The Lancet reports lower back pain being treated badly on a global scale. New smarter approaches needed

The Lancet reports lower back pain being treated badly on a global scale. New smarter approaches needed

More than 540 million people suffer low back pain, the commonest cause of disability in the world. But their condition is often being made worse by costly high-tech interventions and bed rest in what could amount to medical negligence on a global scale.

Large numbers of sufferers across the world are being harmed not healed by invasive surgery, injections and opiates, according to new details published by the Lancet. Prevention is better than cure and what is really needed is better awareness of the dangers of poor posture along with exercise, experts say. 

Lower back pain is a significant challenge for patients, health providers and economies across the globe. Each year, almost 1m years of productive life are lost in the United Kingdom due to disability from low back pain, 3m in the US and 300,000 in Australia.

In the UK, the National Health Service has guidance for doctors on non-specific lower back pain that promotes physical exercise and recommends against surgery. However in the US, operations are very common, setting a poor example to the rest of the world. This is a huge problem as there are many high tech, expensive treatments, many of which simply aren't proven to be any benefit.

Is Sitting Really the New Smoking?

Is Sitting Really the New Smoking?

Our bodies aren't designed to sit for hours, they were designed to stand. During most of the last two thousand years, we hunted for food and we tended crops spending almost all of our time standing on two feet. Fast forward to today over 90% of activities are done sitting down. We surf the web we watch TV we drive cars and we work for hours on end all while sitting on our rear ends. Total it up and we spend nearly 80 percent of our waking hours sitting.

In fact, you are probably sitting right now!

Not to scare you, but if you are, major changes have taken place the electrical activity in your legs to shut off the enzyme that helps break down the fat in your body. Doctor James Levine who maybe said it best “Sitting all day is literally killing us”. According to recent biomedical research, people who sit for most of their day are 54% more likely to die from a heart attack, diabetes, and obesity than the people that set for less than 3 hours.

Researchers are now calling sitting the smoking of the current generation. Maybe you're thinking well I do sit all day but I exercise regularly? Unfortunately, that's not going to cut it. According to recent studies even an hour of exercise, a day isn't enough to offset the effects of prolonged sitting. According to evolutionary biologists, the human body has evolved over several million years to stand on two feet. We did not evolve to sit in chairs all day

The good news is there is no need to give up your seated job or change career path.

Simply stand up!

Experts tell us that standing for just 15 minutes each hour yields amazing life-extending benefits. You'll increase your energy and boost your metabolism as an added bonus. Standing burns an extra 60 calories per hour standing for Just 2 hours a day can help you lose up to 20 pounds per year. So there are plenty of reasons to change up your work routine to something that involves being more mobile.

The Benefits of Great Posture

The Benefits of Great Posture

Has anyone ever mentioned to you or scolded you for slouching at a family dinner? Comments like that might be annoying but they're not wrong. Your posture is the way you hold your body when you're sitting or standing and is the foundation for every movement your body makes and can determine how well your body adapts to the stresses of everyday life. These stresses can be things like carrying weight or sitting in an awkward position. Your muscles have to work harder to keep you upright and while some muscles will become tight and inflexible others will be inhibited over time. These dysfunctional adaptations impact on your body's ability to deal with the forces you experience every day. Poor posture inflicts extra wear and tear on your joints and ligaments and increases the likelihood of accidents and can also make some organs like your lungs less efficient.

Researchers have linked poor posture to scoliosis, tension headaches, and back pain, so it isn't the exclusive cause of any of them. Posture can even influence your emotional state and your sensitivity so there are a lot of reasons to aim for good posture. It's getting harder these days as we spend longer sitting and, worse still, in an awkward position for a long time can promote poor posture and so can using computers or mobile devices which encourage you to look downwards. Many studies suggest that on average posture is getting worse so what does good posture look like?

