Everyone wants to avoid back trouble, but only few of us manage to escape it. Up to 80% people experience back pain at some point in their lives, and each year 15% of all adults are treated for problems such as herniated discs, spinal stenosis or lumbar pain.
But back pain is notoriously difficult, and expensive, to remedy.
"The treatments are varied, and we don't have great science showing what works best for particular patients," said Brook I. Martin, an instructor of orthopedic surgery at Dartmouth Medical School. "There are questions about the safety and efficacy of many therapies, including certain surgeries."
Some back problems, of course, can't be avoided. Over time, spinal vertebrae naturally degenerate and spinal facets become inflamed, causing stress and discomfort. "But majority of back pain is the result of muscle and ligament strain or weakness, and can often be prevented by developing core strength and proper posture," said Dr Daniel Mazanec, associate director of the Center for Spine Health at the Cleveland Clinic.
Maintaining good posture not only helps you look better (there's a reason inept people are called slouches), it improves muscle tone, makes breathing easier and is one of the best ways to stave off back and neck pain, not to mention the dreaded dowager's hump of old age.
"Posture is the key," said Mary Ann Wilmarth, chief of physical therapy at Harvard University Health Services. "If your spine is not balanced, you will inevitably have problems in your back, neck, shoulders and even joints."
Sitting a little straighter now? Good. Here's some advice that will help you make it a daily habit and stave off expensive back problems to boot.
The DIY approach
First, try correcting your slouching habits on your own. Stand up and lift your chin slightly; align your ears over your shoulders and your shoulders over your hips. Place your hands on your hips and pitch forward about two inches.
There should be a slight inward curve in your lower back, an outward curve in your upper back, and another inward curve at your neck. Maintain this posture and sit down.
When you are sitting or driving for long periods of time, place a cushion or rolled-up towel between the curve of your lower spine and the back of your seat. Supporting your lower back will maintain the natural curve of your spine; when the back is supported, the shoulders more naturally fall into place, said Dr. Wilmarth.
Maintaining good posture requires abdominal and back strength. "It's not enough to just sit up straight if your core muscles are weak," said Dr Praveen Mummaneni, a spine surgeon at the University of California, San Francisco. Consider taking a Pilates class, which focuses on developing one's core - the muscles and connective tissues that hold the spine in place - or hire a physical therapist to create a personalised exercise plan.
A cubicle cure
If you sit at a desk all day, you can make some adjustments yourself. The centre of your computer screen should be at eye level, and the desk height should allow your forearms to rest comfortably at a 90-degree angle. Work with your feet flat on the floor and your back against the chair.
Whether you work in an office or at home, get up and stretch every 30 to 60 minutes. "Stretching helps break bad patterns and allows your muscles to return to neutral," said Dr Wilmarth.
Stand up and place your hands on your lower back, as if you were sliding them into your back pockets. Gently push your hips forward and slightly arch your back. Sit back down and circle your shoulders backward, with your chin tucked, about 10 times.
Not likely to remember? Set your phone or computer alarm to remind you to stand up and stretch each hour. An iPhone app called Alarmed has a feature that allows you to create regular reminders throughout the day.
An exercise plan
Habits are hard to break. A physiotherapist can show you how to align your spine and provide you with exercises to both strengthen your core and loosen up stiff neck, back, arm and leg muscles (tight hamstrings can contribute to back pain).
A class in poise
If you want a more systematic, long-term approach to posture change, consider the Alexander technique, a method that teaches you how to recognise and release habitual tension that interferes with good posture.
Recent research suggests that it can help with lower back pain as well as posture. A 2011 study published in Human Movement Science concluded that the Alexander technique enhanced postural tone and reduced stiffness in patients with lower back pain.
Still slouching? A study published in The European Journal of Social Psychology found that subjects who were told to sit up straight with good posture rated themselves higher and had more self-confidence on a given task than those who were told to slouch.
Moral: Sitting pretty yields immediate, not just long-term, benefits.
New York Times