Does Poor Posture Really Cause Pain? Let’s Clear This Up
I’ve come across a number of statements from health professionals suggesting that poor posture doesn’t cause back or neck pain. While it’s true that posture alone isn’t always the sole factor, dismissing it entirely misses a key point: tissue overload.
All tissues in the body—whether muscle, ligament, tendon, bone, or joint—have a tipping point, beyond which they begin to fail. When a bone fails, you get a fracture. When a ligament fails, you develop laxity or instability. When a muscle fails, the result is a strain.
Pain is often one of the earliest signs that tissue is approaching or exceeding its capacity. If someone spends long periods in positions that place excessive or sustained load on their tissues—especially muscles—they’ll reach that tipping point much faster. Once that happens, even small movements can feel uncomfortable or painful, reflecting a degree of tissue failure and reduced performance.
In short, posture matters. It may not cause pain directly in every case, but it can absolutely influence the amount of load your tissues experience—and therefore how soon they fail or recover.
Why Changing Posture Is So Hard
Our posture is a deeply rooted habit, built over years of repetition. Correcting it isn’t easy, because long-standing movement patterns are hard to override. Active corrections—the adjustments you make consciously—are far more effective than passive corrections such as posture supports or braces.
The challenge is that active corrections only work when you’re actually thinking about them. When you’re absorbed in work at your desk, posture is the last thing on your mind. This is where passive aids often seem appealing, but they come with limitations.
Personally, I’m not a fan of posture belts as a long-term solution. Many people believe these devices gently “train” the body to correct itself, but once the belt is removed, posture often returns to its previous state. That’s because while wearing the belt, you’re not engaging or strengthening the muscles responsible for maintaining good posture. The underlying weakness remains, so real improvement doesn’t happen.
That said, posture correctors aren’t completely useless. They can provide valuable cues. Most tend to become uncomfortable after a while—digging into the shoulders or restricting movement—prompting you to make active adjustments to relieve the discomfort. The key question, though, is: how long does it take before that discomfort actually drives meaningful change?
Desk Jobs: The Hidden Endurance Test
One of the groups most affected by posture-related pain and dysfunction are desk-based workers. Humans are simply not designed to spend eight or more hours a day in a sedentary position. Despite this, many people assume sitting equals resting—yet physically, it’s far from restful.
There’s also a major gap in understanding when it comes to workplace ergonomics. Many of my patients tell me their employer has arranged an ergonomic assessment, but when they describe the changes, they’re often minimal, outdated, and rarely conducted by someone who truly understands human movement or biomechanics.
What most people don’t realise is that spending hours at a desk is effectively a long, low-intensity endurance exercise. Your muscles, joints, and supportive tissues are constantly loaded as they hold you upright. Just because you aren’t exerting force like someone lifting weights in a gym doesn’t mean your body isn’t under stress—it absolutely is.
The key difference is awareness. The person training in the gym knows they are loading their body and consciously maintains posture and form to reduce strain. The desk worker, on the other hand, is usually engrossed in their work, unaware that their shoulders are rounding, their head is shifting forward, and their tissues are quietly approaching overload.
The Most Overlooked Factor: Seat Height
I often tell my patients that the single most important factor to address at a desk workstation is the angle of the knees relative to the hips—in simple terms, seat height.
The standard desk and chair heights used in most offices are a postural nightmare. They’re designed around a one-size-fits-all model that ignores human variation. A person who’s 6ft 3in is sitting at the same desk height as someone who’s 5ft 3in—and it’s absurd to think a single standard could suit both.
Seat height doesn’t just influence comfort; it affects the spine’s ability to maintain its natural structure. The spine is designed with gentle curves forming a lazy S-shape. These curves are crucial—they allow each section of the spine to handle load efficiently. When those curves are altered, either flattened or exaggerated, the load distribution changes dramatically, increasing strain on supporting tissues.
Remember, the spine is essentially a tower of joints. If the base of that tower—your pelvis and lower spine—collapses or is tilted out of alignment, the entire structure above must compensate. That’s when you start to see neck, shoulder, and mid-back tension develop from what began as an issue at your seat.
Getting the basics right—especially seat height—helps preserve those natural curves and, in turn, reduces the cascade of postural problems that lead to pain and dysfunction.
Essential Adjustments for a Pain-Free Workspace
Here are some crucial changes that must be made to protect yourself from posture-related injury in the workplace—because that’s exactly what it is: injury caused by prolonged poor positioning.
Seat Height
The larger the angle between your hips and knees, the better. That old “90-degree rule” is utter nonsense. Ideally, your hips should sit noticeably higher than your knees, allowing your pelvis to tilt slightly forward and your spine to maintain its natural curves.
You should be sitting on your buttocks, not on your entire thighs. A light perch on the edge of your seat or stool with your feet planted firmly on the floor works best. Adjust the seat as high as comfortable—as close to standing as possible, while still allowing the seat to take your weight.
Desk Height
Your desk height must match your optimised seat position. When your seat is higher, your desk naturally needs to rise to preserve your alignment. Your monitor should be at eye level, not below, preventing the head from tilting forward and increasing neck strain.
Once you’ve achieved a more optimal seat angle, you’ll often find that your desk must sit much higher than the standard setup. This adjustment is absolutely essential for long-term spinal health and muscular endurance.
Movement: Your Most Powerful Reset
Countering the load caused by prolonged sitting is just as important as perfecting your desk setup. Did you know it takes only 20 minutes for your spinal discs to reach their maximum load while sitting? Yet just 30 seconds of standing and gentle movement can reset that load—IF you get up after those 20 minutes.
If you only stand and move once every hour, your spinal discs have already been under three times their optimal load before they get a chance to recover. Sit for several hours without a break, and the cumulative stress on your discs becomes immense, taking far longer to reverse.
This is a big reason why desk-based workers make up such a large portion of people with disc herniations—contrary to the common belief that it’s mainly those with physically demanding jobs. Sedentary work can be just as harmful, only in a more gradual way.
The good news? You don’t even need to leave your desk to reduce this load. Take phone calls standing, stretch while you read emails, or simply reposition your chair for a few seconds. Even better, set up your printer or copier across the room so you have to stand and move throughout the day. Small changes like these introduce regular movement and keep your spine—and tissues—healthier over time.
Take Control of Your Posture and Protect Your Back
Poor posture and prolonged sitting aren’t just minor annoyances—they are significant contributors to tissue overload, injury, and pain. The good news is that simple changes can make a big difference.
Start by adjusting your seat height so your hips sit higher than your knees, preserving your spine’s natural curves. Match your desk height accordingly and keep your monitor at eye level. Remember to move regularly—ideally standing or stretching for 30 seconds every 20 minutes—to reset spinal load and prevent tissue stress.
You don’t need complicated equipment or expensive posture devices. Small habits like standing on phone calls, walking to your printer, or shifting your sitting position actively strengthen the muscles that support your posture.
By becoming aware of these factors and incorporating these practical strategies, you’ll safeguard your spine, reduce pain, and improve your long-term health—even in a sedentary job.
Start today—you and your body will thank you for it.
For one or two office chair recommendations, check out my blog post “there’s no good way to sit“
