BackWords

Q:Hi Dr. Kirschner,
As a student, I have to sit in a lecture hall for several hours each day. The seats are pretty uncomfortable, and no matter how I try to sit I always have upper back pain by the end of the week. So, I have two questions for you. First, why would I experience upper back / shoulder pain, instead of lower back pain, from sitting in a non-ergonomic position? Second, could you offer some tips on how to correct my posture under these circumstances?

A: These are great questions, and the answers pertain not just to students, but to anyone faced with hours of sitting in the same place all day- secretaries, truck drivers, students, etc…
As to your first question about experiencing upper back and shoulder discomfort, rather than low back pain- it boils down to two things 1) While your lower back postural issues may be obvious to you because of the chair you are sitting in- your upper back (if you are like most students) is not benefitting from great posture either. Most students slouch over their desks, leaning into their notebook, text, or computer and this can exacerbate what is known as the thoracic kyphosis- or the outward curvature you see in your upper back. (The lower back has a lumbar lordosis- causing the indentation in the ‘small’ of your back. 2) Problems in one area of your skeleton almost always have effects in other areas of your skeleton.
Now, as to what you can do about it, there are a couple of things you can try; When in medical school, I was faced with hours upon hours sitting in class and sitting while studying. That being the case, I had to find ways to optimize my seating ergonomics wherever and whenever possible. One thing that I still do to this day is carry a lumbar support if I know I will be sitting for a long time. A small towel or t-shirt rolled into a makeshift support and placed between the chair and the small of your back can help maintain your lumbar lordosis. This can be further helped by keeping your books or other materials in a position on the table/desk in front of you in such a way as to not draw your upper body forward into a slouch- further protecting your upper back.

The second thing I recommend is getting out of your seat and performing some basic range-of-motion exercises in place every 30 minutes or so. I know that this is not always practical in a classroom setting, but you should make every effort to get up and move whenever possible.

And as with everything else related to your spine, you can only help matters by remaining active and limber when you are not in class.

I hope this helps, and thanks for your questions.
Be well!
-Andy