Posture and back pain
prevention, treatment, and cure, including posture chair designs ©
The Posture Theory and the cause, prevention, treatment, and cures for postural and other mechanical back pains which include neckache, lower back pain, loin pain (in the kidney area), shoulder pain, and arm pain.
Treatments include The Alexander Technique, Yoga, posture chairs, and other ergonomic methods.
The human head is perfectly balanced on top of the spine which has a slight S-shape to absorb the pressures of movement as the person sits, stands, or walks. Any factor which alters or exaggerates the natural shape will throw the weight of the head away from the centre of gravity and put mechanical strain on the spinal muscles and cause muscle tension, and aches and pains.
Those pains can be prevented or relieved by understanding and managing the causes. M.B.
 | An example of extreme postural abnormality |
Postural back pain
There are many different causes and types of back pain. Some are due to obvious injuries or disease of the spine. However, by far the most common cause is poor posture, and the condition is called ‘postural back pain’. The poor posture may result from slouching, or from a forward curvature of the upper spine which is known as hunchback or kyphosis. Those things tend to produce round shoulders where the the head and shoulders are pushed forward and downwards.
The back pain occurs because poor posture puts unnatural, excessive and prolonged strain on the muscles, ligaments, discs, and nerves of the spine. The most significant feature of this pain is that there is no evidence of disease on x-rays or other tests, and therefore it is often misdiagnosed as imaginary, trivial, psychosomatic or ‘all in the mind’. It is important to understand the real cause of these pains in order to treat them appropriately and prevent the development of injury or disease.
The faulty natural tendencies which make postural problems worse
One of the reasons that spinal, or postural problems become worse with age is because of the natural tendency to correct it, which is good for maintaining balance, but bad for the body. For example, it the spine is bent forward because of deformity, the head is projected forward, and would result in the person falling over if they didn’t do anything about it. The natural tendency is move the head backwards to put it in a balanced position directly above the spine, but that movement puts an extreme curve in the neck where the middle of the neck is bent forward, and the top and base of the neck are pushed backwards. If the person constantly walks about in that position they will eventually develop pain and arthritis in the neck.
Similarly, if the upper spine is bent forward, the person will naturally move their belly forward as a counter balance, but that drags the lower spine forward and can ultimately result in lower back pain.
Previous wrong methods for correcting posture problems
In the past there have been attempts to cure back pain by improving posture with the military stance which involves throwing the head and shoulders back, pushing the chest out, and pulling the chin and stomach in. Patients have also been advised to sit in chairs which have straight backs and lay on hard flat beds. However such advice did not consider the fact that the normal human spine has slight curves in the neck and lumbar regions which give shock absorbing qualities to the human frame. Therefore straightening it unnaturally and excessively sometimes caused more problems than were cured so it is important to improve posture in a manner which retains the normal slight curves.
The following methods can assist in relieving, managing, or curing postural back pains.
1. The Alexander Technique involves improving posture by raising the head so that the top of the spine is lifted upwards and the spine below straightens. When it has reached a normal position the person then relaxes their back muscles and maintains their posture by moving their head back and forth until it is in a perfectly balanced position. By balancing the head and relaxing the back muscles, there is no strain on the spine and the cause of the back pain is removed, and as long as there has been no severe damage such as disc rupture or arthritis, the pain can be relieved and in many cases cured completely.
Another method of treating the problem of the forward head posture is designed to stop the neck from bending into a forward arch as the head moves back. it is achieved by lifting the chest upwards, and moving the head back while drawing the chin backwards as well. Such methods can be used to treat some types of neck pain, and can be seen in the YouTube Video here. Another series of videos with x-ray images of what is happening to the spine can be seen here.
The difference between these methods and the military stance is the emphasis on the correct position of the spine and balance, rather than force and rigidity.
Note also that in the early twentieth century the military recognised the advantages of the Alexander technique over previous methods, and used it for improving the posture of soldiers.
2. Chair design (a) When sitting the person should use chairs and desks which assist in maintaining the natural spinal shape.
(b) Therefore the height of the seat of the chair should match the height of the knees so that the person can place their feet on the ground and give slight support from their feet.
