The Importance of Good Posture
THE IMPORTANCE OF GOOD POSTURE
Head, neck, and back pain are common patient complaints. Often this pain is chronic and difficult to manage. Physicians want to help patients control pain and improve their quality of life. In so doing, the importance of posture should not be neglected. Good posture is important to the well-being of the patient; it affects mood, health, and bodily function. Good posture entails standing and sitting so that the force of gravity is evenly distributed and not putting stress on any one part of the body. Correcting poor posture has been found to promote pain relief for patients. Physical therapists can help patients correct form and free them from chronic pain.
Physicians seeking a resolution for a patient’s headaches may consider the role of physical therapy. In a study of 20 patients with diagnosis of muscle contraction headache, treatment for pain relief was offered in a physical therapy clinic once a week for six visits.1 The previous 3-week period of no treatment served as a control period during which patients recorded by diary their headache frequency, duration, and intensity using a numeric pain scale. Activity level, as measured by the Sickness Impact Profile, and verbal reports of headache frequency, duration, and intensity were recorded at four points during a 1-year period.1 Measurements were recorded at precontrol, pretreatment, post-treatment, and 12-month follow-up. Treatment included education for posture at home and work place, isotonic home exercise, massage, and stretching to the cervical spine muscles. Results indicated frequency of headaches and Sickness Impact Profile scores were significantly improved (P<0.001) over the course of treatment.
These benefits were maintained after 12 months.1Neck pain is another posture-associated complaint patients may present. A study of the literature was conducted to assess differences in center of pressure (COP) measures in patients suffering from non-specific neck pain (NSNP) or whiplash-associated disorder (WAD) compared to healthy controls and any relationship between changes in postural sway and the presence of pain, its intensity, previous pain duration and the perceived level of disability.2 Over the past 20 years, the center of pressure (COP) has been commonly used as an index of postural stability in standing.
There was broad consensus that patients with either type of neck pain have increased COP excursions compared to healthy individuals, a difference that was more pronounced in people with WAD.2 An increased sway in antero-posterior direction was observed in both groups. Patients with neck pain (due to either NSNP or WAD) exhibit greater postural instability than healthy controls, signified by greater COP excursions irrespective of the COP parameter chosen. Further, the decreased postural stability in people with neck pain appears to be associated with the presence of pain and correlates with the extent of proprioceptive impairment, but appears unrelated to pain duration.2
Increased center of pressure excursions are well documented in patients suffering from non-specific low back pain, whereby the altered postural sway includes both higher mean sway velocities and larger sway area.3 An investigation has was conducted to evaluate a relationship between pain intensity and postural sway in adults (aged 50 or less) with non-specific low back pain.3 Seventy-seven patients with non-specific low back pain and a matching number of healthy controls were enrolled. Center of pressure parameters were measured by three static bipedal standing tasks of 90 second duration with eyes closed in narrow stance on a firm surface. The perceived pain intensity was assessed by a numeric rating scale (NRS-11), an equal number of patients (n = 11) was enrolled per pain score.3 Generally, the study’s results confirmed increased postural instability in pain sufferers compared to healthy controls. In addition, regression analysis revealed a significant and linear increase in postural sway with higher pain ratings for all included COP parameters. This relationship may be of clinical use as an objective monitoring tool for patients under treatment or rehabilitation.3
ASSISTANCE OF A GOOD PHYSICAL THERAPIST:
Something as simple as proper posture does not always come naturally. Years of neglect and weak core muscles can take its toll on an individual, ultimately leading to chronic pain and other health problems. Years of compression from excessive sitting eventually take a toll on patients. Participating in a therapy program where proper exercise and core strength building can change all that. A referral to a physical therapist can help the patient overcome faulty posture ultimately leading to a more productive, pleasant and pain-free life.
“Whatever it takes!” We have a motto that we follow in our clinic. We go out of our way to make sure that our patients do and get whatever it takes to get better.
REFERENCES
1. Hammill, J. M., Cook, T. M. and Rosecrance, J. C. (1996), Effectiveness of a Physical Therapy Regimen in the Treatment of Tension-Type Headache. Headache: The Journal of Head and Face Pain, 36: 149–153. doi: 10.1046/j.1526-4610.1996.3603149.x.
2. Ruhe, Alexander, Fejer, Rene and Walker, Bruce. (2011), Altered postural sway in patients suffering from non-specific neck pain and whiplash associated disorder – A systematic review of the literature. Chiropractic & Manual Therapies 2011, 19:13 doi:10.1186/2045-709X-19-13 Published: 24 May 2011.
3. Ruhe, Alexander, Fejer, Rene and Walker, Bruce. (2011), Is there a relationship between pain intensity and postural sway in patients with non-specific low back pain? BMC Musculoskeletal Disorders 2011, 12:162 doi:10.1186/1471-2474-12-162. Published: 15 July 2011.