Column Low Back Pain and Posture: Reducing Pain by Adopting the Correct Posture
January 17, 2025
It is often said that “ a poor posture causes back pain”.
In this issue, we will explain the relationship between posture and back pain.
What constitutes a good posture and a bad posture?
Good posture is defined as a posture in which the auricularis – acromion / obturator / anterior knee joint / anterior external capsule are aligned in a straight line when in a standing position.
Bad posture is defined as a posture in which the above conditions are not aligned. Bad posture is classified into kyphotic-lordotic (B), flat-back posture (C), and sway-back posture (D).
Is there a relationship between posture and low back pain?
Various papers have been published on the relationship between posture and low back pain.
For example, a study on 766 adolescents confirmed the link between posture and back pain. In the result, more adolescents with poor posture experienced back pain as compared to those with a normal posture. *1
Meanwhile, there are other papers that fail to show evidence of a correlation between poor posture and low back pain. They conclude that it is not so much the presence of bad posture that causes low back pain, but rather the continued use of the same posture. *2
＊1: Smith A., OʼSullivan P., Straker, L. Classification of Sagittal Thoraco-Lumbo-Pelvic Alignment of the Adolescent Spine in Standing and Its Relationship to Low Back Pain. Spine, 33(19), 2008.
＊2: Sai Kripa, Harmanpreet Kaur. Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy. 26-34, 2021.
Strain placed on the lower back
Swedish orthopedic surgeon Dr. Nachemson (*3) investigated the differences in disc load in various conditions.
The results were as follows, in which the strain on the disc in a straight standing position is set at 100.
・Standing straight up: 100
・Lying on the back: 25
・Lying on the side: 75
・Standing with the upper body slightly tilted forward (in a half-sitting posture): 150
・Holding an object in a half-sitting posture: 220
・Sitting on a chair or a similar object: 140
・Bending forward while sitting on a chair or similar: 185
・Leaning forward while sitting on a chair or similar: 275
＊3: Nachemson, A. L. The Lumbar Spine: An Orthopaedic Challenge. Spine, 1(1), 1976.
The greater the strain on the lower back, the more likely it is that the intervertebral discs will age prematurely, and the more likely it is that lumbar disc herniation or other spinal disorders associated with lower back pain will occur.
Strain-free posture
Here are some postures that do not create strain.
Sitting posture
Since the pelvis is at the base of everything, a posture that does not place strain on the lower back can be achieved by properly aligning the pelvis.
When sitting, avoid overstretching your chest. Overly focusing on the chest and shoulder area will increase the strain on the muscles. Sit comfortably with your chest and head positioned above your pelvis.
Standing posture
Place your weight on your heels. Be conscious so that the tanden (the area below the navel) is positioned above the heels. With the tanden above the heels, concentrate on letting the weight of the upper body rest on the tanden.
If you are overly conscious, you will end up putting too much pressure on the tanden, so be wary not to apply any unnecessary force.
Standing properly: how to ease the strain on your lower back
The act of standing is a complex movement that requires several elements to work in unison, such as moving the pelvis, timing the application of force in the lower limbs at the proper moment, and moving the spine while keeping it in the correct posture.
Being able to stand up in the proper posture will not only improve your movements, but also reduce the strain on the lower back.
1. Starting position: Before standing up, be sure to raise your pelvis properly, and assume a posture so that your upper body rests on the tanden (tanden being the area where the upper part of the body rests).
2.Tilt the body forward, not rounding the body, but starting with the pelvis instead.
A smooth weight body shift can be achieved by tilting the body down, while focusing on the pelvis and not rounding the back.
3.When lifting the buttocks, the muscles of the knees and buttocks should work together.
If you are straining your lower back at the time your buttocks is lifted, the strain on your body will intensify, so lift your buttocks so that the strain is on your knees and buttocks instead .
Exercise to improve posture
By improving the movement of the hip joint, which is the connection between the upper and lower body, you can achieve good posture in standing and walking without unnecessary strain.
1.Get on all fours, placing more weight on your knees than on your hands.
2.Keep your back straight and pelvis rounded.
3.Slowly pull your buttocks back so that your pelvis and spine are not rounded.
4.Stop pulling when the pelvis / spine is about to become rounded, and return to the original position.
* Be sure to focus on the movement of the hip joints.
Treatment at our clinic
When you have back pain, fundamental treatment may also be needed.
Our clinic offers the Celgel method, a treatment that repairs damaged intervertebral discs.
With our Cellgel Method, we inject a drug that fills the cracks in the disc, before turning into a gel that repairs the cracks, thus providing a fundamental treatment. It is characterized by the fact that the volume of the disc is not reduced and the drug remains in the disc as a gel-like implant after treatment, thus preserving the disc.
If you are suffering from back pain, please consider a consultation at our clinic.
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