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8 best exercises for posture-related back and thoracic spine pain relief

8 Exercises to Relieve Posture-Related Back Pain

In this article you will learn how to identify mid-back and thoracic spine pain caused by poor posture, as well as which 8 exercises can best relieve this posture-related pain.

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We all experience “bad or poor” posture-related pain at different times throughout our life. Our bodies are built to be in a balanced, neutral position. Unfortunately, some of the jobs that humans have created require us to stay in sub-optimal positions for several hours throughout the day resulting in the onset of back pain and neck pain. Some of these positions create a lot of increased stress on our bodies resulting in pain, stiffness, tightness, and even sometimes nerve damage.

I’ll be the first to admit that it’s hard to always maintain a “good” posture as I too suffer randomly from posture-related pain. Ultimately, though, it is possible to significantly reduce or eliminate these negative side effects with the proper back pain posture exercises. However, we must first understand the basics behind posture and body mechanics. Once we understand that, we need to improve the awareness of our own posture throughout the day. Then, we can perform the following back pain posture exercises that I’ve included in this article, which will strengthen the postural muscles and reduce the frequency of these episodes of neck and back pain.

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What is “Good” Posture?

Good or optimal posture occurs when the joints in our body are anatomically aligned. If you took a plumb line and hung it from the bone just behind the ear, it should fall and bisect the edge of the shoulder, then the hip joint, then falling just behind the knee, and finally ending up slightly in front of the ankle.

When our bodies are aligned perfectly like this our bone structure is neutrally balanced as gravity is pulling straight down on us.

physical therapy posture correction exercises can help relieve back pain

Unfortunately, this optimally aligned position is somewhat rare to see in the real world, especially in older individuals. The aging process takes its toll on our bodies and our muscle and bone structures change over time. This can lead to the onset of back and neck pain.

What is “Bad” Posture?

Bad or poor posture is any position that places excessive stress on the tissues of the body either repetitively or over an extended duration of time that leads to tissue damage or irritation.

Let’s look at an example of a gentleman working at a desk. I’ll call him Greg.

Bad Posture while sitting at a desk can lead to back and neck pain

You can see that Greg is sitting with a significant forward lean, rounded shoulders, and forward head. By leaning forward, gravity is constantly trying to pull his body downwards. The only way for his skeleton to stay erect is for all of the muscles on his backside to work constantly while he is in this position. Otherwise, his body would just collapse to the floor.

The problem is that these muscle groups are mostly not built to stay turned on for several hours. In addition, imagine if Greg came to the office and stayed in this position for 5 days a week, 4 weeks a month, and 50 weeks per year (2 weeks vacation)?

Can you imagine that this might create a problem for Greg? 

  • His muscles will begin to burn out from fatigue, tighten up, and start to refer pain outwards.
  • He’ll have tension-type headaches that creep up the muscles on the back of his head and around the front to his forehead.
  • He may even start to have numbness and tingling in his hands because his forearms and wrists are hanging off the edge of the desk creating compression on the Median nerve resulting in Carpal Tunnel Syndrome.

What is an Ergonomically Ideal Sitting Position at a Desk?

First, let me test you real quick. If you saw Greg sitting at his desk as he is in the following picture, would you say that his position is ergonomically ideal?

Improved sitting position, but his computer is still too low and will cause neck pain

If you answered no, you would be correct.

Greg’s position this time is much improved from his last position, however, he is using a laptop computer that is still sitting far too low. As you can see, this requires him to tilt his head down to see the screen, which will cause increased tension in the back of the neck. This would eventually lead to neck pain and tension headaches.

A simple fix for this issue would be for Greg to purchase a laptop stand and a wireless keyboard.

Laptop Stand
9.8
  • PROMOTES HEAT DISSIPATION
  • COMPATIBLE WITH ALL LAPTOPS 10-16 INCHES
  • ERGONOMIC RISER
  • STURDY & PROTECTIVE DESIGN
  • DETACHABLE PIECES FOR TRAVEL

A laptop stand raises the screen up, which allows the natural eye gaze to look slightly down rather than having to tilt the entire head downwards.

I highly recommend the Nulaxy Laptop Stand for its sleek and supportive design. This stand will give the perfect amount of elevation, so you won’t have to look down resulting in neck pain.

