Mom was right when she said “Sit up straight and don’t slouch”. Proper posture really does decrease the chance of back pain. Of course back pain is not due solely to poor posture. Many factors can contribute. Posture may be the key in recurrent or persistent pain. Sitting, standing and bending are the most frequent postures contributing to pain.

Most chairs do not support the spine well. A slouched spine is more likely to have strained muscles and discs. In fact, pain along the “bra- line” is usually caused by slouching. This problem is common in mothers with young children especially while breast- feeding. It is extremely important to put a pillow under the baby to bring the baby up to you. The number-one rule in posture with osteoporosis is – DO NOT SLOUCH.

Here are some other suggestions to decrease back pain in sitting:

• Avoid sitting in soft chairs and couches
• Sit with your bottom pushed back in the chair
• Use a small foot rest if your feet do not touch the floor (a telepho ne book works well)
• Place a small towel roll at the waist line in the back
• Sit with the rib cage lifted up
• Get out of the chair every 20 to 30 minutes

Standing with the weight unevenly distributed over the feet can also contribute to back pain especially during pregnancy. Carry loads (including toddlers) front and center or piggyback. Avoid sitting the baby on one hip or sticking the hip out to carry the
laundry basket. Also be aware of the sway back posture and avoid excessive low back arch. Backing up against the wall may help you evaluate your standing posture. With your feet slightly away from the wall, lean back so the buttock, rib cage and head touch
the wall. In this position the head and neck should not feel strained. The low back should have a small space (enough to fit your fingers between the low back and the wall, not enough to fit the whole arm). Exercise may be helpful in restoring proper standing
posture at the neck and low back.

Bending is another potentially stressful activity. Women with osteoporosis are especially cautioned against rounding the back while bending forward. Prolonged slouching and bending forward incorrectly can increase the chances of compression
fractures in the spine. Bending should occur at the hip joint, no t at the waist. The spine should be kept bowed in at the low back, as this is the most protected position. Here are some other important points to remember about bending forward.

• Avoid twisting – especially twisting and bending repeatedly
• Bend the knees slightly
• Keep objects close to the body
• Carry even loads

Poor posture places a repeated small strain on the muscles and joints. This small strain may not be painful at first. Slowly over time (sometimes many years) the tissue changes. These changes can contribute to pain. Proper posture is necessary for healing.
Try the above suggestions. If pain persists, ask your doctor if physical therapy may be helpful to clarify proper posture or to provide exercise to help posture.

Beth Shelly PT, BCIA-PMDB