Back Posture

With a basic knowledge of lower back pain we can see if the back loses the normal forward curve, it is vulnerable to injury and ligament damage from overstretching. This is commonly seen with poor sitting posture and activities in which one is bent forward. Since your nerves are behind your disc, bending forward usually squeezes the bulging disc into the spinal nerve roots. Therefore, it is important to avoid slouching or slumping forward when sitting, standing or bending for things.

The protective nature of the disc is lost as the low back is bent forward and the soft inner portion of the disc is pushed to the back. With weakened or damaged ligaments, the disc can bulge, protrude or even herniate to put pressure on the nerves. Loss of the forward curve places abnormal biomechanical stress on the vertebra creating instability. It is this unstable structure that causes much of the premature arthritis seen on x-rays as the body attempts to stabilize the region by forming boney bridges around the joints.

In chronic low back problems there is a noted association between pain and loss of the normal forward curve. A study published in the Journal of Spinal Disorders 1998; 11:430-9, regarding lumbar lordosis discrimination between normal and lower back pain subjects found chronic low back pain shows a significant average decrease in the forward curve by over 10 degrees!

The most common cause of low back pain is postural stress. this type of pain is often brought on by sitting for a long time in a poor position, poor lifting technique, frequent forward bending in working positions, standing or lying for a long time in poor posture. All of these positions place the back under stress by reducing the normal curve of the back, allowing the ligaments to overstretch and the discs to become stressed.

Unfortunately, many of us spend most of our work and/or leisure time with the lower back in this flexed (forward bent) position and completely lose the normal curve (lordosis) of the back. As time passes, this posture causes changes to the structure and shape of the joints as excessive wear and loss of flexibility results in premature ageing of the back resulting in chronic pain. The bent, stooped posture often seen in the elderly are visible consequences of a lifetime of poor postural habits. This bent position affects more than just the lower back as the lungs become constricted and internal organs are deprived of the correct support.

Poor sitting postures commonly produce lower back pain, and once back problems have developed, a poor sitting posture can promote and worsen the problem. Due to our ever increasing sedentary lifestyles, poor posture is a widespread problem. When we sit for prolonged periods, the muscles that support the low back begin to weaken and, as they relax, the body sags into a slouched position which, when maintained for long periods of time, the ligaments become overstretched, discs become distorted and lower back pain results. This condition then produces pain during movement as well. Correct sitting posture is very important after vigorus activity like jogging or tennis because exercised joints easily distort if placed in a slouched position. Often the back pain is blamed on the physical activity, when it is the posture assumed when relaxing afterwards that causes the problem.

For years, many people have had the habit of sitting in a bad posture without low back pain, however, once lower back problems have developed, sitting in a poor position will perpetuate and worsen the problem. It is essential that the lordosis (normal curve) of the lower back is maintained at all times. This requires effort and repeated long enough to make it habit or, as I like to call it, an aquired skill. This should be done slowly and not with jerky motions or with excessive force.

Make sure you are aware and practice correct breathing technique. You should not do this in a chair with a stiff back. Practice using a backless stool or sitting forward in your chair. Begin by sitting and breathe out as you move forward in a slouched position with your body at 2:00, breathe in as you extend up and backward to 11:00, then exhale as you come forward to 12:00 maintaining the forward curve in your lower back and rest for a couple of breathing cycles. It is the 12:00 position that is the normal sitting posture where the lordosis is maintained. This requires your own muscular effort and attention and you cannot fully relax. Without proper back support, you must sit this way. The sitting exercise should be done three times per day (morning, noon and evening) and whenever you experience pain as a result of poor seating.

Most chairs or seats do not provide proper support for the lower back. Fortunately, there are a number of good back supports available to fit most seating arrangements. Portable low back supports are essential for people with ongoing low back problems and when seatd in a chair with a back, can promote the maintenance of correct low back lordosis and posture.

The Posture Curve is a great tool to assist in low back posture recovery. For seats with or without a back rest, the Backtivator is a great seat cushion to keep the muscles of the back active. I use one wherever I go. If you have chronic back problems with significant degeneration, the muscles of the back take over some of the function of the ligaments. This can lead to early fatigue and back strain. The Backtivator keeps muscles active and I notice a significant difference in back stiffness when I use it, especially when driving. Additionally, when there is no back support, a Seat Wedge can help provide support for sitting in a correct posture.

Just as muscles tire and relax when we sit, some people get lower back pain when standing for long periods. Poor standing posture can result in an excessive curve opposite that of poor sitting posture. This allows the low back to hang in an extreme position. This posture is one of sagging chest and protruding abdomen. To correct this, you must hold your low back in a position of reduced curve (lordosis). Stand as tall as you can, lift the chest up, pull in your stomach muscles and tighten your buttocks. This is difficult at first, but practice in this new position will lead to more endurance and you will be able to maintain it for longer and longer periods. Remember to breathe correctly and this new position will strengthen the muscles around the back and help to reduce standing postural lower back pain.

Working in a bent over position causes considerable stress on the ligaments and discs of the lower back. Working around the house: gardening, sweeping, digging, making a bed, vacuuming, along with occupations such as; plumbers, carpenters, bricklayers, assembly line workers, mechanics, ect. require working in bent positions and are more likely to sustain back problems. Since the discs swell with fluids when you sleep and are non weight bearing, you are more likely to suffer back problems in the early hours, so special attention should be paid to your back in the morning and to reduce bending at this time. Working in these positions should be accompanied by frequent breaks to perform standing extension exercises as illustrated below. Similarly, coughing and sneezing cause significant stress in the discs and you should not bend over to cough or sneeze, in fact, you should stand and lead back slightly or if you cannot stand, assume correct posture with the normal curve in your lower back to help protect it.

Lifting objects with your back rounded and bent over places significant stress on the discs of the lower back. It is imperative to follow safe lifting technique at all times. If you use incorrect lifting technique with a heavey object, you may cause damage and sudden and severe back pain. As stated previous, lifting is more risky early in the day than latter, so plan accordingly. While lifting, you must retain the normal curve or arch in the back. Avoid using the back in a crane like motion. Use your legs to power the lift. Stand up and bend backward a few times after lifting a heavy object, or when repeated lifting is involved, interrupt the lifting frequently with standing up and bending back. If you have been sitting for a long period for example; truck drivers lifting after a long ride or lifting suitcases after a long trip, bend backward a few times before and after lifting. If you have lower back pain, you should refrain from lifting if at all possible.

Some people experience low back pain from sleeping in a poor posture or the sleeping surface is not supportive. One way to keep the back from twisting when side sleeping is the use of a body pillow. If you sleep on your back, a pillow under your knees can help take some pressure off the back. Your mattress should not be too soft (sagging) or too hard. A soft mattress, when placed on a firm support, should not sag. If your mattress is too soft, replace it or place a plywood board between the mattress and the frame. In general, a medium-firm mattress should provide the best support and help to reduce low back pain. I find a tempurpedic mattress will fit the needs of most lower back pain sufferers and help ease morning stiffness.

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