So, if Greg’s sitting position isn’t perfect? What would perfect look like?

optimal ergonomics can prevent onset of back and neck pain

As you can see above, Greg’s sitting position is about as good as he can get it. The muscles in the back of his neck and back are mostly resting in relaxed positions. His arms are offloaded and resting on the table and his wrists are in neutral. He changed out his computer screen for a larger one, so he didn’t have to look down anymore.

In this position, he will be able to work for several hours without having any back or neck pain. He’s got it figured out finally! 🙂

Workstation Ergonomics Checklist

  1. Seat Height, Feet on Floor

    • Adjust the height of the chair so your feet can rest flat on the floor without excessive pressure caused under your thighs against the edge of the seat.
  2. Seat Length

    • Ideally, the length of the seat would allow 2-4 finger width distance from the edge of the seat to the back of your calf muscles.
  3. Adjust Backrest Height/Tilt

    • Adjust the height of the backrest, so that the lumbar (low back) support area helps you sit up tall.
    • Tilt the backrest support until you’re leaning back about 5° so that your shoulders are just slightly behind the hips. If your chair does not have a lumbar support built-in, you can purchase a portable one.
    • I recommend this Original McKenzie Lumbar Roll by OPTP to my patients.
    Lumbar Roll Support
    9.4
    • ORIGINAL MCKENZIE LUMBAR ROLL
    • PROMOTES BACK PAIN RELIEF
    • IMPROVE ERGONOMIC SITTING POSITION
    • SUPERIOR CONSTRUCTION
    • GREAT FOR OFFICES, VEHICLES, & PLANES
  4. Move-in Close

    • While sitting supported by the backrest, scoot the chair in close to the desk.
    • Bring the keyboard and mouse in close to you.
  5. Arms Resting at Your Sides

    • Adjust the armrest height to allow the forearms to rest gently on them or allow them to lie flat on the desktop if there is ample desk space.
    • If you’re holding your arms up unsupported, your shoulder/neck muscles will constantly be turned on.
  6. Keyboard and Mouse

    • Adjust any keyboard tray or adjustable desk height to have the keyboard and mouse at elbow height level. This will allow the wrists to lie comfortably in a neutral position.
    • If the keyboard and mouse are on the desktop, you may need to raise the chair height up to allow the wrists and forearms to rest level on the desktop. It may be necessary to place a footrest under the feet to provide proper foot flat support.
  7. Monitor(s) Height

    • Adjust screen height so that it is level or just slightly lower than your eye level.
    • Position the monitor(s) so you will not have to rotate your neck in order to see each of them.
    • The recommended monitor distance is 18-24″ away from your body (arm’s length). If you find yourself leaning in towards the screen, you are too far away from it.
  8. Other Materials

    • Position all materials or other devices that you may use frequently (phone, tablet, etc.) within your general work area to prevent having to rotate your neck or body repetitively.

Simple 10-Step Guide to Improve Workstation Ergonomics

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How Does Using “Good” Posture Stop Me From Having Pain?

Let’s take a quick look at the picture below.

back pain posture exercises

Imagine that a bowling ball is balancing on the top of a stick. In this metaphor, the bowling ball represents our head (about the same weight of 10 lbs) and the stick represents our body. Gravity is a constant force and is always pulling downwards.

When we use good posture and maintain optimal alignment, gravity has almost a neutral effect on us. However, the moment that we lean forward, all of the muscles in our back and neck instantly turn on to prevent gravity from collapsing our body forwards.

Now, multiply that times the number of hours and days that we spend in this forward lean position. Our postural muscles will become exhausted at some point…it’s bound to happen.

So, by doing our best to improve our awareness of using good posture and ergonomics throughout the day, we can reduce the overall stress that is placed on the postural muscles. This will prevent posture-related back pain from occurring.

What Does Posture-Related Pain Feel Like?

Posture-related pain involves the muscles in our back and neck. As these muscles succumb to the chronic stress and work that is placed upon them when sitting or standing in a sustained position, they eventually begin to fatigue.

As they fatigue, they tighten up. Typically, this is around the time when you may begin to feel a burning sensation in the muscles. Eventually, the muscles start to refer pain outwards including the surrounding muscles.

