Poor posture = back/neck pain.  This seems to be a common link made in the world of musculoskeletal healthcare, but just how true does this ring?

You may have heard at one time or another, that you have an exaggerated curve in your middle back (thoracic kyphosis), which can cause your shoulders to roll forward and you neck to protrude. Or perhaps a relatively large curve in your lower back (lumbar lordosis), which causes the pelvis to tilt forward and your stomach to stick out. The general idea is to stretch the muscles that are tight, and strengthen the muscles that are weak in order to correct these issues and improve your static posture to ‘normal’.

This does seem to make sense, however does the science support this idea? And ultimately should you spend your time trying to correct your posture or spine alignment to what is considered ‘normal’?

The evidence

In a nutshell, most of the evidence exploring the link between posture and pain does not support the idea that bad posture causes back pain.

Here are a few key findings:

  1. People who work in occupations involving frequent awkward postures do not have higher levels of back pain.
  2. No association between leg length inequality and back pain.
  3. No significant difference in lumbar lordosis, pelvic tilt, leg length inequality and length of iliopsoas, abdominal or hamstring muscles in 600 people with and without back pain.
  4. Greater increases in lumbar lordosis during pregnancy were no more likely to develop back pain.
  5. No associations between measurements of neck curvature and neck pain.

Does this mean that posture will never, ever be a problem? Not so fast…

If you hold yourself in the same posture for a long enough period of time, even an optimum one, sensors in our tissues will detect a build up of acids (a byproduct of muscle exertion) and convert this into discomfort or pain. Ever sat at your desk focussing on something for 2 hours, only to get up and stretch, feeling a bit sore? This has most likely happened to you then. So essentially this isn’t really a posture problem, so much as it is a movement problem (or lack thereof!).

The long and short of it… (and curvy)

The evidence suggests that trying to alter our posture may not help with our pain, so what to do???

To put it simply…MOVE!

Endeavouring to improve our posture at the gym by lifting weights or flexibility training like yoga is a common goal amongst people with back and neck pain. There are certainly many benefits from this type of training, such as improved muscular endurance and range of motion. It is these improvements that will have the effect on a person’s pain, and not so the physical changes to a person’s lumbar or neck curvature (if indeed this can even be changed through exercise!).

Yes! So the trainer can get off my back about my terrible deadlifting form then? Perhaps not… during sitting or standing, the mechanical load on the joints and tissues is quite small. In contrast, with heavy resistance training, loads are far greater on the body, and it has less opportunity to adapt to those stresses. So posture matters in a heavy deadlift, when you land a jump and when you reach to catch a ball for example. Ensure you use optimal spine alignment and biomechanics to decrease the risk of injury and increase performance when performing more demanding activities.

What about at work?

The sedentary nature of our jobs these days require that people can sit or stand in the same position for hours. If this causes some discomfort or pain, subtle variations will generally work better for comfort than maintaining one ‘optimal’ posture for the whole time. Moving and changing your posture regularly will distribute the stress of supporting your body weight across many areas, rather than concentrating it on one area. Keep moving and take regular breaks.

Key take homes:

  • Poor static posture itself does not = pain.
  • Small, regular alterations to posture is better than one long standing ‘optimal’ posture.
  • Movement/exercise is the key to reduce back/neck pain.
  • Optimal posture is important for high load activities.

If you think posture may be the cause of your discomfort, or simply want to know more about this topic, get in touch! Call the clinic or book online 🙂


The Thrive Physio Plus team.