“Stand up straight, shoulders back, don’t slouch, tighten your tummy muscles, and tuck in your glutes!” If you remember to do all these things on a daily basis, your back will thank you for it. At least that’s what most people think. As a matter of fact, patients naturally assume that poor posture causes back pain.

After all, how many times have you been told that strengthening your abdominals is the key to back pain relief? It makes sense that if you slouch, your back will pay the price, right? Well, not necessarily.

There is no question that how we move throughout our lives has long-term effects on our bodies. Pain is the body’s way of telling you that something is wrong. When your body is out of alignment it causes undo stress on the pelvic girdle, spine, mid-back, shoulders, and neck. So if you stand, sit, or move in a way that effects the natural positioning of your spine, your body compensates in order to keep on going.

The majority of physical therapy and corrective exercise is focused on correcting imbalances through stretching and strengthening core muscles. The idea that bad posture causes back pain is universal. Just google posture and pain and you will find 4 million hits that deal with improving posture to fix your back.

Although poor posture may contribute to back pain, there is just as much evidence to show that the link between posture and pain is not all its cracked up to be. Take a look at some of the research that dispels these assumptions.

•Study #1: Teenagers with chest slumping, and overly arched low back, were tracked into adulthood to see if they developed back pain. The results indicated that they were no more likely to suffer back problems than others with “better” posture.

•Study#2: Looked at low back curve and pelvic angle that increased during pregnancy. Women with more distortion were no more likely to experience back pain.

•Study#3: Adults with lumbar scoliosis and increased back curve were no more likely to have back pain than others with no distortion.

In general, results from other studies found no correlation between pelvic asymmetry and low back pain. Oddly enough other factors like leg length inequality, hamstring tightness, and even orthotics do not prevent or cause back pain.

What’s interesting is that some research studies clearly found other factors to be associated with back pain, such as exercise, job satisfaction, educational level, stress, and smoking. The fact that poor posture is associated with back pain does not mean it necessarily causes it. It could actually be that pain causes bad posture instead of the other way around.

Mind-body Link

There are numerous studies to test whether core strength exercises reduce back pain. One study showed that strengthening weak abdominals did not necessarily reduce the likelihood of future back pain. However, the findings were in favor of core work for improving back outcomes but not anymore than the beneficial effects of exercise in general.

If you are looking for a way to reduce back pain and core exercises aren’t helping, consider looking into another type of therapy. Although there doesn’t seem to be one method that works best for everyone, researchers all agree that movement is key. The most successful techniques are those that work with structure, posture, movement and the connection between the mind and body.

Here are just a few:

Tai chi chuan – this is a flowing, steady rhythm of smooth and relaxed movements. It is not based on fitness level, but adapts to anyone regardless of age. This gentle, soft-style martial art requires deep breathing and balanced movement to improve body alignment and muscular control.

Franklin Method – this is a science-based approach stressing the connection between the mind and body. This method combines both scientific and anatomical analysis with movement and imagery exercises. It attempts to draw lines from the body/mind, posture, breath, health, imagery and motivation. It is aimed at getting the individual to move the way the body was designed, in a healthy manner.

Alexander Technique – this technique helps people learn how to go about their daily routine with more ease, and less pain and tension. It is based on the assumption that many pain problems are a result of tensions and stress that people carry in their body from day to day. Teachers of this method guide individuals through simple movements such as sitting, standing, walking, or bending to help them move more easily.

Feldenkrais Method of Somatic Education – this is about the process of self-discovery, as opposed to being taught to do something in a certain way. To help someone with back pain, the idea is to look at the big picture so rather than fixing a part, the solution is to improve the whole system. Experiences are introduced to help develop a clear self-image done through gentle, easy ranges of motions.

Egoscue Method – this is a series of personalized corrective exercises that concentrate on the cause of pain and work on posture and joint alignment. The exercises can be done in the comfort of your own home so you can feel results almost immediately.

As you can see, posture and pain are definitely connected but how, and in what way is still up for discussion. Pain anywhere in your body is an indication that something is wrong.

Remember, pain can come as the result of a number of things; a blockage of energy flow, stress, poor body mechanics, or injury. Be sure to consult your doctor to determine the best method of treatment designed for your specific needs. With the right program you will not only strengthen your body but engage your mind as well.

Mark Bromson, M.D.


Author's Bio: 

•University of Miami Graduate School-M.B.A (Health Administration)
•University of Pennsylvania School of Medicine
•Harvard College Biology-Graduated Magna cum laude
•Fellowship: Baylor University of Medical Center
•Residency and Internship: The Mount Sinai School of Orthopedic Surgery
•Fellow, American Academy of Orthopedic Surgeons
•Fellow, American Orthopedic Foot & Ankle Society
•Fellow, Florida Orthopedic Society