Sit up straight. Don’t slouch. Elbows off the table. We’ve probably all heard these before. Most likely from our parents or teachers. And perhaps we’ve said them ourselves. There was fear if we continued to slouch we would end up that way forever. Good sitting posture is often considered proper and a reflection of discipline (think of soldiers standing at attention). It’s also believed to help prevent muscle and joint pain.

The notion of an ideal posture harkens back to Victorian times and has gained popularity since then. Even the world-renowned Cleveland Clinic has a blog on what good posture is. They define it as sitting up straight, shoulders back with your butt touching the back of the chair. Even many physiotherapists promote a good posture. Out of 544 surveyed, 94% felt a good posture was important. And while there was no consensus of what an ideal posture is, many described it as some form of upright sitting. The emphasis on posture is so popular, you can even buy posture correction gadgets.

Sitting, sitting and more sitting…

With many of us spending more time at home, we’re sitting around more. One study in college students and staff found people increased their sitting by one hour per day as a result of the pandemic. Another survey found it could be as much as four more hours per day. This at first may not seem like a lot, but when added on to the average six hours per day we already spend sitting, and that quickly becomes a lot. Therefore, if we’re not sitting properly, that could be a problem.

We know that a lot of sitting isn’t good for us, as it increases risk for diabetes and heart disease, but what is it doing for our posture? For some people, the pandemic means working or studying from home. And most of us don’t have ergonomically designed work spaces, so we’re left with makeshift desks at the kitchen table, on our bed and even in the bathroom (yes, I know someone who has to use that for office space).

The concern with poor posture is how it relates to muscle and joint pains, and predominantly low back pain. Estimates of low back pain range between 1.4% to 20.0% of the population. This wide range is likely due to the nature of the various studies in terms of age, place and occupation type. However, even at the low end, it would still mean millions of people with chronic pain resulting in billions of dollars in health care costs, missed work days and poor quality of life. And low back pain is considered a leading cause of disability.

Can sitting posture be a pain in the back?

It’s often believed the cause of low back pain is poor posture, and correcting posture is therefore the obvious solution. There is some indication that posture may affect pain and discomfort in those with existing back pain. And when people with an acute bout of back pain were interviewed, performing a manual task while in an awkward position was reported to occur in 27% of those interviewed. However, when studied more closely using wearable sensors placed on 12 people with back pain, there was no single sitting posture that reduced pain in everyone.

But the evidence to suggest that slouching or other forms of poor posture is a cause of pain, is weak at best. Some studies have found an association between posture and pain. However, a review of 25 studies didn’t find an association between sitting itself and back pain, but it did note in certain occupations in which the person was in twisted or bent over positions increased the chances of having low back pain.

When comparing those with and without low back pain, those with back pain tend to spend more time sitting and this sitting is more likely to be uninterrupted. Uninterrupted sitting has been shown to decrease disc height, which may be related to back pain, while even small movements every 15 minutes seems to prevent it. Therefore it seems the predominant concern is how long someone has been sitting in the same position, rather than the specific position. And one can imagine that even sitting upright would lead to discomfort over time.

Posture and Confidence

That being said, there may be other reasons why you may want to practice a certain posture. A good posture is generally thought of as more attractive and aesthetically pleasing. Ballet wouldn’t quite look the same if the dancers were slouching. Sitting upright is also seen as a sign of confidence. When asked to evaluate themselves, a group of people had a more positive and confident attitude when they sat upright compared to slouching.

There is some suggestion sitting upright may also help with concentration. A study of 125 college students found performance on a math test to be perceived as harder when slouched compared to siting upright. However, this finding was only apparent in those students with higher anxiety regarding math itself. An earlier study in grade four students found they tended to slouch when performing a harder math test. The slouching was the result of less muscle activity and the authors suggested this allowed the students to place more attention on the difficult task.

While the studies to date are far from conclusive, they tend to indicate time spent sitting without movement is more problematic than how one sits. And even though people with back pain may get relief by sitting in a certain way, there’s no single posture that seems to work for everyone. So find what is comfortable to you. And also make sure to get up and move around to give your body a break.

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