When you look at the spine from the front or the back all 33 vertebrae should appear stacked in a straight line from the side the spine should have three gentle curves. One at your neck one of your shoulders and one at the small of your back.  You aren't born with this as babies fine have just one curve, with the others usually developing by 12 to 18 months. As the muscles strengthened these curves help us stay upright and absorb some of the stress from activities like walking and jumping. If they are aligned properly when you're standing up, you should be able to draw a straight line from a point just in front of your shoulders to behind your hip to the front of your knee to a few inches in front of your ankle. This keeps your center of gravity directly over your base of support which allows you to move efficiently with the least amount of fatigue and muscle strain. If you're sitting, your neck should be vertical not tilted forward your shoulders should be relaxed with your arms close to your truck your knees should be at a right angle with your feet flat on the floor. But what if your posture isn't that great? Try redesigning your environment. Adjust your screen so it's slightly below eye level and make sure all parts of your body like your elbows and wrists are supported using ergonomic aids. If you sleep on your side try placing a pillow between your legs. Wear shoes with low heels and good arch support and use a headset for phone calls.

It's also not enough to just have good posture. Keeping your muscles and joints moving is extremely important in fact being stationary for long periods with good posture can be worse than regular movement with bad posture. When you do move, move smartly keep anything you're carrying close to your body. Backpacks should be in contact with your back and carried symmetrically. If you sit a lot get up and move around on occasion and be sure to exercise using your muscles will keep them strong enough to support you effectively. Small adjustments can really help improve your posture over time!

Best sleeping position to reduce back strain

Best sleeping position to reduce back strain

A few people messaged us to ask about preferred sleeping positions for people with back pain. Starting with the pillow, no matter what position you lie in, it should be under your head, but not your shoulders, and should be a thickness that allows your head to be in a normal position, not at some weird angle.

  • It's best to try to sleep in a position which helps you maintain the curve in your back (such as on your back with a pillow under your knees or a lumbar roll under your lower back; or on your side with your knees slightly bent). Do not sleep on your side with your knees drawn up to your chest. It might be best to avoid sleeping on your stomach, especially on a saggy mattress, since this can cause back strain and can be uncomfortable for your neck.
  • Select a firm mattress and box spring set that does not sag. If necessary, place a board under your mattress. You can also place the mattress on the floor temporarily if necessary. If you've always slept on a soft surface, it may be more painful to change to a hard surface. Try to do what's most comfortable for you and remember you should change your mattress every few years.
  • If you need, try using a back support (lumbar support) at night to make you more comfortable. A rolled sheet or towel tied around your waist may be helpful.
  • When standing up from the lying position, turn on your side, draw up both knees and swing your legs on the side of the bed. Sit up by pushing yourself up with your hands. Avoid bending forward at your waist.

Protips for good workplace posture.

Protips for good workplace posture.

If like large numbers of people, you sit in an uncomfortable office chair all day, chances are you aren't doing you posture any favours. But there are a number of things you can do to help improve your posture and take the strain off your spine..

Better support your spine

Start by adjusting your chair so that your lower back is better supported as a correctly adjusted chair will help reduce the strain. Many office chairs are easily adjustable, so tweak the height, tilt and if possible, the lumbar support so that your knees are a little bit lower than your hips. You may also consider using a footrest as well to help adjust

Change the height of your chair

Adjust the chair height so you can reach the computer keyboard with your forearms and wrists level and straight with the ground. This can also help prevent RSI. Remember to keep your elbows close to your body and your forearms at a 90-degree angle. 

Flat feet

Try to keep your feet totally flat on the floor and remember to try and not cross your legs as this can cause other problems.

Adjust your screen to your eye level


If its possible, your screen should be in front of you and around an arm's length away with the top of the screen at around eye level. This can be harder with laptops compared with the desktop computers, so you may need to invest in a laptop stand if it.Some people like using a wrist-rest to help keep their wrists straight and at the same level as the keys.

Move your mouse

Use and keep the mouse as close to you as possible so you don't have to stretch to reach it and try and avoid using the mouse at an awkward angle. 

