Does bad posture cause back pain?

by Simon Cabot, physio for Better Physio Group

After working in physio for nearly 30 years, I’ve heard this all the time. 

“My bad posture is causing my back pain.” 

“I’ve got the worst posture; it’s why my back hurts.” 

Honestly, I hear some version of this at least once a day in clinic. 

For 20 years of my career, I worked as a corporate physio, working with people at organisations like Google, Morgan Stanley, Schroders, and Microsoft. 

If posture really was the problem, I would have solved it decades ago. 

Here’s the good news, backed by both science and clinical experience: 

It’s not the posture you’re in; it’s how long you stay there.  

The longer you spend in  any  posture, the higher the risk of developing pain, particularly in the neck and back. 

 That’s why the most useful question isn’t: 

“Is this good or bad posture?” 

but rather: 

“How long have I been in this position?” 

One of my favourite phrases (because it works) is this: 

“The best posture is your next posture” 

Here are some examples of times when posture could be the culprit, and when it wasn’t. 

Case Study 1: The “Worst Posture” That Didn’t Hurt 

When I worked in-house at Google, my clinic door opened onto a sea of desks. 

One man in his 30s always caught my eye. 

Every time I opened the door, every 30 minutes, he was in a different position. 

Slouched. Slumped. Hunched. Leaning. Twisting. Knees up. Sideways. 

By conventional standards, his posture wasn’t just bad, it was “terrible”! 

Out of curiosity, I asked him: 

“Do you ever get neck or back pain?” 

He sat bolt upright (a bit sheepishly) and said: 

“No… I probably should. I’ve got the worst posture.” 

In reality, what he was doing was exactly right. 

He was constantly moving. Changing position. And as a result, he never needed to see me. 

Case Study 2: When “Perfect Posture” Causes Pain 

One patient, a woman in her early 30s, had been a ballet dancer since the age of three.
She had been trained, by instructors and parents, to always sit up straight. 

Even into adulthood, her posture was impeccable. 

Bolt upright. Elegant. Effortful. 

She had also been suffering with back pain for nearly 20 years. 

Despite strengthening exercises and multiple treatments, pain continued unabated, nothing changed, especially not her posture, it stayed “perfect”. 

When I first asked her to slouch, she looked shocked. 
“It feels weird. I don’t know what to do.” 

Her nervous system simply wasn’t used to anything other than rigid uprightness. 

Over several weeks, we worked on letting go of that proud posture, and on simply moving between different postures, to soften, slouch, shift, and explore different positions. 

Within about six weeks, her pain significantly improved. 

Her issue wasn’t posture… it was static posture! 

Here’s the simplest and most effective rule I’ve seen in nearly 30 years of practice:  

Every 30 minutes, move for 30 seconds. 

In a fast-paced, busy environment, time is limited. But most people can spare 30 seconds every 30 minutes. 

I worked with one client that was working a 100-hour week, and this was no exaggeration, he was one of the rare people that I could say really did not have time to exercise. But he committed to 30 seconds of movement, every 30 minutes. And guess what? He felt significantly better with this simple hack. 

And it doesn’t even matter what you do! 

• Stand up 

• Walk to the bathroom 

• Make a cup of tea 

• Stretch 

• Lean back if you’ve been hunched 

• Go talk to a colleague instead of sending a Slack 

It’s not the exercise, it’s the frequency. 

I’ve seen people fail with “perfect” exercise programs because they only did them once a day. 

And I’ve seen others succeed doing the “wrong” exercises, simply because they moved every 30 minutes. 

This even links usefully to the Pomodoro Method for focussed work (25 minutes of work, 5-minute break). 

Movement reactivates the motor cortex, which plays a key role in: 

• Problem-solving 

• Creativity 

• Focus 

• Mental clarity 

When you move, you don’t just help your body, you help your thinking. 

 Many teams I’ve worked with notice less pain and better productivity simply by moving together every 30 minutes. 

There are times when upright and considered posture is useful: 

1. Presenting or pitching  

Posture breeds confidence 

2. Meeting people  

A considered posture signals engagement and presence  

3. Mood  

A more upright posture can help us feel energised and positive, whereas a slouched posture can lead to us feeling down or depressed. 

But, for the rest of your day? 

Movement, frequently, beats perfection. 

Static, maintained posture is the enemy, not slouching. 

You don’t need special equipment.
You don’t need a perfect chair.
You don’t need a complicated program. 

Just move. “30 every 30” 

Give it a try, it’s simple, free, and you’ve got nothing to lose.
And for many people I’ve worked with, it’s been genuinely life changing. 

Book a session or a free video call with Simon Cabot to see how you can solve your posture related back pain problems