As already discussed, for correction of poor posture it is important to determine where improvement is needed, such as when sitting in an office chair. Next, patients must work on changing daily habits to correct those areas. This effort will improve back support and over time help decrease back pain. It will take some effort and perseverance, and will seem a little unnatural at first. It is typical to feel uncomfortable, and even feel a little taller, but over time the new posture will seem natural and more comfortable.

Following are some guidelines of how to achieve good posture and ergonomics in the workplace and other situations.

Sitting Posture for Office Chairs

  • Be sure the back is aligned against the back of the office chair. Avoid slouching or leaning forward, especially when tired from sitting in the office chair for long periods

  • For long term sitting, such as in an office chair, be sure the chair is ergonomically designed to properly support the back and that it is a custom fit
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  • When sitting on an office chair at a desk, arms should be flexed at a 75 to 90 degree angle at the elbows. If this is not the case, the office chair should be adjusted accordingly
  • Knees should be even with the hips, or slightly higher when sitting in the office chair
  • Keep both feet flat on the floor. If there's a problem with feet reaching the floor comfortably, a footrest can be used along with the office chair
  • Sit in the office chair with shoulders straight
  • Don't sit in one place for too long, even in ergonomic office chairs that have good back support. Get up and walk around and stretch as needed

Standing Posture

  • Stand with weight mostly on the balls of the feet, not with weight on the heels
  • Keep feet slightly apart, about shoulder-width
  • Let arms hang naturally down the sides of the body
  • Avoid locking the knees
  • Tuck the chin in a little to keep the head level
  • Be sure the head is square on top of the spine, not pushed out forward
  • Stand straight and tall, with shoulders upright
  • If standing for a long period of time, shift weight from one foot to the other, or rock from heels to toes.
  • Stand against a wall with shoulders and bottom touching wall. In this position, the back of the head should also touch the wall - if it does not, the head is carried to far forward (anterior head carriage).

Walking Posture

Driving Posture

  • Sit with the back firmly against the seat for proper back support
  • The seat should be a proper distance from the pedals and steering wheel to avoid leaning forward or reaching
  • The headrest should support the middle of the head to keep it upright. Tilt the headrest forward if possible to make sure that the head-to-headrest distance is not more than four inches.

Posture and Ergonomics While Lifting and Carrying

  • Always bend at the knees, not the waist
  • Use the large leg and stomach muscles for lifting, not the lower back
  • If necessary, get a supportive belt to help maintain good posture while lifting
  • When carrying what a heavy or large object, keep it close to the chest
  • If carrying something with one arm, switch arms frequently
  • When carrying a backpack or purse, keep it as light as possible, and balance the weight on both sides as much as possible, or alternate from side to side
  • When carrying a backpack, avoid leaning forward or rounding the shoulders. If the weight feels like too much, consider using a rolling backpack with wheels.

Sleeping Posture with Mattresses and Pillows

  • A relatively firm mattress is generally best for proper back support, although individual preference is very important
  • Sleeping on the side or back is usually more comfortable for the back than sleeping on the stomach
  • Use a pillow to provide proper support and alignment for the head and shoulders
  • Consider putting a rolled-up towel under the neck and a pillow under the knees to better support the spine
  • If sleeping on the side, a relatively flat pillow placed between the legs will help keep the spine aligned and straight.

    See Pillow Support and Comfort and Choosing the Best Mattress for Lower Back Pain

It is important to note that an overall cause of bad posture is tense muscles, which will pull the body out of alignment. There are a number of specific exercises that will help stretch and relax the major back muscles. Some people find that meditation or other forms of mental relaxation are effective in helping relax the back muscles. And many people find treatments and activities such as massage therapy, yoga, tai chi or other regular exercise routines, or treatments such as chiropractic or osteopathic manipulation, etc. to be helpful with both muscle relaxation and posture awareness and improvement.

Dr. John Schubbe is a chiropractor with more than 31 years of experience treating and managing spine pain. He practices at Schubbe-Resch Chiropractic & Physical Therapy Centers in Appleton, WI.

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