Quick answer: Poor posture usually builds up from daily habits, such as long hours at a desk or looking down at a phone. Extra weight, high heels and age related changes in the spine can add to it, and some rounded backs have a medical cause, such as osteoporosis or Scheuermann’s disease. Posture can add to neck and back aches, but the link is weaker than many people think, so aim to change position often rather than hold one “perfect” posture.
What causes poor posture?
For most people, posture is shaped by the positions they spend the most time in:
- long hours sitting at a desk, often leaning towards the screen
- looking down at a phone or tablet
- a screen that is too low or a chair that doesn’t support your back
- carrying extra weight, or wearing high heels for long periods
- normal age related changes in the spine
Some changes in posture have a medical cause. A rounded upper back can come from osteoporosis, where weakened spinal bones compress, or from Scheuermann’s disease, where the bones of the spine grow into a wedge shape during adolescence. The curve in the lower back also tends to increase during pregnancy, in people over 50, and during growth spurts.
Your spine’s natural curves
A healthy spine isn’t straight. Seen from the side, it has three natural curves that make an S shape: your neck and lower back curve inwards (lordosis) and your upper back curves outwards (kyphosis). “Poor posture” usually means one of these curves has become more or less pronounced than usual for you.
Common posture patterns
Forward head posture
The head sits in front of the shoulders, often with rounded shoulders. It is common in people who spend long hours at screens. On average, adults with neck pain hold their head further forward than adults without it, although that doesn’t prove the posture caused the pain.
Rounded upper back (kyphosis)
A rounded upper back can come from slouching, which causes a mild, flexible curve that most often affects teenagers. A firmer curve can come from Scheuermann’s disease, arthritis or osteoporosis. If the upper back looks like a hump, read our guide to neck humps.
Increased lower back curve (lordosis)
The lower back arches more than usual, so the bottom sticks out. It is more common in pregnancy, in people over 50 and in teenagers going through growth spurts.
Does poor posture cause neck and back pain?
It can play a part, but it is rarely the whole story. Sitting for long spells can leave your neck or back stiff and sore, and long hours at a desk are a common trigger for neck pain. However, research has not found strong evidence that sitting, standing or bending “incorrectly” causes back pain. Back and neck pain often has more than one cause.
The most useful habit is to avoid staying in any one position for too long. Your body likes movement and variety.
How to improve your posture
Change position often
If you sit for work, get up, stretch or walk around regularly, and change your sitting position often. Moving regularly matters more than holding one perfect position.
Set up your desk
- Put the top of your screen at or slightly below eye level, so you aren’t looking down.
- Sit with your back supported and your feet flat on the floor or on a footrest.
- Keep your keyboard and mouse close, so your shoulders can relax.
- Hold your phone higher rather than bending your neck down for long periods.
Simple exercises
- Chin tucks: sitting tall, draw your chin straight back, keeping your eyes level, as if making a double chin. Hold for a few seconds and repeat 10 times.
- Shoulder blade squeezes: gently squeeze your shoulder blades back and down, hold for a few seconds and repeat 10 times.
- Doorway chest stretch: place your forearms on either side of a doorway and step forward until you feel a gentle stretch across your chest. Hold for 20 to 30 seconds.
- Upper back strength: exercises such as rows with a resistance band help you sit and stand taller.
These help with stiffness and with sitting and standing taller. If a rounded back comes from the shape of the bones, as in Scheuermann’s disease or after a spinal fracture, exercise can ease symptoms but won’t change the curve much. Stop any exercise that causes pain, pins and needles or numbness.
When to see a doctor or physiotherapist
Go to A&E or call 999 if you have a stiff neck with a high temperature, a severe headache, eye pain in bright light or a rash that doesn’t fade when you press a glass on it, as these can be signs of meningitis.
Go to A&E or call 999 if you have back pain with any of these:
- pain, tingling, weakness or numbness in both legs
- loss of feeling around your genitals or bottom
- new problems controlling your bladder or bowels
- chest pain
- pain that started after a serious accident, such as a car accident or a bad fall
See a doctor if you have lost weight without trying, the pain is worse at night, you have pins and needles, numbness or weakness in your arms or legs, you notice a change in the shape of your back, or a curve is getting worse. Any curve in a child’s spine should be checked.
See a doctor or physiotherapist if your pain isn’t improving after a few weeks.
Frequently asked questions
Can poor posture cause neck pain?
It can play a part. Long spells at a desk are a common trigger, and adults with neck pain tend to hold their head further forward. But the link is not straightforward, and in studies of teenagers no clear link has been found.
Does slouching cause back pain?
There is no strong evidence that sitting, standing or bending “incorrectly” causes back pain, or that one posture prevents it. Changing position often and staying active are good habits.
Can poor posture be improved?
Often, yes. Strengthening your upper back and stretching your chest can help you sit and stand taller. If the rounding comes from the shape of the bones, posture work won’t change the curve much, but it can still ease stiffness.
Can bad posture cause numbness or tingling?
Pins and needles aren’t a usual posture ache, so see a doctor. Numbness in both legs, or around your genitals or bottom, is an emergency.
Related reading: neck pain in the office and how your hips can cause lower back pain.
Sources
- NHS: Neck pain
- NHS: Back pain
- NHS: Kyphosis
- Cleveland Clinic: Lordosis
- MedlinePlus: Guide to good posture
- Slater et al. 2019, JOSPT: “Sit up straight”, time to re-evaluate
- NHS: Meningitis
- Mahmoud et al. 2019: forward head posture and neck pain, a systematic review
Need help with this? Our posture and neck pain physiotherapy team at Total Health by Hong Kong Sports Clinic can assess you and start treatment in your first session, in Central, Kai Tak or Tin Hau. Message us on WhatsApp to book.
