Posture

Posture is the way the body is held when standing, sitting and moving. For much of the twentieth century a single upright position was taught as correct. Research has not borne this out: people with very different postures have similar rates of back and neck pain, and no one position has been shown to prevent it. What matters more is how long a position is held, and how strong and mobile the body is.

What the evidence says

• There is no strong evidence that slouching causes back pain, or that sitting upright prevents it.
• Staying in any one position for a long time, however good it looks, leads to stiffness and discomfort.
• Posture reflects habit, mood, tiredness and body shape, and varies widely among people with no pain.
• Physiotherapists often put it as "the best posture is the next one": regular change of position matters most.

Why posture still matters

Some habitual positions do load particular tissues for long periods, and changing them can relieve symptoms that already exist. A head held well forward of the shoulders for hours at a screen increases the work of the neck muscles. Rounded shoulders go with a tight chest and a weak upper back. An upright, open posture also allows the chest to expand fully when breathing.

Sitting at a desk

The Health and Safety Executive's guidance for work at display screens advises:

• a chair adjusted so that the lower back is supported and the feet rest flat on the floor or on a footrest;
• forearms roughly horizontal, with the wrists straight when typing;
• the top of the screen at about eye level and an arm's length away;
• the keyboard and mouse close enough to be used without stretching;
• a separate keyboard and mouse, and a stand, when a laptop is used for long periods;
• short, frequent breaks from the screen in preference to occasional long ones.

Employers must assess display screen workstations and provide an eye test to regular users who ask for one.

Phones and tablets

Looking down at a hand-held screen for long periods bends the neck forward. Raising the device towards eye level, supporting the arms and taking breaks reduce the strain.

Standing and lifting

• Weight is spread evenly between both feet, with the knees unlocked.
• During long standing, shifting from foot to foot or resting one foot on a low step eases the back.
• Loads are lifted with the knees bent and the object held close to the body, without twisting.
• A rucksack worn on both shoulders spreads weight better than a bag on one.

Exercises that help

Strength and mobility do more for posture than conscious effort to sit up straight.

• Strengthening the upper back: rows with a resistance band, and squeezing the shoulder blades together.
• Strengthening the trunk and hips: planks and bridges.
• Stretching the chest and the front of the hips, which tighten with sitting.
• Gently drawing the chin straight back, to counter a forward head position.
• Yoga, Pilates and tai chi.

See strength training and stretching and flexibility.

When to seek advice

Persistent pain, a visible curve of the spine, a change in posture with loss of height in later life, or posture problems in a growing child are reasons to see a GP or physiotherapist. The effects of long sitting are covered under sitting and health, and back pain under exercise for back pain.