Back Pain More Likely to Persist Due to Anxiety Than Bad Posture

Cognitive Dissonance is a contributor of back pain researchers say. AdobeStock

The idea that “good” posture prevents back pain is well known—but a new review of the research calls for a second look as Australian experts say that habits and mental processes such as anxiety are more likely to have an impact than lousy posture.

Prof. of musculoskeletal physiotherapy Peter O'Sullivan, prof. of physiotherapy, Leon Straker, and Nic Saraceni from Curtin University have found that anxiety about maintaining good posture can create stress and detract from other factors known to be important for spine health.

“Back pain is more likely to persist if a person becomes overly worried and fearful about their back pain, or overprotects their back and avoids movement, physical activity, work and social engagement,” the authors said in an article published in The Conversation.

“People’s spines come in all shapes and sizes, so posture is highly individual.”

“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.”

Clinicians commonly define “good” posture as sitting “upright”, standing “tall and aligned”, lifting with a squat technique and “straight back”.

On the other hand, “slump” sitting, “slouch” standing and lifting with a “round back” is warned against due to the risk of damaging the spine and creating back pain.

Their overview of the research found a surprising lack of evidence for a strong relationship between good posture and back pain, saying that ergonomic interventions for workers, and advice for manual workers on the best posture for lifting, have, in fact, not reduced work-related back pain.

What can people do instead?

The ten percent of people whose back pain is caused by a fracture, malignancy, infection, or nerve compression should seek medical care, according to the researchers.

For 90 percent of people, back pain is due to sensitivity in the back structures rather than tissue damage. In this case, “too much focus on maintaining “good” posture can be a distraction from other factors known to be important for spine health.”

These factors include moving and relaxing their back, engaging in regular physical activity, building confidence and keeping fit and strong for daily tasks, maintaining healthy sleep habits and body weight, and caring for their general physical and mental health.

As people are more vulnerable to back pain when their health is compromised, the researchers advised that they firstly reduce stress, be active, and ensure they care for their mental health.