University of Limerick study shows ‘proper’ sitting posture does not prevent back pain

University of Limerick study shows ‘proper’ sitting posture does not prevent back pain

The research shows there is a lack of evidence that sitting upright either prevents or treats back pain.

A new study involving researchers at University of Limerick has found that common understanding of ‘proper’ sitting posture is outdated and may hinder the treatment of back pain.

Back pain is the most costly and disabling health condition in the world, with the costs of back pain exceeding that of cancer and diabetes combined.

For decades, one of the most common approaches to preventing and treating back pain has been to change the way people sit – with advice to sit in a more upright manner being promoted widely.

However, a series of recent studies – including many by the group of researchers at UL – have highlighted the lack of evidence that sitting upright either prevents or treats back pain.

In this latest study, which has been published in the journal Musculoskeletal Science and Practice, the usual sitting posture of people without pain was compared to what the same people perceived to be ‘optimal’ sitting posture.

Every single one of the 100 people tested believed their own - perfectly pain free - sitting posture was ‘suboptimal’, and demonstrated a more upright posture when asked to select a good sitting posture. This over-emphasis on correcting their own posture to being more upright was particularly marked for women.

The study builds on other recent research at UL showing that physiotherapists and members of the public have an unnecessarily negative view of ‘slouched’ sitting postures, and also that physiotherapists and manual handling instructors often promote very stiff, straight ways of bending and lifting, even though they are not shown to prevent or ease back pain.

Commenting on the study, Dr Kieran O’Sullivan from the School of Allied Health at UL, said: “There are two major concerns when it comes to how we view the role of posture in back pain. First, it has been clear for decades that back pain is influenced by not only physical factors, such as posture, but also psychological factors such as worries and mood, and lifestyle factors such as sleep and fitness."

Dr O'Sullivan says the importance of posture in back pain is overstated in general and that when posture has a role, it does not seem that there is one ‘safe’ or ‘proper’ way to sit when it comes to back pain.

"We come in many different shapes and sizes, and aspects such as comfort and function – am I comfortable, and can I do what I need to do – are perhaps all that are worth considering from a posture perspective. Unfortunately, many of the ideas about sitting upright are more related to aesthetics and ideas about what is deemed elegant, attractive or motivated – the fact that females changed their posture even more than males when asked to assume a good posture likely reflects the greater pressure on females to conform to societal expectations of appropriate posture,” he said.

In the middle of a global pandemic, with millions of people working from home – often at their kitchen tables – the new study has obvious practical implications.

“At the end of the day, nobody has ever shown that people without pain should be advised to change their posture,” explained Dr O’Sullivan.

“So if you feel ok, then don’t worry about sitting posture, and don’t lecture your kids or friends about how they sit. And if you have pain, it is reasonable to see if changing posture helps your pain – just don’t assume that the solution is always sitting up straight, and think of all the things other than posture that could be important,” Dr O’Sullivan added.

The study was conducted in conjunction with international collaborators in Greece, Qatar and Australia.

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