(c) The depth of the seat from front to back should be equal to the distance from the back of the knee to the back of the hips, because if it is too long the knees will be dragged forward, and the lower spine will follow, and the back will be forced into a C-shaped curve.
(d) The height of the desk should be such that the person can read and write by lowering their eye line without having to lean forward, and if necessary they should lean forward from the hips rather than by slouching at the midriff.
(e) The back of the chair should have a slight curve in the lumbar area to maintain the slight lumbar curve, and the back rest should be slightly inclined backwards so that when the person sits in the chair they can sway back and forth to maintain and establish a balanced position for their spine, and so that they can use it for support if they lean back.
(f) Where chairs are designed with an additional fully hinged lay back feature the chair should be suitably padded as well.
(g) A person who works an 8 hour day at a desk should get up and move about as often as possible or for 10 minutes of each hour to prevent or relieve constant, or persistant static strain on the spinal muscles.
The bedding design for good posture – also called the orthopedic mattress
3. Bed design When laying down the person should use a bed that is flat, but has a surface which is soft enough to absorb the weight of the heavy protruding parts of the back. As the back of the heels, hips, and shoulders sink into the mattress the lumbar region comes into contact with the bed and is supported.
Posture Chair Design
Some things to consider
1. The symptoms of poor posture can be prevented or relieved by providing a person with chairs which are properly designed for enhancing natural posture.
2. Visiting a dentist tends to produce some anxiety in many of the dentists patients, but sitting or laying in the contoured dental chair generally produces a sense of comfort and relaxation.
3. In early human history all men spent all day hunting and gathering or resting and sleeping, but by the seventeenth century 10% of men were sedentary workers (they sat at desks all day) and 90% were generally farm labourers. By the twentieth century 90% of workers were engaged in desk work and only 10% were involved in manual activity or labour.
6. Posture chairs are generally promoted as relieving backache, neck pain, arthritis, and fatigue.
A quote from the past
A chair which has a straight back “forces you to droop forward in a round-shouldered position”. At a medical convention attended by 500 doctors who all “sat in beautiful little straight ballroom chairs” Dr. Janet Travell recalled “After half an hour I never saw so much squirming and turning . Every one of those restless people was trying to find a position that would allow him to relax and lean back”. They would have been more comfortable if those chairs “had been tilted 15-20 degrees behind the vertical”.
Reference: Our Human Body It’s Wonder and It’s Care (1962), The Reader’s Digest Association, Pleasantville, N.Y. p.220-224
Seat design in passenger jets and swelling of the feet
If the seating in passenger jets is poorly designed the passengers will tend to slump forward in their seats and that puts postural pressure on their large abdominal veins which causes abdominal distension and pain, fatigue, and swelling of the feet, especially in passengers with poor circulation who travel on long flights.
Reference: The British Encyclopaedia Of Medical Practice 2nd edition, (1950) Vol.2 p. 419-420
Car seat design
Nowadays car seats are designed with padding an contours built into them to match the natural shape of the spine, but in some older cars the padding loses its density and doesn’t hold it’s shape and tends to flatten, which can cause the spine of the driver to be excessively straight. Back or lumbar supports for car and office seats have been manufactured to solve that problem and may be worth considering. They are readily available in many shops and on the internet. e.g. here and here.
The five Posture Chair Design Principles
1. The normal body shape
The spine has slight natural curves in the neck and lumbar regions that give it shock absorbing qualities, so the chair should be designed with a back rest that is shaped to correspond with those curves.
2. Balance
The human body has evolved with a spinal shape which allows a person to walk in an upright position with the head balanced directly above a slightly s-shaped spine. The balance enables the person to walk effortlessly without stain on the spinal muscles. The chair should therefore be designed with the back rest slightly inclined backwards so that the person can sway slightly to and fro to get and maintain proper balance in the sitting position.
3. One size fits all
In the modern industrialised society mass production has become universal and items such as chairs are designed to be suitable for the maximum number of people, which are those with average physiques. However such chairs are unsuitable for school students who are too small, and have their feet dangling off the floor without support, or tall students who have to slump forward because their knees are excessively bent. Each individual should be educated to recognise and acquire seating that is suitable to their own dimensions.
4. Dimensions
The height of the top surface of the seat section should be equal to the length from the base of the persons heel to the base of their thigh when they are seated.
