Posture and back pain, prevention, treatment, and cure, including posture chair design

Posture and back pain

prevention, treatment, and cure, including posture chair designs ©

The Posture Theory and the cause, prevention, treatment, and cures for postural and other mechanical back pains which include neckache, lower back pain, loin pain (in the kidney area), shoulder pain, and arm pain.

Treatments include The Alexander Technique, Yoga, posture chairs, and other ergonomic methods.

The human head is perfectly balanced on top of the spine which has a slight S-shape to absorb the pressures of movement as the person sits, stands, or walks. Any factor which alters or exaggerates the natural shape will throw the weight of the head away from the centre of gravity and put mechanical strain on the spinal muscles and cause muscle tension, and aches and pains.

Those pains can be prevented or relieved by understanding and managing the causes. M.B.

An example of extreme postural abnormality

Postural back pain

There are many different causes and types of back pain. Some are due to obvious injuries or disease of the spine. However, by far the most common cause is poor posture, and the condition is called 'postural back pain'. The poor posture may result from slouching, or from a forward curvature of the upper spine which is known as hunchback or typhoid. Those things tend to produce round shoulders where the the head and shoulders are pushed forward and downwards.

The back pain occurs because poor posture puts unnatural, excessive and prolonged strain on the muscles, ligaments, discs, and nerves of the spine. The most significant feature of this pain is that there is no evidence of disease on x-rays or other tests, and therefore it is often misdiagnosed as imaginary, trivial, psychosomatic or 'all in the mind'. It is important to understand the real cause of these pains in order to treat them appropriately and prevent the development of injury or disease.

Previous wrong methods for correcting posture problems

In the past there have been attempts to cure back pain by improving posture with the military stance which involves throwing the head and shoulders back, pushing the chest out, and pulling the chin and stomach in. Patients have also been advised to sit in chairs which have straight backs and lay on hard flat beds. However such advice did not consider the fact that the normal human spine has slight curves in the neck and lumbar regions which give shock absorbing qualities to the human frame. Therefore straightening it unnaturally and excessively sometimes caused more problems than were cured so it is important to improve posture in a manner which retains the normal slight curves.

The following methods can assist in relieving, managing, or curing postural back pains.

The chair design for good posture - also called ergonomic seating

1. The Alexander Technique involves improving posture by raising the head so that the spine straightens below. When it has reached a normal position the person then relaxes their back muscles and maintains their posture by moving their head back and forth until it is in a perfectly balanced position. By balancing the head and relaxing the muscles, there is no strain on the spine and the cause of the back pain is removed, and as long as there has been no severe damage such as disc rupture or arthritis, the pain can be relieved and in many cases cured.

2. (a) When sitting the person should use chairs and desks which assist in maintaining the natural spinal shape.

(b) Therefore the height of the seat of the chair should match the height of the knees so that the person can place their feet on the ground and give slight support from their feet.

(c) The depth of the seat from front to back should be equal to the distance from the back of the knee to the back of the hips, because if it is too long the knees will be dragged forward, and the lower spine will follow, and the back will be forced into a C-shaped curve.

(d) The height of the desk should be such that the person can read and write by lowering their eye line without having to lean forward, and if necessary they should lean forward from the hips rather than by slouching at the midriff.

(e) The back of the chair should have a slight curve in the lumbar area to maintain the slight lumbar curve, and the back rest should be slightly inclined backwards so that when the person sits in the chair they can sway back and forth to maintain and establish a balanced position for their spine, and so that they can use it for support if they lean back.

(f) Where chairs are designed with an additional fully hinged lay back feature the chair should be suitably padded as well.

(g) A person who works an 8 hour day at a desk should get up and move about as often as possible or for 10 minutes of each hour to prevent or relieve constant, or persistant static strain on the spinal muscles.

The bedding design for good posture - also called the orthopedic mattress

3. When laying down the person should use a bed that is flat, but has a surface which is soft enough to absorb the weight of the heavy protruding parts of the back. As the back of the heels, hips, and shoulders sink into the mattress the lumbar region comes into contact with the bed and is supported.

Posture Chair Design

Some things to consider

1. The symptoms of poor posture can be prevented or relieved by providing a person with chairs which are properly designed for enhancing natural posture.

2. Visiting a dentist tends to produce some anxiety in many of the dentists patients, but sitting or laying in the contoured dental chair generally produces a sense of comfort and relaxation.

3. In early human history all men spent all day hunting and gathering or resting and sleeping, but by the seventeenth century 10% of men were sedentary workers (they sat at desks all day) and 90% were generally farm labourers. By the twentieth century 90% of workers were engaged in desk work and only 10% were involved in manual activity or labour.

6. Posture chairs are generally promoted as relieving backache, neck pain, arthritis, and fatigue.

A quote from the past
A chair which has a straight back "forces you to droop forward in a round-shouldered position". At a medical convention attended by 500 doctors who all "sat in beautiful little straight ballroom chairs" Dr. Janet Travell recalled "After half an hour I never saw so much squirming and turning . Every one of those restless people was trying to find a position that would allow him to relax and lean back". They would have been more comfortable if those chairs "had been tilted 15-20 degrees behind the vertical".
Reference: Our Human Body It's Wonder and It's Care (1962), The Reader's Digest Association, Pleasantville, N.Y. p.220-224

Seat design in passenger jets and swelling of the feet
If the seating in passenger jets is poorly designed the passengers will tend to slump forward in their seats and that puts postural pressure on their large abdominal veins which causes abdominal distension and pain, fatigue, and swelling of the feet, especially in passengers with poor circulation who travel on long flights.
Reference: The British Encyclopaedia Of Medical Practice 2nd edition, (1950) Vol.2 p. 419-420

