Not only does poor posture cause neck and back pain, it puts your body in a state of chronic stress. From sitting too long to bending your neck forward to look at devices, your spinal discs are affected and in turn your overall body function suffers.
Can slouching while sitting and hunching over a computer actually cause back pain?
Dr. Luke Stringer: Yeah, absolutely. That’s essentially one of the major causes of spinal pain and back pain that could be lower back, it could be upper back, mid back, and pain along the spine. How you sit and stand, and the ergonomics of sitting and standing, are critically important for good spinal health, good spinal alignment, and essentially, how we function both on a biomechanical and a physiological level.
Slouching is quintessentially leaning forward. So, you might be sitting and leaning forward from the hips, and then your head is leaned forward, and your shoulders are rounded. But regardless, whenever your body moves forwards, that’s called flexion. If you are seated and/or standing, and you are in flexion from the waist or from your neck moving forwards, i.e. your chin coming down towards your chest, what happens is you actually increase the vertebral disc pressure.
For example, if you’re sitting and you’re slouched over your desk so you’re bending forward from the hips and your chin is on your chest, you can actually increase the pressure in the disc by over 300%. Obviously, if you’re repetitively doing this over time, that increase in your disc pressure is going to break those discs down, cause disc pathology, bulging, and herniation. It’s going to create degeneration, and obviously, those things aren’t great. So, if you’re dealing with degenerative spine or disc issues from just chronic poor posture from being pinned to your desk, then, yes, it is absolutely going to cause pain.
How can neck pain be caused by poor posture?
Dr. Luke Stringer: Great question. There’s a medical phenomenon we’re dealing with more recently called tech neck. So, in your mind’s eye, if you imagine you’re looking at yourself from the side, you want to see that the hole in your ear is on top of that bony point in your shoulder called the AC joint, and you want a 42-degree curve in your neck. You want to have good alignment in the neck because, on average, our head heads weigh anywhere from 10 to 12 pounds. The curve that’s within the neck displaces the weight of the head nice and evenly into the back of the joints of the neck.
In the back of the joints in the neck you’ve got something called facets. Facets help absorb force. This keeps pressure off the joint, the tissue, the discs. However, if we’re in poor posture, typically, what we see, we’re talking about corporate America, is that classic anterior head carriage. That’s where that ear travels in front of the chest, and then your chin’s hanging out over your chest. Then you can just see it’s like someone’s sticking their neck forwards. What that does is it reduces the curve in your neck.
Then imagine your head is a bowling ball, and you’re going bowling. If you keep that bowling ball nice and tight to your chest before you bowl it, you don’t really feel the pressure, but if you held it a couple of feet out from your chest, that bowling ball, although it’s the same weight, is a lot heavier.
For example, if we’re in poor posture, for every inch forward our heads translate forwards, you can add anywhere from 12 to 50 pounds of pressure into the front of the spine. So, to imagine, if you’ve got an inch shift, plus the weight of a head, you’re adding 30 to 45 pounds of pressure to the musculature in the joints and the discs in your neck. Obviously, over time, when you’re upright and you’re absorbing force, and gravity is hitting the spine, that poor posture is absolutely going to break you down. It’s going to create pain in the base of the skull, the neck, the upper back. We’re going to get compensation issues, where our shoulders round. That creates upper back pain. Over a long period of time, you can get disc degeneration.
Posture is a window into your health, and you want to make sure that you are working in good posture to avoid any form of neck pain.
What other aches, pains and discomfort can be traced back to poor posture?
Dr. Luke Stringer: Great question. In our clinical space, we treat the neuromusculoskeletal system. It’s, typically, the classic pain that you’re going to see. The number one disability in America is low back pain. Number two is neck pain, so we’re in chronic poor posture. You can create pain and dysfunction along the spine. So again, neck pain, upper back pain, and low back pain. Obviously, when you’re in poor posture, you start to transfer weight, and when weight is transferred poorly into joints, it can also create pain in the extremities. So that could create pain in the shoulder, the hip, the knee, the foot, and the ankle.
But don’t just think having poor posture is going to create aches and pains. It absolutely does. We’re going to discuss this on a later podcast, but if you are in poor posture, that, essentially, means your body is in chronic stress, just physical stress. If the body is in chronic physical stress, it’s going to increase our cortisol levels. It’s going to block hormone reception, increase insulin in the blood, and this can have physiological effects.
Typically, in the office, we’re helping a lot of our corporate athletes with what we call those lifestyle diseases, metabolic diseases, poor sleep, poor mood, poor energy levels, and poor metabolism due to the posture creating stress within the body. That goes off our homeostasis, and that creates other forms of dysfunction.
So poor posture is absolutely going to break you down over time and create pain, but it also can create dysfunction within the organ system or physiologically overall. So, we want to absolutely make sure we’re keeping an eye on that stuff too.