The length of the seat from the front edge to the back of the chair should be equal to the measurement from the back of the knee to the back of the buttock.
The height of the back of the chair (for a half back chair) should equal the measurement from the base of the buttock to the base of the shoulder blade, and for a full back chair, should be equal to the measurement between the base of the buttock and the middle of the back of the head.
The height of the arm rests should be equal to the measurement between the base of the buttock and the base of the elbow.
The width of the chair should be suitable for the person to comfortable sit between the arm rests.
5. Padding
The seat should be padded so that it compresses for about an inch under the persons weight.
The base of the seat should be padded at the front because pressure from the front edge can compress the main arteries and veins of the legs against the thigh bone and impede blood flow to the feet.
The section of the lower back which corresponds to the lumbar curve should have additional padding to accommodate the natural curve of the lumbar spine, and this will offer support for the natural upright shape of the spine and prevent it from slumping into a C-shape.
There should also be additional padding at the top of the chair to accommodate the natural curve in the neck.
Contoured and padded back rests are available as accessories for seats, particularly in motor vehicles and can be used where the original padding has deteriorated due to the age of the vehicle. Examples can be seen here and here
See also here http://www.healthycomputing.com/office/setup/chair/index.html
Mechanical back pain and it’s treatment ©
Postural back pain occurs because of the chronic or repetitive mechanical strain placed on the spine by poor posture. However there are other factors which have a similar effect, and which, when removed, can lead to relief or cure of the pain.This pain also exists in the absence of any evidence of spinal disease, because there is no disease. The condition is called mechanical back pain. The causes and cures of mechanical back pain are listed below.
The cause | The treatment or cure |
1. Sideways curvature of the spine (Scoliosis). This can produce back and shoulder pain, and arm pain on the left or right side depending on which way the spine curves. The pain can be in the muscle between the neck and shoulder bone, and, or in the upper arm, and or in the muscles over the shoulder blade. | The Alexander Technique. e.g. raise your head to lift your spine and straighten it, and use balance, rather than straining your spinal muscles |
2. Having one leg longer than the other. This can cause back pain and hip pain. | Shoe inserts which equalise leg height |
3. Carrying a wallet in the back trouser pocket and then sitting in a chair; the presence of the wallet raises one hip and twists the spine. | Remove the wallet from the back trouser pocket before sitting down. |
4. Regularly carrying heavy items such as satchels in one arm; this puts sideways strain on the spine. This can cause back and shoulder pain and hip pain. Being left or right handed will have some influence because it involves lifting weights with one arm more than than the other etc. | Only keep essential and light items or books in the satchel and stop carrying heavy satchels or bags in one arm, especially for long distances, such as when walking several miles to school every day. Use knapsacks instead, with the weight evenly distributed on both sides of the back. |
5. Having a computer keyboard in front of the computer and the mouse pad alongside of the screen which requires repetitive stretching forward with one arm to use the mouse. This places sideways and rotational strain on the spine. This can cause back, neck, shoulder, and upper arm pain. 5a. Having the computer screen too high, or too low can cause excessive and repetitive leaning upwards or downwards to cause neck and back aches. | The Alexander technique, and keep the mouse pad in a position where it is not necessary to stretch forward, or, if possible, alternatively use the left arm until the pain in the right arm subsides. Place the computer screen at eye height or slightly below so that repeated bending at awkward angles isn’t necessary when reading. |
6. Obesity; Overweight people tend to get a pot belly or a beer gut and as the abdomen protrudes forwards the weight drags the lower spine forward and produces a compensatory curve in the neck. This can cause lower back pain and neck pain. | Losing weight often results in relieving or curing the neck and back pains. |
7. As the womb becomes larger with advancing pregnancy the weight drags the lower back forward and produces similar back pains to those of obesity. | The woman should rest to take the weight off their spine, and the lower back pain usually subsides after giving birth. |
8. Wearing high heel shoes puts mechanical strain on the spine by altering its shape. The hips are thrown upwards and back, the lower back is thrown forward, and the upper shoulders tend to slouch. | It is best not to wear high heel shoes or to only wear them for a few hours each day, and if they cause back pain they should not be worn at all. As long as they have not caused permanent change in the shape of the spine a change to wearing flat shoes can relieve the back ache. |
9. Sleeping on spring mattresses that sag like a hammock are likely to result in C-shaped curves of the spine, and mattresses that are too hard or too soft are likely to cause alterations in the natural curves of the spine. | The mattress should be flat, and firm enough to absorb the weight of the shoulders and hips so that the spine remains in it’s normal alignment. The pillow should be soft enough to absorb the weight of the head without flattening, or in general, so that it feels comfortable, particularly for the neck. |
10. Sitting in chairs that are too high, or that have a back rest that is too straight, or at too great an angle, or where the base inclines downward at an angle can alter the mechanical strains on the spine. | The chair should be the correct height for your legs and back, with the base horizontal and the back rest slightly curved to match the natural curve of a normal spine. Resting in properly shaped recliner chairs can be beneficial. |
See also the Alexander Technique here
How to cure the agony of a Slipped Disc
The WSM & M/WIL method
The cause and how to prevent recurrences – SC & SS
In March 2012 I was sitting in a chair when I noticed an ache in my neck. It gradually became worse and worse until it was as bad as the worst pain I have ever been in. It was extreme pain for several weeks but by the eighth week it was completely gone.
