Many of us suffer from lower back pain that gets in the way of work, daily life and movement. Back pain and posture are common topics at workplaces, yet many people don’t know what causes recurring low back pain. This piece explores the link between back pain and posture through a client story — revealing some surprising angles that greatly relieved the client’s mind.

A woman in her early 40s came to my clinic looking quite distressed; she even cried while telling her story. She’d been dealing with long-term low back pain that had worsened about a week earlier, leaving her feeling quite stuck.

Sitting triggered almost unbearable low back pain, making work and driving nearly impossible. She’d been studying for two years with two more to go, and the associated pressure had caused significant stress. She also mentioned struggling with depression and that her therapy course had just ended.

Is “good” posture always best for your back?

Behind the client’s tense body language were beliefs and habits about posture. I explained how attitudes toward posture have changed recently. As a conscientious person she’d been trying to maintain so-called good posture when sitting and standing. She also wanted to appear taller, so she kept herself in an upright, proud stance. Yet she suffered constant low back pain despite sitting the way she’d always been taught. So, is striving for “good” posture really beneficial for the back after all?

So something about the sitting position had to change to calm her lower back pain. We turned the idea into action and tried a few experiments with how she sat. I wanted her to feel firsthand how even small changes in posture while sitting can make you feel better.

Watching how she sat on the chair, her posture looked exactly like what many of us were taught: spine straight, chest proud— textbook good posture. From another angle, though, she also looked very stiff sitting on the edge of the seat. It seemed like she had to work to hold that posture with her core muscles. I wondered how well her back and abdominal muscles could sustain that all day, every day.  

Is sitting relaxed actually better?

I asked her to sit back against the chair and slide her buttocks slightly away from the backrest. That small move lets the lower back round a little, which relaxes the muscles there. By the way, ‘backrest’ is a fitting word—it’s literally something you can rest your torso against. The muscles are less tense in this position than when you’re holding an upright, proud posture. Sounds efficient if you’ve got to sit for hours a day, doesn’t it?

Next we watched how her breathing changed in this more relaxed position and I asked her to take a slightly deeper breath. When you sit relaxed, the lowest ribs can move more freely, which allows the diaphragm—our main breathing muscle—to work properly. Sitting rigidly locks the ribs and can limit diaphragm movement, which makes breathing less effective.

The more relaxed posture felt strange to her and gave the impression of slouching. “I look totally slumped,” she said, almost alarmed. I took a photo of her new position and, to her surprise, it didn’t look nearly as bad as she imagined. I reassured her that no one else would notice the change, but her back would definitely appreciate it.

I asked him to return to the familiar upright pose and take a few slightly deeper breaths in that position. As his core muscles tightened like a corset, breathing became harder and his familiar back pain flared up. We shifted back into a more relaxed posture and the pain eased immediately. We managed to create a contrast between rigid and relaxed sitting, which also had an immediate effect on the back pain. We concluded that sitting more relaxed might help him break free from persistent back pain.

Putting perfect posture above your back’s comfort is pointless

I argue that thousands of low back pain cases are caused by unnecessary tension in the back muscles while sitting. Each of us spends so much time sitting that how we sit really matters. That’s why it’s best to sit efficiently — using your core muscles only as much as needed so they can keep working without locking up. Muscles need good blood flow and oxygen to keep functioning. I was interviewed by Iltalehti about myths around back pain — read it here.

If your job requires sitting, sit more relaxed and your back will thank you. Counterbalance sitting by taking breaks and getting up to move as often as possible.

If you’d like to come to my clinic you can book an appointment via this link.

Thanks for reading my blog 🙂

You might also be interested in my article “Back pain while sitting — how to get rid of it”.

Jerry
Osteopath, sports masseur, non-fiction author
Member of the Finnish Association of Qualified Masseurs.