What can people do every day to maintain good posture?
Dr. Luke Stringer: Obviously, ergonomics are really important. So, if we’re in a corporate environment, typically, we’re required to sit for extended periods of time. Particularly during the pandemic, not many people have been able to go into the offices. Offices are typically design around ergonomics, good working spaces. The majority of people listening to the podcast have probably, if they’re in the corporate environment, spent the last 24 months working from home, and work from home, typically, in a non-ergonomic sound environment.
Two things that we stress in the office are “motion is lotion.” You’ve got to move. So, if you’re sitting, you’ve got to start standing and use a proper stand up desk. The rule of thumb is 20 to 30 minutes sitting, 30 to 40 minutes standing. Also, the four finger rule we use in our office. If we ever see anyone on the phone or reading a book while they’re waiting for treatment, they’ve got a to make sure their chin is four fingers from their chest. You can do this quickly yourself. Grab your hand, open the palm, and you’re going to put your little finger right in the maneuver of that little indent in your chest. And then you’re going to bring your chin down until you hit the top of that fourth finger. That’s as much flexion that we just discussed that we should have in the cervical spine in the neck. So, if you’re on your tablet, or you’re typing, you’re looking at the keyboard, you’re working, or you’re reading a book, four fingers chin to chest is the absolute maximum amount of flexion that we should see in the cervical spine.
Lastly, intrinsic muscles pick up our movement. A lot of the posture muscles that sit deep in your neck, deep between the shoulder blades, pick up on movement. So, if we’re not moving, a.k.a., we’re sitting eight to 10 hours a day, obviously, those muscles are going to get weak and lazy. That creates compensation issues, that upper syndrome and the lower cross syndrome which just essentially means the big muscles in the upper back or the lower back get dominant and little muscles tend to switch off, and that creates poor posture.
What do we need to do? Break up your workday. Between breakfast and lunch, lunch and dinner, spend five to 10 minutes taking some postural breaks, engaging those muscles that sit deep in your neck, between your shoulder blades, deep between your pelvis. Simple, basic exercises you can do sitting, standing at your desk that are going to really activate those posture muscles. It’s all about being proactive, not reactive. And if you do those proactive steps, then there’s no reason why you shouldn’t maintain good posture.
Is it possible to correct the effects of poor posture and reduce the pain caused by it?
Dr. Luke Stringer: Absolutely, yes. Obviously, everyone’s going to have different changes to their posture. It’s all going to be on a case-by-case basis. However, based on those changes, a detailed analysis would have to be done. If we use our clinic for example, you’ll come in, sit down with the doctor, perform a detailed history, perform a physical examination, an orthopedic examination, and a neurological evaluation. We’ll take a posture picture with a really cool piece of equipment that we have that will do some analysis from normal to where you are. And to see is to know, so we’ll take x-rays. Do we have that forward head shift? Do we have a reduction in the curve? Do we have degenerative changes?
From there, you can then lay out a treatment plan based on, obviously, those clinical findings and that patient’s goals. What do they want to achieve through coming in, and what is it going to take for them to achieve those goals?
If you’re going to address posture, joint mechanics are critically important. You can’t expect to have good posture if the joint doesn’t move well. So how do you get a joint moving? Adjust the joint. A spinal adjustment, extremity adjustment, repetitively, is going to get that joint moving.
Typically, with poor posture, you get chronic tissue changes. So, like we discussed, if their head shifted forward, then you’re creating tension in the base of the skull. There are little muscles that help rotate the head, they’re going to get weak and inflexible, which doesn’t allow the neck to rotate as well. That can create impingement on those nerves in the upper part of neck. They can create headaches, for example. You’ve got to break that adhesion down, so you’ve got to be doing some form of soft tissue work. There are many ways you can do it. We do an active form of adhesion release. And then, obviously, traction is critically important. If someone’s got a two-inch shift in their head carriage, i.e., their ears shifted two inches out in front of their chest, we’ve got to address that through traction. You’ve got to pull that spine back into alignment.
Chiropractic biophysics is the most researched form of chiropractic science and data. It’s all based on biomechanics of the spine. Idealspine.com is a good resource for patients that are specifically looking to improve their posture. Doctors like ourselves spend extensive time training on biomechanics of the spine, and how to fix it.
And then lastly, rehab. All of the exercises that we just discussed on the podcast, they’re good postural exercises, ones that engage those muscles that sit deep in the neck, working on your shoulder mobility, the muscles that sit between your shoulder blades. Obviously, there are varying degrees of exercises that we should be doing that can be done at home and that can be done in the gym. But you add all those things up together, repetitively, over time, there’s absolutely no reason that you can’t improve and or fix your posture.
If you are interested in speaking with Dr. Luke Stringer visit www.southloopchiropractor.com or call (312) 987-4878 to schedule an appointment.