The five Posture Chair Design Principles

1. The normal body shape
The spine has slight natural curves in the neck and lumbar regions that give it shock absorbing qualities, so the chair should be designed with a back rest that is shaped to correspond with those curves.
2. Balance
The human body has evolved with a spinal shape which allows a person to walk in an upright position with the head balanced directly above a slightly s-shaped spine. The balance enables the person to walk effortlessly without stain on the spinal muscles. The chair should therefore be designed with the back rest slightly inclined backwards so that the person can sway slightly to and fro to get and maintain proper balance in the sitting position.
3. One size fits all
In the modern industrialised society mass production has become universal and items such as chairs are designed to be suitable for the maximum number of people, which are those with average physiques. However such chairs are unsuitable for school students who are too small, and have their feet dangling off the floor without support, or tall students who have to slump forward because their knees are excessively bent. Each individual should be educated to recognise and acquire seating that is suitable to their own dimensions.
4. Dimensions
The height of the top surface of the seat section should be equal to the length from the base of the persons heel to the base of their thigh when they are seated.
The length of the seat from the front edge to the back of the chair should be equal to the measurement from the back of the knee to the back of the buttock.
The height of the back of the chair (for a half back chair) should equal the measurement from the base of the buttock to the base of the shoulder blade, and for a full back chair, should be equal to the measurement between the base of the buttock and the middle of the back of the head.
The height of the arm rests should be equal to the measurement between the base of the buttock and the base of the elbow.

The width of the chair should be suitable for the person to comfortable sit between the arm rests.
5. Padding
The seat should be padded so that it compresses for about an inch under the persons weight.
The base of the seat should be padded at the front because pressure from the front edge can compress the main arteries and veins of the legs against the thigh bone and impede blood flow to the feet.
The section of the lower back which corresponds to the lumbar curve should have additional padding to accommodate the natural curve of the lumbar spine, and this will offer support for the natural upright shape of the spine and prevent it from slumping into a C-shape.
There should also be additional padding at the top of the chair to accommodate the natural curve in the neck.

Contoured and padded back rests are available as accessories for seats, particularly in motor vehicles and can be used where the original padding has deteriorated due to the age of the vehicle. Examples can be seen here and here

See also here http://www.healthycomputing.com/office/setup/chair/index.html

Postural back pain occurs because of the chronic or repetitive mechanical strain placed on the spine by poor posture. However there are other factors which have a similar effect, and which, when removed, can lead to relief or cure of the pain.This pain also exists in the absence of any evidence of spinal disease, because there is no disease. The condition is called mechanical back pain. The causes and cures of mechanical back pain are listed below.

The cause	The treatment or cure
1. Sideways curvature of the spine (Scoliosis). This can produce back and shoulder pain, and arm pain on the left or right side depending on which way the spine curves. The pain can be in the muscle between the neck and shoulder bone, and, or in the upper arm, and or in the muscles over the shoulder blade.	The Alexander Technique
2. Having one leg longer than the other. This can cause back pain and hip pain.	Shoe inserts which equalise leg height
3. Carrying a wallet in the back trouser pocket and then sitting in a chair; the presence of the wallet raises one hip and twists the spine.	Remove the wallet from the back trouser pocket before sitting down.
4. Regularly carrying heavy items such as satchels in one arm; this puts sideways strain on the spine. This can cause back and shoulder pain and hip pain.	Only keep essential and light items in the satchel or use knapsacks.
5. Having a computer keyboard in front of the computer and the mouse pad alongside of the screen which requires repetitive stretching forward with one arm to use the mouse. This places sideways and rotational strain on the spine. This can cause back, neck, shoulder, and upper arm pain. 5a. Having the computer screen too high, or too low can cause excessive and repetitive leaning upwards or downwards to cause neck and back aches.	The Alexander technique, and keep the mouse pad in a position where it is not necessary to stretch forward, or, if possible, alternatively use the left arm until the pain in the right arm subsides. Place the computer screen at eye height or slightly below so that repeated bending at awkward angles isn't necessary when reading.
6. Obesity; Overweight people tend to get a pot belly or a beer gut and as the abdomen protrudes forwards the weight drags the lower spine forward and produces a compensatury curve in the neck. This can cause lower back pain and neck pain.	Losing weight often results in relieving or curing the neck and back pains.
7. As the womb becomes larger with advancing pregnancy the weight drags the lower back forward and produces similar back pains to those of obesity.	The woman should rest to take the weight off their spine, and the lower back pain usually subsides after giving birth.
8. Wearing high heel shoes puts mechanical strain on the spine by altering its shape. The hips are thrown upwards and back, the lower back is thrown forward, and the upper shoulders tend to slouch.	It is best not to wear high heel shoes or to only wear them for a few hours each day, and if they cause back pain they should not be worn at all. As long as they have not caused permanent change in the shape of the spine a change to wearing flat shoes can relieve the back ache.<
9. Sleeping on spring mattresses that sag like a hammock are likely to result in C-shaped curves of the spine, and mattresses that are too hard or too soft are likely to cause alterations in the natural curves of the spine.	The mattress should be flat, and firm enough to absorb the weight of the shoulders and hips so that the spine remains in it's normal alignment. The pillow should be soft enough to absorb the weight ot the head without flattening, or in general, so that it feels comfortable, particularly for the neck.
10. Sitting in chairs that are too high, or that have a back rest that is too straight, or at too great an angle, or where the base inclines downward at an angle can alter the mechanical strains on the spine.	The chair should be the correct height for your legs and back, with the base horizontal and the back rest slightly curved to match the natural curve of a normal spine. Resting in properly shaped recliner chairs can be beneficial.