Does bad posture lead to pain?

As a physiotherapist, one often mentions the term 'posture'. Bad posture is mostly associated with people in pain and good posture is for people without pain. It does make me think, is it really that simple?

It's been a controversial topic for many years. The relationship between pain and posture is extremely difficult to determine. I hope to shed some light on the topic by using information from studies and fellow physiotherapists.

Assuming bad posture does cause pain, that brings us to the question of what do we mean by bad posture? Posture relates to the anatomical norms and how they relate to each other, in other words, the alignment of body parts. Bad posture would indicate a deviation of these norms. We have categories for bad postures. Examples include forward head posture, upper cross syndrome and lower cross syndrome to name a few.

What does the literature say about pain and posture. Extensive studies have been done to prove the relationship, but most have inconclusive results. A study published in 2017 found that a forward head posture was related to pain in office workers, however that was not the only influence on the pain. Other influences included high stress levels and poor ergonomic setups.

Forward head posture has also been established as a contributing factor to pain intensity and disability in adults aged 50 and older, in contrast to not having a lasting effect in adolescents. This was confirmed in a systematic review examining the relationship of forward head posture to neck pain.

So does this mean that forward head posture does cause pain?

Not quite.

Variations in the shape of our spines are normal. Deviating from the normal anatomical alignment does not necessarily mean you will have pain. Pain is a very complex concept and does not rely solely on one component. It's often influenced by our social, psychological and emotional states and is always varying. Alignment doesn't necessarily have to be perfect. What is important is that we have the capacity, physically and psychologically, to tolerate the activity we want to take on.

To quote Adam Meakins, a renowned physiotherapist: 'the inconvenient truth is that many musculoskeletal conditions are often consequences of our convenient lifestyles.' From the research, it's clear that bad postures don't cause pain at a young age, but years of neglect and indifference does catch-up to us.

Make your health a priority right now, by moving regularly, adding strength training to prevent muscle loss, drink enough water and manage your weight correctly.

Perhaps the question shouldn't be whether bad posture leads to pain but rather whether bad lifestyle choices do.