In the meantime I had conversations with many people, and gained the impression that back aches are very common, and slipped discs often leave people with chronic pain, on a lifetime of medication, or walking about with walking sticks or walking frames, or having expensive surgery to fuse the bones in their neck together etc.
The cause
The most common causes of slipped discs are heavy manual work which gradually compresses the bones in the neck and weakens the covering on the discs between until one of them tears and the inner section bulges out and compresses the nerves to cause the pain. It can also occur in sedentary workers because they are always sitting slightly stooped at desks, and the degenerative changes occur for that reason.
In my case it was probably due to a combination of factors that included measles which infected my left eye when I was five years old, and would have contributed to stooping forward and slightly sideways to read and write later in life. I contracted hepatitis a year later which produced weight loss and a more significant effect on my spine which left me with thin bones, and a thin and slouched physique.,
More recently, I had a whiplash injury after heavy traffic in front of my car came to a sudden stop. I also stopped, and the car behind me stopped, but a third car continued to hit the car behind me, which in turn ran into the back of my vehicle. I immediately felt mildly faint, and had mild headache, and a few isolated stabbing pains in the top back and centre of my head. Within a few minutes I got out of my car to inspect the damage, and about an hour later drove home.
A few hours after that I sat in a chair and felt as if my back bones were a string of pearls and each of them popped one at time from top to bottom. That only occurred once but it indicated that all of the ligaments and muscles which held them in place had been stretched. I also has extreme pain and difficulty lifting my head off the pillow the next morning because the muscle tissue in my neck had been torn by the accident, and become inflamed overnight. The problems became progressively worse over the next two weeks and included neck aches and headaches which were interfering with my ability to sleep. Fortunately, four weeks of massage followed and relieved most of those problems, and the mild headaches persisted for about 3 years, and I eventually seemed to have made a complete recovery.
I then became involved in activities which required a lot of bending, and after a few years I started to get a mild ache in my lower back. It became a more frequent and persistent problem during a period of about three months. I stopped that activity and the ache ceased except on some rare occasions when I have been in the bending position since.
Sometimes there was some discomfort in my neck when I was sitting and watching television, and sometimes when I was standing at the computer.
A couple of years went by when the severe pain in my neck started suddenly while I was sitting in a chair.
I had absolutely no idea what the specific cause was so I reviewed the previous 24 hours and remembered that I had lifted one end of a lounge with my left hand on the lower front base, and my right hand on the top back section . I then walked clumsily backwards at an awkward angle and after a few yards had to drop it. There seemed to be some sort of strain on my left shoulder as my arm was stretched downwards by the weight, but it didn’t cause any immediate or significant pain. I then lifted the lounge about a foot off the ground and moved backwards, and to the left, and continued backwards in that direction for about fifteen feet, and put it down again. I didn’t notice any pain in the immediate period after that and I cannot remember if that incident was a few hours or a day or two earlier. However, when consulting a doctor and physiotherpist, they told me that I had a slipped disc in my neck.
