Too much sitting is an epidemic in the U.S. We sit in front of computers all day at work, sit in traffic for an endless commute home, and then sit in front of the TV or a laptop at home. Maybe this is counteracted with the occasional bout of exercise, but in general, we spend upwards of 12 hours a day seated. All of this sitting is wreaking havoc on our upper backs and necks, causing an increase in back and shoulder pain.

There is a simple reason for the rise in upper back pain and shoulder pain: poor posture.

The structure of the spine is built in such a way that, when correctly aligned, the spine supports the entire body with balance and strength. The spine has four natural curves that exist to balance the body: a sacral curve that tilts the pelvis slightly under, a lumbar curve that arches the low back slightly, a thoracic curve in the mid- and upper back, and a slight curve as the cervical spine rises up to support the skull. When we slouch at our desks all day then come home to lounge on the couch, the correct alignment of the spine is destroyed and it can cause upper back pain.

  • Shoulders round forward: The thoracic spine’s natural curve gets more pronounced, making the chest more concave and rounding the shoulders forward.
  • Head thrusts forward: In response, the head thrusts forward, following the curve.
  • Lumbar spine rounds: The lumbar spine also rounds as these changes occur in the upper back, destroying the natural curve in the opposite direction.

In general, the elegant, gentle curves of the spine are replaced by an unnatural and dramatic C-shaped posture. These changes place tremendous pressure on different parts of the body, from the muscles in the upper back to the joints in the shoulders and pelvis and the vertebrae in the cervical spine. Over time, this poor posture can cause stress fractures, herniated disks, and other serious back conditions that result in chronic upper back pain. On the most basic level, the muscles in the neck, shoulder, and upper back become tight and strained, resulting in chronic upper back pain and shoulder pain. The effects of this are felt in the front of the body, too, as core muscles atrophy and hip flexors in the front of the legs shorten and tighten.

To counteract these changes and help prevent them from causing permanent, painful upper back pain, there are several steps you can take to change the way you use your body.

Stand up

Taking regular breaks at work to stand and walk around is imperative if you want to have a healthy spine. This does not to have to be disruptive to your workflow. Take phone calls standing up. Talk to coworkers instead of sending inter-office email. Conduct walking meetings for fresh air, exercise, and increased productivity. Aim for two hours of increased standing during your work day, gradually increasing to four over time.

Work on better posture

Better posture may be difficult at first as it will feel “unnatural” because your body is used to its poor posture. Keep at it, and eventually it will become easier and feel more natural. Essentially, no matter whether you are sitting, walking, or standing, the aim is to have the top of the hipbone (greater trochanter) and the shoulder bone (humerus) in a straight line when sitting, adding the ankle bone to that straight line when standing. Your head should not be thrust forward but should rest slightly back.


Maintaining good posture after a lifetime of poor posture requires stretching and retraining of the muscles of the body. There are some simple stretches for your upper back and shoulders that can help counteract the effects of poor posture.

  1. Chin tuck: Sitting up straight with eyes level, take a deep breath in and move your chin straight back. The crown of your head will lengthen up, and the action of your chin moving back will create a double chin. This stretches and lengthens the back of the neck and begins to help you train yourself to move your head back. Hold for ten seconds, then release to a more relaxed posture (but try not to return to your head thrust forward).
  2. Brugger’s relief position: This position can be combined with the chin tuck to begin to re-set the curves in the spine. Sit on the edge of a chair with feet hip-width distance apart, flat on the floor, with ankles stacked under the knees. Inhale and arch your back, arms hanging down and palms forward. As you exhale, rotate your hands so that your thumbs are now pointing backwards. This internal rotation of humerus in its socket helps move the shoulder blades down the back for proper thoracic support. Breathe deeply in this position for ten seconds.
  3. Scapular retraction: This posture also helps open the chest and moves the shoulder blades (scapulae) down the back where they belong (instead of up and rounding forward in a slump). Sit at the edge of a chair in the same way as for Brugger’s relief position. Arch your back and concentrate on pulling your shoulder blades together and moving them down towards the seat. If your shoulders allow it, you can stand up, interlace your hands behind your back, and pull/push them down towards the floor to help get the feeling of this action.

These exercises may be difficult to hold for ten seconds at first. Repeat each one of them every hour, and you will feel them getting easier to hold. You may also feel a reduction in upper back pain and shoulder pain as you increase flexibility in the upper back and shoulders and improve posture.

As you read this sentence, how is your posture? What changes can you make to better support your head, neck, upper back, and shoulders?

Image by Maureen Didde via Flickr


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