Minimise screen reflection

Ideally, your computer screen should be as glare-free, so once you have identified the source of the glare, try and adjust the screen angle to minimise it. You may need to adjust blinds or ceiling lights to facilitate this, and remember, you can also adjust your screen brightness or contrast to make the screen a little easier to see.

Accessible desk objects

Also helps have a tidy workstation, but try and position regularly used office equipment within easy reach and if possible avoid repetitive stretching or twisting to reach things. 

Phone strain

Do you spend a lot of time on a phone? You might be better off switching your handset for some kind of headset or handsfree kit. Cradling the phone between your shoulder and head isn't great and is even harder with modern smartphones. Remember you can use Bluetooth headsets or the free wired headphones that ship with most smartphones.

5 exercises to improve flexibility and posture whilst at work

5 exercises to improve flexibility and posture whilst at work

If you have an office job, chances are, you are pretty tired when you are finished at the end of the day. Thus the last thing you are looking to do is go out and exercise once you have wrapped work for the day. However your posture and all round health needn't suffer. Now of course this won't take the place of good exercise sessions, but every little helps!

Exercise 1: Check your posture

If you are sitting for long periods of time, chances are, your posture is one of the first things to suffer. A quick way to keep this in check is to use the "ice cube trick". Write the word "ice cube" and stick it to the corner of your screen. Then, whenever you look at it, imagine an ice cube has been dropped down the back of your chair. I can pretty much guarantee you’ll pull back your shoulders and puff out your chest. This will train you over time to improve your posture.

Exercise 2: The 30 minute suggestion

Don't sit around for hours on end, try and stay mobile. Get up, walk around, grab a coffee, have a chat etc. Sitting for long periods can slow your metabolism, which can impact the the body’s ability to manage blood sugar levels, blood pressure and even process.

Exercise 3: Tone up your thighs

Thigh lifts, leg lifts and knee bends - these kind of workouts are great for the office environment and can also help with toning your thighs. It can also help burn calories without anyone knowing, whilst seated at your desk.

Exercise 4: Stand tall

On a conference call, push that chair back and stand upright. This will help to engage more of your muscles. You don’t have to stand on one leg for this exercise but do just stand up on both feet whenever you can.

Exercise 5: The 2-minute march

Get your blood moving with this clever two-minute workout. Sit with strong, upright posture at your desk, with your feet about a hips width apart and quietly march your feet up and down for 2 minutes.

This will both burn off a few calories and give your legs a quick workout!

Great set of core exercises

Great set of core exercises

Here is a great infographic of a series of useful exercises which with regular practice will help avoid injury, improve your posture and maybe even rehabilitate old niggling injuries.  

I recently started incorporating this into my daily routine and its been working wonders. Frankly it would be great to see schools encouraging pupils to learn and practice these as it would do wonders for their long-term flexibility and as we know, prevention is far better than cure when it comes to poor posture.  Even if you are a relatively active person, this will work groups of muscles that don't commonly get used, so there is huge benefit for people of all levels of fitness to utilize something like this.

Posture Infographic

Improve your posture with a great lower back workout.

This is a great series of exercises to help your lower back and improve your posture.

Some of them are a little tricky, but take it slow and steady and after 12 minutes or so, you should definitely be feeling the benefits of being more limber. Over time, this will absolutely improve your core stability, posture and loosen up your lower back.

Do pay attention to the details and cues and continue only as long as is comfortable. If you have acute or chronic back pain, want to enjoy the benefits of better posture, or simply want to become a better athlete, this is a great posture improvement video.

3 simple exercises to improve your posture

3 simple exercises to improve your posture

The months and years of sitting slouched at your desk have started to take their toll on your back and you've realised you need to do something about your bad posture. But how do you actually go about starting to improve your posture? Beyond products like Smarter Posture Mat, just by taking that first step of being aware of sitting smarter can actually have an impact. Whilst the years spent slumped will have inevitably tightened your muscles, with some simple exercises, these can easily be loosed and you can achieve a smarter posture.

