A physical therapist says the way you sit and stand might be the cause of your back pain—here’s why and how to correct it

When you can’t shake a backache, it’s only natural to go in search of the cause, but that’s easier said than done if you suffer from the most common type—non-specific back pain.

There can be a unique collection of reasons that have caused your individual case, but Nicole Shirley, a physical therapist for Cape Concierge Physical Therapy, suggests the way you sit and stand is a common contributory factor.

It all comes down to the position of your pelvis.

“Overall posture is largely driven by the position of the pelvis. When the pelvis is not in a neutral position, it can significantly affect the alignment of the spine and how forces are distributed through the body,” says Shirley.

Your pelvis can move out of a neutral position in one of two ways: posterior pelvic tilt and anterior pelvic tilt.

“[Posterior pelvic tilt] commonly occurs with prolonged sitting and slouching,” says Shirley, while anterior pelvic tilt “is when the pelvis rotates forward and downward as a result of tight hip flexors and poor core activation.”

“Both of these pelvic positions can lead to muscle imbalances over time, where some muscles become tight or shortened while others become overstretched and weakened. These imbalances further compromise spinal support and increase the risk of back pain,” says Shirley.

Shirley has provided explanations of how to sit and stand with a neutral pelvis, but this shouldn’t be characterized as “good” posture that will help you avoid back pain.

Some experts say there is no such thing as “perfect posture”, and that any posture held for too long may present issues.

It’s something that Shirley acknowledges, but considering the amount of time most of us spend sedentary, lessening the forces your body has to cope with pays dividends.

“Whether at a desk, in the car, or relaxing on the couch, most of us are spending more time sitting than ever before,” says Shirley.

“My belief is that you put less unnecessary pressure through your spine with a more ideal posture or ergonomic setup.

"However, no matter how ideal your posture is, it is still necessary to move and change your position frequently to prevent any muscle imbalances that can still occur."

How to stand

• Align your knees, hips and shoulders.
• Your weight should be evenly distributed through both feet and hips.
• Your shoulders should be gently pulled back, but avoid excessive arching in the lower back.

How to sit

• Your hips and knees should be bent at approximately 90° and your feet should be flat on the floor.
• Your pelvis should remain in a neutral position with weight evenly distributed.
• A cushion, small rolled-up towel roll or other support can be placed behind the lower back to help maintain its natural curve and prevent slouching.

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