Introduction
For decades, the idea that there is a single “correct posture” has been widely promoted as an essential strategy for preventing musculoskeletal pain, especially in the cervical and lumbar spine. However, the latest scientific research has challenged this simplistic view. Current evidence suggests that the relationship between posture, pain, and sitting time is complex and multifactorial, and that the real problem may not be how we sit, but how long we remain in the same position.
This article aims to summarize, in a clear and evidence-based manner, what we currently know about posture in the context of sedentary work and to present practical implications for musculoskeletal health.
“Correct posture” vs. pain: what the studies say
Contrary to what has long been believed, there is no direct and consistent association between maintaining a posture considered “correct” and the prevention of pain. (1)
Even in studies that touted the benefits of “correct posture,” there were people with severely “abnormal” postures who did not complain of pain, while people with upright posture experienced severe pain. One explanation proposed by the authors themselves is that individuals without pain changed position more frequently throughout the day. Those with severe pain, on the other hand, seemed to have greater stiffness, less variability of movement, and difficulty in changing posture. (2)
These findings raise a fundamental question: is pain a consequence of the posture adopted or of maintaining it for a prolonged period of time? Current evidence suggests that the critical factor is not being in flexion or extension, but rather remaining in the same position for too long, regardless of how “correct” it may seem. (3)
Movement, variation, and breaks: evidence in favor
More and more studies point to movement as a central element in the prevention and management of pain associated with sedentary work. Systematic reviews of movement breaks in desk work contexts show low to moderate evidence that:
- Regular short breaks throughout the day reduce musculoskeletal pain and discomfort. These breaks can include standing up, walking briefly, stretching, or simply changing position. (4, 5)
- Productivity is not impaired; in some cases, it may even improve. (6)
Evidence-based physical therapy reinforces this perspective by viewing the human body as an adaptable system, designed to move and vary loads. In this context, a frequently quoted phrase comes to mind: “the best posture is the next posture.” This idea sums up the concept that no position, however good it may seem, is healthy when maintained for too long.
Practical implications for everyday life
Instead of seeking perfect alignment, the evidence suggests a more functional and realistic approach:
- Vary your posture frequently throughout the day (more upright, more relaxed, slightly inclined, etc.).
- Take regular breaks to move around, even if only briefly.
- Develop body awareness and self-regulation skills, adjusting your position according to comfort and fatigue.
- Compensate sitting time with regular physical exercise that improves mobility, strength, and tolerance to different postures.
Conclusion
The notion of a “single correct posture” is not supported by current scientific evidence. Musculoskeletal pain associated with sedentary work seems to be more related to lack of movement and postural variability than to perfect spinal alignment. Promoting movement, variation, and breaks throughout the day is a more effective, sustainable strategy that is in line with how the human body works.
In physical therapy and clinical Pilates, this approach translates into empowering people to move better, with more confidence and less fear of their posture, reinforcing that the body is resilient—as long as it is allowed to move.
References
1. Karen V Richards, Darren J Beales, Anne L Smith, Peter B O’Sullivan, Leon M Straker, Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study, Physical Therapy, Volume 101, Issue 3, March 2021, pzab007, https://doi.org/10.1093/ptj/pzab007
2. Barra-López M. E. (2024). The standard posture is a myth: a scoping review. Journal of rehabilitation medicine, 56, jrm41899. https://doi.org/10.2340/jrm.v56.41899
3. Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2007). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283–298. https://doi.org/10.1007/s00586-006-0143-7
4. Waongenngarm, P., van der Beek, A. J., Akkarakittichoke, N., & Janwantanakul, P. (2021). Effects of an active break and postural shift intervention on preventing neck and low-back pain among high-risk office workers: a 3-arm cluster-randomized controlled trial. Scandinavian journal of work, environment & health, 47(4), 306–317. https://doi.org/10.5271/sjweh.3949
5. Radwan, A., Barnes, L., DeResh, R., Englund, C., & Gribanoff, S. (2022). Effects of active microbreaks on the physical and mental well-being of office workers: A systematic review. Cogent Engineering, 9(1). https://doi.org/10.1080/23311916.2022.2026206
6. Waongenngarm, P., Areerak, K., & Janwantanakul, P. (2018). The effects of breaks on low back pain, discomfort, and work productivity in office workers: A systematic review of randomized and non-randomized controlled trials. Applied Ergonomics, 68, 230–239. https://doi.org/10.1016/j.apergo.2017.12.003