It is very common to feel the muscles in-between the shoulder blades begin to refer burning-type pain down the backs of both arms. The muscle tightness and burning will worsen throughout the day. The pain will decrease when you’re resting while lying down or leaning back as this allows the over-worked muscles to relax.

Scapular Trigger Point Locations From Posture Pain
Trigger Point Locations

Best Neck Stretches

In addition to the back pain posture exercises below which will also help reduce neck pain, you should start by intervening in the actual cause of the neck pain (i.e. elevate your computer screen using a laptop stand as mentioned before). Then, follow that up with some gentle neck stretching. I’ve already covered some great neck stretches in a previous post titled “Best Neck Stretches for Pain Relief,” so you can head over a check that article out too!

Best Low Back Stretches

First, be sure to do the back pain posture exercises below that will help to improve the strength and endurance of your back and postural muscles. Then, check out my “Five Key Low Back Stretches” article for further reading into my favorite 5 stretches to relieve low back pain.

Should I Use a Posture-Correcting Brace?

I am NOT a fan of using a posture-correcting brace in most cases. These braces are marketed as devices that can help reduce posture-related back and neck pain by forcing you into a better posture position.

However, I find that in most cases, people simply start to rely on the brace to do all of the work. They don’t address their workstation ergonomics nor their postural awareness.

Unless you want to go through the rest of your life wearing one of these braces, I would recommend that you start with my back pain posture exercises, which can give you and your body the tools to live pain-free without requiring any external supports. Strengthen your postural muscles to improve your posture

The 8 BEST Exercises to Relieve Posture-Related Back Pain!

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Includes Additional Exercises for Comprehensive Rehab Program

Custom-Designed by Dr. Tim, PT, DPT, OCS

Shoulder Blade Squeeze

  • Start by sitting in an upright position with both hands resting on your thighs.
  • Without moving your hands, squeeze your shoulders and shoulder blades in a down and back direction. Pretend that you are trying to squeeze and hold a pencil lying between both of your shoulder blades.
  • Make sure that you are NOT shrugging your shoulders!
  • Perform: 10 sec holds x 10 reps (3-4x/day)

Foam Rolling

  • Use this: OPTP Pro Foam Roll
  • Lie on a foam roller (horizontal) under the upper back.
  • Lift your hips up off of the floor.
  • Roll up and down slowly on the foam roller from the tops of your shoulder blades down to your mid-back area.
  • Perform: 3-5 mins (1x/day)

Side-lying Open Book

  • Perform: 10 sec holds x 10 reps (2x/day)

Prone Chest Lift

  • Lie face down, lift your chest up off of the floor while simultaneously squeezing your shoulder blades down and back (similar to the seated scapular squeeze exercise).
  • Pro Tip: Roll and hand towel up and place it under your forehead while lying on your belly. This will allow you to breathe easier. Also, keep your neck straight in line with your upper back to protect it (as seen in the picture).
  • Perform: 3 sets x 10 reps (1x/day)

Dual Shoulder External Rotation

  • Use this: Theraband Flat Resistance Band
  • Keep both elbows tucked into your sides while simultaneously pulling the band apart equally.
  • Squeeze both shoulder blades together as you pull the band apart.
  • Perform: 3 sets x 10 reps (1x/day)

Dual Shoulder Horizontal Abduction

  • Use this: Theraband Flat Resistance Band
  • Keep the band at chest height or just slightly lower.
  • Squeeze the shoulder blades together as you pull the band apart.
  • Perform: 3 sets x 10 reps (1x/day)

Soft Tissue Massage/Mobilization

  • Use a tool such as a Tennis Ball, Acumobility Massage Balls, or RAD Trigger Point Release Ball.
  • Lie on your back, cross both arms across your chest to “give yourself a BIG bear hug.”
  • Place the chosen tool in between the shoulder blade and the spine where the muscles are tight and tender to the touch.
  • Gently rock slowly from side to side to allow the tool to relax and massage the tight muscles.
  • Perform: 3-5 mins (1x/day)

Pectoralis Stretch

  • Perform while standing in an open doorway or while standing facing the corner in a room.
  • Raise your arms in a “goal post” position.
  • Gently lean forward until a moderate stretch is felt across the front of the chest and shoulders.
  • Perform: 3 reps x 30 seconds (2x/day)

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