Peter O’Sullivan is a professor of musculoskeletal physiotherapy at Curtin University. But make sure you are fit and strong enough for the task, and care for your overall health. If you are lifting, the current evidence suggests it’s OK to lift naturally – even with a round back.
So if you are sitting or standing, find comfortable, relaxed postures and vary them. Sometimes this requires some support and coaching with a skilled clinician. Maintaining healthy sleep habits and body weightĬaring for your general physical and mental health In this situation, too much focus on maintaining “good” posture can be a distraction from other factors known to be important for spine health.Įngaging in regular physical activity of your preferenceīuilding confidence and keeping fit and strong for usual daily tasks In these cases, seek medical care.įor 90% of those with back pain, it is associated with sensitisation of the back structures, but not identifiable tissue damage. In a small group (between 1% and 5%), back pain can be caused by pathology, including a fracture, malignancy, infection or nerve compression (the latter is associated with leg pain, and a loss of muscle power and sensation). Overprotects their back and avoids movement, physical activity, work and social engagement Importantly, people are more vulnerable to back pain when their health is compromised, such as if someone is:īack pain is more likely to persist if a person:īecomes overly worried and fearful about their back pain Back pain can be like a sprain related to awkward, sudden, heavy or unaccustomed loads on our back, but can also occur, like a bad headache, where there is no injury.
While back pain can be intense and distressing, for most people (90%), back pain is not associated with identifiable tissue damage or pathology. Movement is important for back health, so learning to vary and adopt different postures that are comfortable is likely to be more helpful than rigidly adhering to a specific “good” posture. People’s spines come in all shapes and sizes, so posture is highly individual. There is no evidence for a single “good posture” to prevent or reduce back pain. In a small study, as people with disabling back pain recovered, they became less protective and generally moved away from the “good” posture advice. In other words, people with back pain tend to follow “good” posture advice, but people who don’t lift in the “good” way don’t have more back pain.
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In comparison, manual workers with back pain tended to adopt more of a squat lift with a straighter back. Our recent lab study found people without back pain, employed in manual work for more than five years were more likely to lift with a more stooped, round-back posture. Our systematic review found no evidence lifting with a round-back posture was associated with or predictive of back pain. Globally accepted occupational health practices about “good” or safe back postures during lifting also lack evidence. Photograph: Panther Media GmbH/Alamy Stock Vector Lifting posture However these guidelines are without an evidence base. Many of us have posters like this in our workplaces. People with both slumped and upright postures can experience back pain.
People adopt a range of different spine postures, and no single posture protects a person from back pain. These findings are consistent with systematic reviews that have found no consistent differences in sitting or standing posture between adult populations with and without back pain. We investigated whether “slump” sitting or “non-neutral” standing postures (overarching or slouching the back, for example), in a large population of adolescents, were associated with, or predicted future back pain. Our group has conducted several studies exploring the relationship between spine posture and back pain. Systematic reviews (studies looking at a number of studies in one area) have found ergonomic interventions for workers, and advice for manual workers on the best posture for lifting, have not reduced work-related back pain. Perceptions of “good” posture originate from a combination of social desirability and unfounded presumptions. Surprisingly, there is a lack of evidence for a strong relationship between “good” posture and back pain. This view is widely held by people with and without back pain, as well as clinicians in both occupational health and primary care settings. Good posture is commonly defined as sitting “upright”, standing “tall and aligned”, and lifting with a squat technique and “straight back”.Ĭonversely, “slump” sitting, “slouch” standing and lifting with a “round back” or stooped posture are frequently warned against. There is a common belief that “good” posture is important to protect the spine from damage, as well as prevent and treat back pain.
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