Health conditions helped by sitting with good posture
Sitting with bad posture can result in back pain for anyone. But if you suffer from any of the following conditions, sitting with bad posture will only aggravate your symptoms. After reviewing much research, we’ve put together some information and tips to help you reduce your pain.
Conditions involving the lower back
All types of back pain are classed as multifactorial, which means that there are many factors of daily living that can influence the severity of the pain. There is no one solution. Studies show that sitting with bad posture in a vehicle makes things significantly worse. As someone who suffers from back pain, there are things you can do to make it better, see our driving posture tips
Sitting slumped in a vehicle (as a driver or passenger) has the following consequences that make lower back pain worse:
- it puts you into a forward bending position
- it increases the forces through your spinal joints
- it increases the pressure on your discs
- it puts forces through your lower back that you don’t do in daily life and have been not designed to do
Indicators of sitting with bad posture in a vehicle are that:
- you experience pain while driving
- you cannot stand up straight immediately on getting out of your vehicle
- you are stiff and sore when getting out of your vehicle
Sitting with good posture and a neutral spine is important for the following conditions:
Ankylosing spondylitis (AS) –– if you have been diagnosed with AS, you will already know that there is an inflammatory spinal component and that it may stiffen your spine. It is important to habitually sit with good posture wherever you sit, to maintain the arch in your lower back and, whenever possible, to keep moving.
Disc issues – sometimes referred to as “bulge/herniation/injury/collapse/slipped” – we will refer to these conditions as ’disc issues’.
- 90% of us will eventually have disc issues in our lumbar spine
- most of these disc issues will give us normal backache at worst and often will give us no symptoms whatsoever
- the presence of a disc issue, even if highlighted by an x-ray or MRI scan, does not automatically mean that you will have pain, or that you will not get better
- the extent of the disc issues has a poor correlation to both your symptoms and recovery.
- The majority of lower back surgeries are carried out on disc issues.
- Lower back pain is very common and so are disc issues, a connection between the two cannot be ignored.
- Even when sitting in perfect spinal posture, the internal disc pressure in our lumbar discs increases compared to standing.
Sitting slumped increases the disc pressure even more and it is thought that if this pressure is maintained for long periods of time, it is one of the factors that helps to produce disc issues.
- For people with ongoing back pain, prolonged sitting increases the chance of an acute attack more than physical exercise.
Hypermobility disorders – e.g. Ehlers-Danlos or Marfan’s Syndromes. If you have a hypermobility disorder you will know that you are very flexible. Unfortunately, this reduces joint stability and you need good muscle action over the joints to control them well. When sitting, and you let your muscles relax, your flexibility will allow you to slump much further than someone who is not as flexible. This puts more load on your joints. Sitting with good lumbar support to hold you in your neutral posture is important.
For further information http://hypermobility.org/
Osteoarthritis (OA) – Lumbar spine – sometimes called spondylitis or degeneration – this reduces the mobility of the lumbar spine and can make it a bit stiff and sore. Because of the stiffness, we fully slump earlier than when we were 20. With age, the ‘margin for error‘ is reduced and you need to focus more on sitting correctly.
Rheumatism – Autoimmune arthritis – the most common is rheumatoid arthritis (RA).
These conditions have an inflammatory component, as does osteoarthritis but from a different cause, however the advice to sit with good posture is the same as for OA above.
For further information https://www.arthritis.org.nz/
Sciatica – sciatica means pain originating from the sciatic nerve. The sciatic nerve is the biggest nerve entering the leg, supplying the whole leg, except for the front and inner thigh. The most common causes of sciatica are:
There are a few other rare causes of sciatica so make sure you have a diagnosis from your health professional.
Spinal stenosis – Foraminal – this is the name given to the condition where your nerves are being compressed as they leave the spine through their bony ‘windows’.
Typically, you will gain relief by bending forwards. If and when you have pain, sustained backward bending will bring on more pain.
Initially, sitting slumped is often a relief, particularly if you have pain when standing or walking. However, sitting too slumped, for too long, will tend to aggravate the underlying condition that causes compression of the nerve in the first place. In the long term, maximum slumping makes your problem worse. Your goal is to sit a little bit slumped, enough to relieve the pain, but not completely slumped.
