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Your Bad Posture Can Create or Even Contribute Additional Pain to Your Low Back Pain

Your Bad Posture Can Create or Even Contribute Additional Pain to Your Low Back Pain

Your Bad Posture Can Create or Even Contribute Additional Pain to Your Low Back Pain

Author: Dr. Faisal Hayat, MBBS

What is postural back pain?

Back pain is one of the most prevalent medical conditions that affect individuals of all ages. It leads to a significant amount of professional and social disability.  It is estimated that almost 70-75% of individuals experience low back pain at least once in a lifetime.[1]

Posture has been frequently being discussed among patients and clinicians. If no pathology or anatomical lesion is found, postural back pain is called. Posture is not a position; it is defined as a body’s attitude or the positioning of the limbs when standing or sitting. Various structures and groups of muscles are usually involved in maintaining a posture.

What may cause back pain?

The back pain can begin suddenly due to a severe injury to the spine, a strenuous workout after a long time, or any other. Back pain has a large number of causes. Only in limited back pain patients can we identify a specific underlying pathology. Smoking, obesity, associated medical conditions, and physically demanding jobs are the most typical risks for developing back pain.

Lifting heavy subjects and fatigue may also precipitate back pain episodes. In most cases, the exact etiology remains unknown for postural back pain. We are unable to find out the underlying pathology.

The postural imbalance may also lead to back pain. Faulty postures may cause excessive stress to the bones and soft tissues like muscles and ligaments. These soft tissues get overstretched and tensed, leading to an unpleasant sensation called pain.

Lumbar disk disease, lumbar spinal stenosis (LSS), spondylosis, infections, and trauma may cause low back pain (LBP). In addition, low back pain can also be caused by primary and metastatic malignancies, osteoporosis, genitourinary, gastrointestinal, and gynecological reasons.

A narrative about posture and back pain

The back is a complicated structure having bones, ligaments, muscles, and joints. Sprain ligaments, strain muscles, rupture disks, and irritated joints, all of which can lead to back pain. Everyone has a unique structural appearance. Because of differences in bone shapes, muscles, and ligaments, any dysfunction in the alignment to one person will be acceptable for the other one.

Bad posture or sitting for an extended period in the same posture may produce muscle tightness, tension, and fatigue. It may lead to an imbalance among the soft tissues, vertebral joints, and discs.

  • A study was conducted in 2010 to systematically evaluate the available evidence on the association between physical activity (i.e., occupational load and non-occupational physical activities) and low back pain (LBP). The literature was explored between 1999 and 2009. Strong associations were found for flexed, rotated, and faulty lumbar spine positions.[2]
  • Heavy physical activity, trauma, bending, twisting, and prolonged non-neutral work postures have been suggested to be associated with disc degeneration. Degeneration of the lumbar intervertebral disc is a common cause of chronic low back pain (CLBP). The etiology of lumbar disc degeneration (LDD) is not fully explained. It is considered a multifactorial disorder involving numerous genetic and environmental factors and their interactions.

Counter-narrative about posture and back pain

Some papers published recently also conclude that there is an absence of solid evidence to support a common belief that spinal pain is caused by sitting, bending, or standing in poor posture. Because people come in different sizes and spinal curvatures naturally. Comfortable posture varies among individuals.

The link between back pain and spinal posture is not fully understood. Spinal posture is a widespread focus in the clinical assessment and management of back pain patients. If the spinal curves are balanced and aligned, it is good posture. Slouched and hunched over position may strain the soft tissues and vertebra.

Some facts about posture[3]

  • The spine is a flexible structure and can be trusted.
  • There is no substantial evidence that there should be one posture or avoiding an incorrect posture to prevent back pain.
  • Changing position and being physically active is healthy.
  • Because of natural variations in spinal curvatures, the difference of postures is the fact of life.
  • Comfortable posture may vary among individuals.
  • It is safe for individuals to adopt a relatively more comfortable posture
  • It is not dangerous to sit for more than half an hour in one position.
  • A relaxed posture is beneficial.

Role of PEMF in postural back pain

Pulsed electromagnetic field (PEMF) devices are clinically approved and safe for back pain patients. Magnetic fields are generated through a device using low voltage in multiple coils. These magnetic fields are directed to the targeted body tissues.

PEMF enhances blood supply, repairs cellular dysfunction, and activates metabolism. Eventually, PEMF relieves pain, swelling, and inflammation. Analgesics, antidepressants, and exercise may be used to alleviate the symptoms.

Pulsed electromagnetic field (PEMF) devices are evolved as a new alternative for treating various problems. It can alter pain perception and cognitive processing.

  • A study was conducted, and 68 patients with fibromyalgia were recruited to evaluate the efficacy of pulsed electromagnetic field (PEMF) therapy for the treatment of fibromyalgia in a randomized, double-blind, sham-controlled trial. This 12-week clinical trial showed that low-frequency PEMF therapy has beneficial effects on function, pain, fatigue, and global status in patients with fibromyalgia. The patients reported no treatment-related serious adverse events.[4]
  • A paper was published in 2018 with a title. “Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain.” A total of 512 patients were included. It concluded that “Postural awareness is associated with pain intensity, physical and mental impairments in patients with chronic pain; and improvements in postural awareness through multimodal interventions were associated with improvements in pain intensity.”[5]

DcCure: FDA-listed, pain-relieving device

McClure is a safe, FDA Class 1 listed, non-invasive pulsed electromagnetic field (PEMF) therapeutic device. It was used in a randomized clinical study conducted in 2019. Almost 42 patients 18-75 years of age with non-specific low back pain (NLBP) were randomized. The trial has proven its efficacy and safety in LBP patients.

  • A Randomized Controlled Trial (RCT) was conducted in 2019 by Anthony J Lisi et al. The paper was published under the title “A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain.” The PEMF device used in this trial was “MDcure®, Aerotel Ltd., Holon, Israel, Aerotel Inc. USA, New York, NY, USA.” It was concluded that the PEMF device is safe and effective in improving function in patients experiencing non-specific low back pain (NLBP). No side or adverse effects were seen in the trial.[6]


  1. Deyo RA, Rainville J, Kent DL. What can the history and physical examination tell us about low back pain? JAMA 1992;268:760–5.
  2. Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L. Physical activity and low back pain: a systematic review of recent literature. Eur Spine J. 2011;20(6):826-845. doi:10.1007/s00586-010-1680-7
  3. Slater D, Korakakis V, O’Sullivan P, Nolan D, O’Sullivan K. “Sit Up Straight”: Time to Re-evaluate. J Orthop Sports Phys Ther. 2019;49(8):562-564. doi:10.2519/jospt.2019.0610
  4. Sutbeyaz, SerapTomruk MD; Sezer, Nebahat MD; Koseoglu, Fusun MD; Kibar, Sibel MD Low-frequency Pulsed Electromagnetic Field Therapy in Fibromyalgia, The Clinical Journal of Pain: October 2009 – Volume 25 – Issue 8 – p 722-728
  5. Cramer, Holger et al. “Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain.” BMC musculoskeletal disorders vol. 19,1 109. 6 Apr. 2018, doi:10.1186/s12891-018-2031-9
  6. Lisi, A. J., Scheinowitz, M., Saporito, R., &Onorato, A. (2019). A Pulsed Electromagnetic Field Therapy Device for Non-Specific Low Back Pain: A Pilot Randomized Controlled Trial. Pain and Therapy, 8(1), 133–140.

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