Can ‘Poor Posture’ Result in Back Pain?

Hinge Health member’s question:

“I’ve always had bad, hunched-over posture. Is this what’s causing my back pain?”

Hinge Health physical therapist Paige Nelson's answer:

I hear this question often, and the short answer is probably not. Research shows that “poor posture” doesn’t directly lead to back pain. The issue is more about how long you stay in one position, regardless of whether it’s considered a “good” or “bad” position. 

Imagine sitting with what many people consider “perfect posture” — shoulders back, spine straight — for eight straight hours without moving. There’s a good chance that by the end of the day, you’ll experience some aches or stiffness in other parts of your body, like your neck, hips, or knees. Our bodies aren’t designed to stay static;  they’re designed to move. 

That’s why I encourage my patients to let go of the idea that there’s one “ideal” posture. Instead, think of movement as your best defense against back pain. If you’re sitting for long periods at a desk, get up, stretch, or take a short walk. These movement breaks allow your muscles to relax and can prevent stiffness or tension from building up, which is important because tight muscles can lead to pain.

Ergonomics and Back Pain

While posture isn’t the main culprit when it comes to back pain, it can be helpful for some people to make ergonomic adjustments, particularly to their work setup if they sit at a desk. Things like having your feet flat on the floor, using a chair with armrests, and positioning your computer monitor at eye level can help keep you comfortable.

Back Strength and Flexibility

Aside from changing positions and ergonomics, factors like back muscle strength and flexibility play a big role in back pain. Sometimes pain arises because the muscles in your back aren’t strong or flexible enough to handle the activities you’re doing — whether it’s an increase or decrease in activity, or a change in the intensity of an activity. Strength and stretching exercises can prevent back pain by making your body more adaptable to different movements and demands.

Skip Correction Devices  

The other thing I get asked about a lot is posture correction devices, which are typically worn like a harness or backpack with straps that fit around your shoulders to encourage you to maintain an upright posture. I typically advise against relying on them because, while they can be a good reminder to sit up straight or change positions if you start slouching or rounding forward, they don’t strengthen the muscles that support your posture. It’s better to build muscle strength than rely on external aids in the long run.

My Main Takeaway

My main takeaway is this: Posture does not directly cause back pain. As we Hinge Health physical therapists like to say, your next position is your best position — the more you move and change positions, the better off your back will be.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Slater, D., Korakakis, V., O’Sullivan, P., Nolan, D., & O’Sullivan, K. (2019). “Sit Up Straight”: Time to Re-evaluate. Journal of Orthopaedic & Sports Physical Therapy, 49(8), 562–564. doi:10.2519/jospt.2019.0610

2. Kripa, S., & Kaur, H. (2021). Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy, 26(1). doi:10.1186/s43161-021-00052-w