A couple of months ago, New Scientist magazine published a feature which challenged the idea that there is a link between posture and pain. ‘If you worry that slouching is causing you long-term discomfort, think again’, wrote the author. The article examined the large body of research that has failed to find a connection between posture and pain. For instance, a 2021 review by researchers at Monash University concluded that there was no reliable evidence linking specific driving postures with lower back pain.
And yet there is also evidence to the contrary. Another recent review paper found that Forward Head Posture (FHP) is significantly correlated with neck pain in adults and older adults. Age-related hyperkyphosis (as it is also known) is also understood to cause a raft of other adverse effects on health and quality of life, such as impaired breathing and balance, and greater risk of spinal fractures. It is even a predictor of mortality.
Over the years, our bodies mould themselves to the habitual ways we hold them. ‘Bones are getting rebuilt every day, and they get rebuilt in response to the stresses we put on them’, notes Professor Leon Strakerin in the article. And some researchers are worried: ‘We don’t know yet what’s going to happen to these kids who slouch all day long,’ said Wendy Katzman at the University of California, San Francisco.
Postural support is multidimensional
The research referenced in New Scientist focused on the link between pain and postural alignment – in other words, how segments of the body line up with each other. Yet this approach ignores the multidimensional system that underlies our posture. For example, alignment doesn’t capture the overall level of tension a person may be holding, or the particular distribution of muscle tone through the system, or how adaptable that tone is. Our nervous systems have multiple strategies for maintaining posture – for example, with differing levels of activity in surface and deep muscles – and these contrasting strategies do not reveal themselves in a snapshot of postural alignment.
The Alexander Technique and posture
There is good evidence that the Alexander Technique is effective in dealing with chronic back and neck pain, but it influences postural alignment in an indirect fashion. The most recent research into the Alexander Technique suggests that it changes the postural muscle tone in the body, both by making it more adaptable and better distributed. And it is the latter effect of the Alexander Technique – the re-distribution of muscle tone away from surface muscles – that has so far been correlated with a reduction in neck pain.
Concluding remarks
This short blog post is a reminder that both ‘posture’ and ‘pain’ are more complex than most people think: the different processes underlying posture are only just beginning to be explored scientifically, and pain itself is a multidimensional biopsychosocial phenomenon, according to the dominant theory among scientists.
Should we therefore be surprised that the relationship between the two is also complicated?