How to prevent posture related back conditions

Posture typically refers to how the body is positioned as a whole.  Good posture indicates a position with alignment of the neck, torso, pelvis, arms and legs in such a manner that our spine curves remain neutral, or not bent, as we sit, stand or move about.

Bad posture is when our spine is carried or positioned in unnatural positions in which the spinal curves are altered, thus positioning the joints, muscles and vertebrae in stressful positions. This prolonged poor positioning or use of stressful movements result in accumulation of pressure on these tissues. Over time, dysfunction will occur because these tissues are overused, resulting in undesirable symptoms

Most of us gradually suffer from the negative effects of bad body postures and yet we do not change the factors which cause these problems; most likely due to either not being able to trace that our problems are posture related or ignoring them all together.

One might not feel any ill-effects after sitting with poor posture for a few hours, but over time the stress that poor posture places on the spine can lead to physical changes in the spine.

This, in turn, can provoke back pain through the compression of the blood vessels and nerves. In addition, the stress from poor posture can lead to back pain by causing problems with the muscles, discs, and joints.

Also, because the body is unbalanced, certain muscles and joints are over-utilised and others are under-utilised resulting in body asymmetry. This, also known as postural dysfunction, typically is a result of an individual’s lifestyle and/or occupational demands.

One should suspect that their back pain could be caused by poor posturing if; it is worse at certain times of the day, starts in the neck and moves down into the upper and lower back, it subsides after switching positions while sitting or standing.

Sudden back pain that coincides with a new job, a new office chair, or a new car should alert one about the possibility of being posture related.It is, therefore, very important that we maintain good body posturing as we sit, walk, lift things or do anything to prevent such long term morbidities.

While walking or jogging, it’s important for one to look straight ahead of them and to keep the head balanced straight above the spine. Additionally, one should remain tall (avoid drooping their shoulders) while walking, and make sure to land on their heel and then gently roll forward to push off the front of the foot when taking a stride.

While sitting, it is imperative, especially for people that spend long hours seated (such as office jobs, bankers, some pharmacists, long distance drivers and others) that they maintain proper body posturing.

One common posture mistake many people make is the “office chair hunch,” where a person sits at the front of their chair and bends forward to reach their computer screen.Instead of bending forward, one should keep their back leaned against the chair with the shoulders tall and head level over the spine without bending. When sitting at a desk, one should keep their arms flexed at a 75 to 90 degree angle at the elbows and the knees should level with the hips—or sit with the knees slightly above the hips if seated at a desk.

One should try to keep their feet flat on the floor. If they are unable to reach the floor, a footrest can be utilised.

When lifting, one should keep their chest out and ensure that they keep their back straight while lifting, bend the hips and not the lower back. When changing directions while lifting, one should lead with their hips to avoid placing additional strain on their back. The objects being lifted should as much as possible be kept close to the body to minimise straining to the spine.

Also, for people who do a lot of work while standing, measures should be taken to minimise bending either of the neck or back. These include medical health workers such as surgeons, among others. For surgeons, raising the operating tables to one’s working height will reduce on the need to bend and the associated long term morbidities.                              

Dr Ian Shyaka,
Resident in Plastic Surgery, Rwanda Military Hospital

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