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Posture and Chronic Pain: How Physical Therapy Holds the Key To Relief

August 11th, 2023 | 7 min. read

Posture and Chronic Pain: How Physical Therapy Holds the Key To Relief
Caroline Durbin

Caroline Durbin

Licensed Physical Therapist, PT, DPT // Dry Needling Certified // LSVT Big Certified // EW Motion Therapy Trussville

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In today's fast-paced world, where many spend hours hunched over screens and smartphones, maintaining proper posture and other body mechanics often takes a back seat. Unbeknownst to many, poor posture can lead to various health issues, with chronic pain being one of the most debilitating consequences. However, the good news is that these two seemingly unrelated factors are intimately connected, and physical therapy can provide a path to improved body mechanics, better posture, and chronic pain relief. We always do postural assessments on our patients at EW Motion Therapy, as good posture is vital for healthy movement. Even if you decide not to do physical therapy with us, you can still read on as we discuss how posture and chronic pain are related, other body mechanics that can worsen chronic pain, and how physical therapy can help. 


Download our Physical Therapy Q&A Here!


The posture-chronic pain connection

Posture, the alignment of your body's parts, is vital in maintaining overall health and well-being. When posture deviates from its natural alignment for an increased amount of time, it can put undue stress on various muscles, ligaments, and joints. Over time, this stress can lead to muscle imbalances, joint dysfunction, and chronic pain. Here's how bad posture can worsen chronic pain:


  1. Muscle imbalances: Poor posture often involves staying in the same position for a long time, which allows certain muscle groups to become tight while others become weakened and lengthened. For example, slouching can lead to tight chest muscles and weak upper back muscles. These imbalances create an uneven distribution of forces on the body, leading to discomfort and pain.
  2. Increased load on joints: Incorrect posture for increased amounts of time can place added pressure on joints not designed to bear such loads. For instance, poor posture can increase stress on the spine’s intervertebral discs, leading to herniated discs or degenerative disc disease.
  3. Nerve compression: Poor posture can compress nerves over time, leading to conditions like sciatica. When nerves are compressed or pinched due to improper alignment, it can radiate pain, numbness, and tingling.
  4. Altered movement patterns: Bad posture can affect how you move. Your body may compensate by adopting unnatural movement patterns, which can strain muscles and joints. Over time, this can lead to chronic pain conditions like tendinitis or bursitis.
  5. Reduced blood flow and oxygen supply: Improper posture can impede blood flow and reduce oxygen supply to muscles and tissues. This can result in muscle fatigue, pain, and reduced healing capacity.
  6. Impact on breathing: Posture affects how you breathe. Slouching can restrict the expansion of the lungs and diaphragm, leading to shallow breathing. Reduced oxygen intake can contribute to muscle tension and pain.
  7. Spinal misalignment: Poor posture can lead to spinal misalignment, such as kyphosis (rounded upper back) or lordosis (exaggerated lower back curve). These misalignments can strain muscles, ligaments, and joints, contributing to chronic pain.
  8. Head and neck strain: Forward head posture, common in people who spend long hours looking at screens, can strain the neck and upper back muscles. This can lead to tension headaches, neck pain, and even migraines.
  9. Digestive issues: Slouched posture can compress the abdominal cavity, affecting digestion and leading to discomfort or pain after eating.
  10. Psychological impact: Chronic pain caused by bad posture can lead to psychological stress, anxiety, and depression. Conversely, psychological stress can contribute to poor posture, creating a vicious cycle.


It's important to note that chronic pain conditions and posture can create a feedback loop, each exacerbating the other. Addressing posture through physical therapy, ergonomic adjustments, and mindful awareness can help break this cycle and alleviate chronic pain. It's essential to prioritize movement as part of a holistic approach to maintaining healthy posture and overall well-being. 


What else can worsen chronic pain? 

Other body mechanics and habits can impact chronic pain as much as your posture. Let’s review three other key areas to be aware of in your daily routine.


Sleeping position 

How you sleep can influence the alignment of your spine, the pressure on joints and muscles, and overall comfort during sleep. Poor sleeping positions, such as sleeping on your stomach, can exacerbate chronic pain or contribute to developing new ones due to spinal misalignment. Make sure you have the best mattress and pillow for your body type, and putting a pillow between your knees while on your side can help maintain a neutral spine. Remember that individual preferences and conditions vary, so listening to your body and adjusting is essential. By prioritizing proper sleep posture and making conscious choices about your sleeping position, you can significantly contribute to managing and alleviating chronic pain.



