’t have to stop working, make a call on your phone while you walk around, or go chat to a colleague rather than send an email.

If you’re physical in your work, ensure you take breaks from repetitive or heavy activity to limit fatigue.

Stay comfortable. If you aren’t comfortable in the position you’re in, change it. If you’ve been working from home since COVID sprung into existence, take turns working at your desk, dining table, kitchen bench, couch, and change it up regularly.

If you’ve got some back pain that is bothering you, you can book an appointment with me by clicking the button at the top right of this page. In the meantime, block out the SIGs and move!