The difference between these two positions is often quite small, and you will need a strong lumbar support to help you.
Spinal stenosis – Central – this is the name given to the condition where your spinal nerves are being compressed in the spinal canal/tunnel.
This will often behave in a similar way to foraminal spinal stenosis (see above), however not always.
Firstly, find a sitting position that puts the least amount of pressure on the nerves being affected to reduce the pain. Secondly, try and sit as well as you can without being fully slumped. As with foraminal spinal stenosis, there is an association between sitting with bad posture and the progression of central spinal stenosis.
Spondylolysis/spondylolisthesis – if you have been given one of these diagnoses you will almost certainly have been advised to avoid excessive backward bending of the lower back. This action is difficult to do when you are sitting down and so is generally not a problem. These conditions are also seen as instability conditions, which mean that the area concerned has a little less control from the bones and ligaments, and therefore requires good muscular support. When sitting for prolonged periods your muscles will tend to have a rest and give less support. Sitting slumped will tend to exaggerate this instability.
Surgery – Lumbar Discectomy – if you have already received disc surgery, then good posture, core stability and other rehab activities are imperative to help reduce the chance of a 2nd surgery.
Surgery – Lumbar Spinal fusion – this surgery is carried out to support and control the lumbar spine when changes have occurred that create instability. Good posture and core control are important to look after the joints immediately above and below the fusion, which now have to do more work.
Surgery – Lumbar artificial disc replacement – Good core stability, functional and postural controls are important to ensure a good long-term outcome.
Other conditions that can be affected by sitting with bad posture.
Hip osteoarthritis (OA) – this will make the affected hip stiff and often painful. Having the hip bent up too far will affect the way that you sit. This will force you to slump. Increasing the hip angle by raising the seat base and reclining the seat back a little, should help.
Respiratory conditions – if you have any condition that makes you breathless or interferes with normal breathing, then sitting slumped will make breathing even harder.
In a slumped position the diaphragm cannot move properly. Sitting tall decompresses your abdomen and allows better diaphragm movement.
Gastrointestinal (GI) disorders – almost all gut conditions are made slightly worse when the gut is not able to move. Normally when you can walk about and use your diaphragm to breathe, the gut is massaged by both your diaphragm and your stomach muscles. When you sit, this general mobility is reduced, if you sit slumped your diaphragm movement is reduced further.
Haemorrhoids – the link between haemorrhoids and prolonged sitting is well-established. Haemorrhoids are made worse by sitting with bad posture. Sitting slumped encourages pooling of your blood in the pelvis, because it is movement that helps pump blood back up to the heart. The movement of the diaphragm is a key player for this pump action. Sitting tall encourages better movement in your diaphragm.
Haemorrhoids are a common complaint amongst truck drivers. This site might help:
For further information https://www.hemorrhoidinformationcenter.com/truck-drivers-and-hemorrhoids/
Heartburn – gastro oesophageal reflux – if you suffer from heartburn you will already be aware that certain postures are better than others. Sitting slumped increases your abdominal pressure which can force gastric juices up into your oesophagus.
For further information https://americanpostureinstitute.com/your-heartburn-isnt-just-from-your-food-its-from-your-posture/
Neck and upper back/shoulder pain – if you suffer from pain in your neck and upper back while sitting for a long time, slumping in your lower back may be the cause. When you sit slumped, the top of your body flexes forwards and your head faces down. To look forwards, you must lift your chin by extending your neck and upper back. If you were to mimic this position when standing, it would be the same as looking up at the ceiling. Doing this for long periods of time will cause pain in your neck and upper back.
Headaches – the posture described above in ’neck and upper back/shoulder pain’ can also manifest as headaches, which of course might impair concentration.
Pregnancy – if you are pregnant you will already know that prolonged sitting, especially in a slumped position, is generally discouraged, as it does not allow your baby to move easily. It also puts more pressure on your organs.
Pregnancy – with pain in your lower back pain or sacroiliac joint (SIJ). – Driving will almost always make your pain worse, especially if you are sitting slumped. Often if you are a passenger with no steering wheel to hold onto, the side-to-side forces when cornering are also uncomfortable. It’s therefore a good idea to have good lateral as well as lumbar support when driving.