The symptoms of a slipped disc
It is difficult to explain how severe pain is when it can’t be measured by any type of scientific instrument.
However on the one to ten scale where one is mild and ten is the most severe, I would put it at between 8 and 9.
According to the medical literature the most severe pain that humans get is caused by kidney stones. I have had that pain once when I had to wait a week for surgery, and it was as bad, and at times worse than that.
I will discuss the details of the pains, the numbness, and the other symptoms related to my slipped disc later.
The treatment
The pain was agonising, and so severe that in the first week I brought about six different packs or pills such as aspirin, paracetamol, and codeine. I also bought or used three types of arthritic cream which I rubbed on my neck many times a day. The pills were not very effective at relieving the pain, but the massage creams seemed to have some mild benefit.
I purchased three extra pillows and a mattress topper in an attempt to find a pain free position for my neck at night. I also had massages from 2 physiotherapists, a clinical massage therapist, and 4 Chinese massage therapists, and sat in electronic massage chairs at shopping centres, but there were frequent instances of pain, and the treatment was only mildly effective. The third massage I had was given with a lot of pressure on my back. Pressure on the top right side, and the lower left and right side caused no significant pain at all, but pressure in several tender spots on the top left side of my back caused severe pain which made me yell out probably fifty times in twenty minutes. That pressure, on the left side of my upper back, also caused pain in my neck, and pains and tingling sensations in my the tips of two fingers of my left hand which would sometimes radiate up my fingers, and sometimes to the back of my hand, and sometimes all the way up my forearm to my elbow.
By the sixth week the pain had become intermittent and tolerable, but I thought I would probably be affected by neck pains for the remainder of my life. I sometimes felt as if a stone was between the fifth and sixth bones in my neck. It would occur several times, or most of the day, and stop me from straightening my neck, or bending it back, so I tended to walk with a slight stoop.
By the eighth week there was no pain at all and I had made a complete recovery.
A few weeks later I had a massage to see what would happen. I asked the masseuse to give me the strongest and hardest massage possible and there was no pain at all, other than the usual pressure that you would normally expect.
I may write a detailed account of exactly what I did to cure that problem later.
The diagnosis
The cause of the pain was a slipped disc between the fifth and sixth vertebral bones in my neck, which pinched the nerves on one side.
I may discuss more details about that process later.
The Prognosis
The injury is primarily due to the various circumstances of life which lead to gradual weakening of the discs between the spinal bones. For example a person with forward or sideways curvature of the spine puts more pressure on one side of the discs than another, and the ordinary affects of aging can dispose to the problem, To some extent the instance which eventually causes it can be ‘the straw which breaks the camels back‘.
When it heals it is not as strong as before. Consequently I will be more careful about how I lift items in the future.
For example, several weeks after the pain was completely gone, I was about to move some furniture to do some cleaning. I felt a weakness in my neck and stopped, and just cleaned around it instead.
Now that I know how bad that pain is, I don’t want it again.
Next time I might not be able to cure it
Lower back pain in a staff member of the Prime Minister
The Channel 9 TV show “A Current Affair” of 4-10-12 included an interview with a housekeeper who injured her back while changing the bed sheets of the Australian Prime Minister, Julia Gillard. She said that when she bent over she felt a sharp pain in her back, and within a short time was in hospital suffering from agonising pain. Since then she has had constant problems with tingling sensations and pain in her back which occur when she sits or stands still, so she has to constantly get up and move about. She did not receive any treatment for six months, during which time a medical specialist diagnosed the cause as a bulging disc between the fourth and fifth bones in her lower spine, and advised her that there is no cure, and she is not able to do the same type of work again.
A method of treating back pain recommended by Dr. Oz
On 14-12-13 at noon, on channel 7 TV, Adelaide, South Australia, Dr.Oz presented a segment of his show in which he used a model of the human spine to explain the nature and effect of torn discs and slipped discs, and then made some suggestions for treatment. One method was to rub some castor oil over the area of pain, and then cover it with a cling wrap plastic to keep it in place, and then cover it again with a heat pad.
I haven’t had the pain since I treated it by using my own methods in early in 2012 s, but I mention the Dr.Oz method for anyone who currently has the pain, and wants to try it. Whether it helps or not is up to the person who tries it to decide.