Back pain is one of the most common musculoskeletal complaints that leads people to seek health opinion. Whilst a significant proportion of these episodes occur because of an incident or accident, a lot of these problems seem to come out of nowhere, for no rhyme or reason.

When we look more closely at these ‘unexplained’ episodes, it is often the postures and positions people assume that can contribute to not only the onset of pain, but also how long it persists. So, let’s take a deeper look at posture, and the role it can play in LBP.

When we think about posture, most of us will remember being told to ‘sit up straight’ However when you look at the human spine from side on, it is anything but.

Full spine diagram

The spine is actually a series of curves, designed to provide stability, mobility and shock absorption. Typically, when we adopt a slouched or flexed posture, we lose the curves in our lower back and neck, whilst accentuating the cure in our mid back region.

Woman at desk
2.5 man at desk

This posture can potentially lead to the development of lower back discomfort, stiffness, and pain. By adopting this position, especially for extended uninterrupted periods, we are placing some of the soft tissue components (muscles, ligaments, tendons etc) of our spine on stretch. This is a little like bending your fingers back.

Hand hold

This strain is completely harmless if it occurs infrequently, and for short periods of time. However, if it is sustained it can lead to the development of microtrauma. This is where tiny amounts of insignificant damage to the soft tissues accumulates, eventually leading to the onset of tissue disruption, inflammation, and eventually pain.

The other major effect of poor posture on the development of LBP is what it does to our intervertebral discs. The discs sit between the bony vertebrae and allow for movement between the joints. The discs are extremely sturdy and durable structures, well designed to absorb and distribute the stress and strain placed on the spine.

When our spinal curves are maintained, this force/pressure is dispersed evenly across the disc, ensuring that load does not exceed the capacity of the soft tissues.

Normal spinal segment

In contrast, if we sit in poor posture and lose our natural spinal curves, this load becomes unbalanced.  The force and strain is transferred onto the rear portion of the disc. For short periods of time, this is not an issue. However, if this posture is sustained and repeated, eventually this can lead to tissue damage. As a result, the disc can stretch, bulge, and potentially herniate.

Normal vs Herniated

So it is clear that one’s posture can play a role in the development of LBP. With this understanding, it is possible to take positive steps to help maintain our spinal wellbeing.

When we are thinking about Posture, we need to start by forgetting about trying to ‘sit up straight’. Sitting up straight effectively eliminates these curves and makes it very difficult for our musculoskeletal system to function efficiently. On top of this, it is typically quite uncomfortable, and a lot of hard work!

Woman in seat

Rather we should think about. Optimal posture means ensuring that all three of our curves are comfortably maintained. Now, it is impossible to sit in this position all the time. In fact, being stuck in any one posture for extended periods is not good for your musculoskeletal health. Instead, we should aim to sit in optimal posture for more of our day, adjust our chairs/workstation to encourage optimal posture, and most importantly, take frequent short walking or standing breaks to interrupt stress and strain on our spine and soft tissues.

In closing, provided you can make an effort to adopt a more optimal sitting posture more of the time, combined with frequent and consistent short breaks for sitting, you will go a long way to maximise the health and function of your spine.