Footwear affects chronic pain, especially in the lower body and spine. The shoes you choose can impact your posture, alignment, and how you walk, which in turn can contribute to or alleviate chronic pain conditions. Ill-fitting or unsupportive shoes can lead to poor posture, as they may cause you to stand or walk in ways that strain your muscles and joints. High heels, for example, can tilt the pelvis forward, increase pressure on the lower back, and contribute to chronic back pain. Conversely, flat shoes with inadequate arch support can lead to collapsed arches, contributing to discomfort in the feet, knees, and hips. Thick soles are also essential - inadequate shock absorption from shoes with thin soles can increase joint impact and contribute to conditions like plantar fasciitis, knee pain, and hip pain.


Look for shoes with proper arch support, cushioning, and shock absorption, especially if you are a runner. Orthotic inserts can also help provide additional support if needed. Ensure your shoes fit properly and have enough room for your toes to move comfortably. Avoid shoes that are too tight or narrow. Choose shoes with moderate heel height to minimize strain on the lower back and calves. Opt for lower, chunkier heels rather than high stilettos if you prefer heels. Consider consulting a podiatrist or orthopedic specialist for personalized footwear recommendations if you have specific foot issues or chronic pain conditions. By selecting shoes that provide proper support, cushioning, and alignment, you can significantly contribute to alleviating or preventing chronic pain in various parts of your body. 



Your diet can significantly impact chronic pain, as certain foods and nutrients can either exacerbate or alleviate inflammation, influence nerve function, and affect overall health. Processed foods, sugary snacks, and foods high in trans fats and refined carbohydrates can contribute to inflammation. These foods can activate inflammatory pathways and lead to pain, especially in chronic conditions such as arthritis and fibromyalgia. Inadequate intake of certain nutrients, such as vitamin D, magnesium, and B vitamins, can contribute to muscle pain, nerve issues, and overall discomfort. Additionally, dehydration can lead to muscle cramps, headaches, and overall discomfort. 


It is essential for everyone to maintain a balanced diet of whole grains, fruits, and vegetables, especially those with chronic pain. Antioxidants, omega-3 fatty acids, fiber, prebiotics, and probiotics are essential to reduce inflammation and promote healthy gut function. A balanced diet can also help you achieve and maintain a healthy weight, reducing stress on joints and muscles and helping with blood sugar regulation. By making informed dietary choices, you can actively manage and alleviate chronic pain while promoting overall well-being.


The role of physical therapy

Physical therapy, a science-based practice focusing on movement and function, has emerged as a cornerstone in addressing posture-related issues and chronic pain. To create a personalized treatment plan, a skilled physical therapist assesses the individual’s posture, movement patterns, and pain levels. Here's how physical therapy can significantly improve posture, body mechanics, and chronic pain:


  1. Postural education: Physical therapists educate patients about the importance of proper posture and its impact on pain. They guide how to maintain optimal alignment during daily activities, whether sitting at a desk, lifting objects, or exercising.
  2. Muscle strengthening and flexibility: Physical therapy exercises target specific muscle groups that support good posture. Strengthening weak muscles and stretching tight ones helps restore balance, alleviate strain, and promote better alignment.
  3. Pain management techniques: Physical therapists employ pain management techniques such as manual therapy, joint mobilization, and soft tissue manipulation to reduce pain and improve mobility. These techniques directly address the root causes of chronic pain.
  4. Ergonomic advice: Physical therapists can recommend ergonomic modifications to workstations and daily activities. These adjustments minimize the risk of poor posture and its associated pain.
  5. Functional movement training: Physical therapists help patients relearn proper movement patterns and body mechanics through functional movement training. This empowers individuals to move more efficiently and safely, reducing the likelihood of future pain.
  6. Holistic approach: Physical therapy takes a holistic approach, considering the interconnectedness of the body's systems. This approach can uncover underlying factors contributing to poor posture and chronic pain, leading to more comprehensive and lasting solutions.


The interplay between posture and chronic pain is undeniable, with poor posture often precursing ongoing discomfort and health issues. However, the cycle can be broken through the guidance of physical therapy. By addressing the root causes of poor posture and providing targeted interventions, physical therapists empower individuals to improve their alignment, alleviate pain, and regain their quality of life. We strive to empower our patients in this way at EW Motion Therapy - our physical therapists want to be the biggest cheerleaders in your journey toward improved health and wellness. If you are curious about what else physical therapy can do for you, click the button below to download our answers to 20 frequently asked questions. 


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