So here are three simple exercises to improve your posture:

  1. The Superman - Start by lying facedown on the floor and raise your hands above your head, palms down. Then gently lift your torso whilst rotating your shoulders so your palms are facing each other. Hold for five to ten seconds and try and align your head with your neck and back. Lower your torso and repeat 10 times or so.
  2. Static Back - This one's a cracker and you just need a bed or chair! Start by lying down on the floor. Best start ever!! Now raise your legs onto the bed or chair with your knees at a 90-degree angle, getting your hips in as close as possible to the chair or bed and keep your arms grounded by your side. Now do nothing for 5 - 10 mins and just relax as this will loosen up the muscles in your lower back and stretch your thoracic muscles.
  3. Static Wall - A slightly more intensive version of the static back stretch. Whilst the previous exercise rested legs on the bed, this one has your entire leg at a 90-degree angle to your body rather than just your knew. Start by on the floor with a wall in front of you and slide your legs vertically up the wall bringing your behind in as close as possible to the wall, so you form an L shape. Simply keep your arms by your side and hold for 5 minutes. This delivers the same benefits as the previous posture exercise, but a more intense feeling

Remember, improving your poor posture is very much within reach. Whilst it won't happen overnight, start by taking the first steps with these and other exercises and you'll be sitting smarter in no time!

Is sitting the new smoking?

Is sitting the new smoking?

Is sitting down really the new smoking? With a significant proportion of the populations of most developed countries suffering from poor posture or back issues, more people are starting to become aware of the impact of sitting on your posture. Everyone knows that smoking is bad for your health, but people choose to do it and that's a whole different blog post. But sitting? Research has suggested that sitting might actually be one of the most underrated health threats facing society and that sitting more than six hours a day can not only be bad for your posture but also greatly increase your risk of an early death.

Especially in today's society when we are conditioned to work between 9-5 or later in some cases. You know the drill - we sit or slouch with terrible posture, in a chair all day at a computer (I'm even writing this post sat in a coffee shop!!) we then come home, eat dinner and then sit watching TV or other sedentary activities. Inactivity really isn't good for us, some might say dangerous if the research is to be believed, Now this doesn't mean you should suddenly start training for a marathon or start doing everything standing up, but making small positive changes to your lifestyle can only be a good thing.

Try getting one of the simple pedometers to help track activity so you can ultimately target 10000 steps a day. A sedentary person may only be doing 1k to 3k steps so hitting between 5k and 10k would literally be a great step forward and 10k steps isn't really a large distance - only around 5 miles.

Now the technology exists to cheaply and relativelyaccurately track not just the number of steps, but also your sleeping patterns, it makes it very easy to see how small adjustments can lead to big positive changes. 

So try and find that happy medium of eating well, sleeping well and moving around more and your body will thank you for it. 


Choosing the right mattress to support your spine

Choosing the right mattress to support your spine

In the same way that choosing a good pillow helps support your neck, selecting the right mattress for your spine to support your posture is equally important. It's true that your body type will largely dictate the type of support you need, with the general rule being if your hips are wider than your waist, a softer mattress can accommodate the width of your pelvis and allow your spine to remain neutral. Although if your hips and waist are in a relatively straight line, a firm surface offers better support. Whilst we obviously can't easily control our posture when we sleep, at least a supportive mattress will help keep your posture in check.

There are so many different types of mattresses on the market today and for people with spinal issues or poor posture, a foam mattress rather than one with inner springs will largely be preferable. This is because springs or pocket springs can create pressure points on the body and don't support the natural curvature of the spine. By comparison, foam mattresses adjust to the contours of the body, so as you move in your sleep, your bed adjusts to you.

The excellent page Sleep like the Dead has a great comparison of a variety of mattresses and some great pointers on what to look for when buying a new one. There are also several interesting startups like Casper and Tuft and Needle producing some great value, well-engineered foam mattresses and they also offer 100 day free trials meaning you can test it out before you buy.

So do you research before you spend the cash and try out a variety of beds and find one that's right for you. You spend 1/3 of your life sleeping so do it right!