Posture, Neck Pain, and Headaches: How Physical Therapy Can Break the Cycle

How are posture, neck pain, and headaches all related and can physical therapy help you break this cycle?

Do you struggle with neck pain after a long day of work?

Can you feel the neck tension creeping up the back of your head after a full day at your computer?

Do you wonder if your posture, neck pain, and headaches are all connected?

Sometimes you can just feel your neck getting tighter as the day goes on and sitting up straight feels harder than the work you’re doing.

Posture can definitely be a driving factor in neck pain and headaches, especially for desk workers, crafters, and anyone doing a lot of seated work. But what is the best posture?

In this blog post we will break it all down for you: 

• • How posture is related to your neck pain and headaches
  • What the best posture is
  • How to optimize your posture and work setup so that your head and neck don’t feel wrecked by the end of the day. 

How does posture affect your neck pain and headaches?

You may have heard the phrase “it’s all connected.” This is true and along with gravity, has a huge influence on posture and how different postures make you feel.

All posture is driven from the low back. I give this demo all the time with my clients and you can try it at home too. Slouch in your chair. Like really round forward. You can see this depicted in the picture below.

Now, all I want you to do is straighten through your low back. Watch what happens…

Isn’t it amazing how much more upright you’re sitting just by addressing your lower back position? It drives 80-90% of your upright posture. Once you straighten through your lower back, then you can bring your head, neck, and shoulders upright to address the last 10-20% of upright posture.

You better believe that focusing on your lower back position is important in fixing neck pain and headaches with posture correction!

Now where does gravity come in? Gravity is represented by a vertical line that pulls everything downward. When body parts move in front of or behind the line of gravity, muscles work to fight that downward force and keep you upright. The more upright you hold yourself, the less your muscles have to work to keep you upright. The opposite is also true- the further away your body is from the line of gravity, the harder your muscles have to work to keep you upright.

This is really important when it comes to posture. Heads are heavy, about 10-12 pounds. That’s around the weight of a bowling ball. For every inch forward your head comes from the line of gravity, your neck muscles have to work two to four times harder just to hold your head up. Here’s what the numbers look like.

• • • Head upright= 12 pounds of force needed by muscles to keep head upright
    • Head 2 inches forward = 32 pounds of force needed by muscles to keep head upright
    • Head 4 inches forward = 42 pounds of force needed by muscles to keep head upright

Isn’t that wild?! All this extra force causes neck muscles to get tight and painful, which in turn can lead to headaches, shoulder pain, and jaw or TMJ pain. 

What is the best posture?

This is a loaded question. Based on what we discussed above, it seems natural to think that the best posture is one in which you are upright and in line with gravity. 

But let’s be honest. Who actually can sit up straight like that all day? Even with the best intentions to stay upright, gravity always tends to win and we end up slouched and sitting in all kinds of weird positions.

I say that the best posture is one that is always changing. No one position is inherently better than another position. 

Where people run into issues is spending much more time in one position at the exclusion of others.

Almost everything we do brings us forward- typing at a computer, washing dishes, picking things up from the floor, carrying tiny humans, driving…you name it. As a result, our body tends to come forward as well. The upper back and shoulders round and our heads follow suit. So we spend a vast majority of our time in something called a Forward Head Posture or Upper Cross Syndrome. 

These are both very dramatic ways of saying we are stuck in a forward position and need more things to bring us into the opposite position. Don’t panic, we can do something about this!

How can you optimize your posture and work setup to get rid of neck pain and headaches?

There are two parts to optimizing your posture and work setup based on what we talked about. 

1. Set up your workspace to support you in an upright position. 
2. Frequently change your position. 

With this combination of strategies, you will get the most relief from your neck pain and headaches.

Let’s break it down.

Posture tip #1: Set up your workspace to support you in an upright position.

Remember that first exercise you did where you slouched then straightened up through your lower back? This is where we need to start to optimize upright posture. When sitting in your chair, you need good lumbar support. Many office chairs have this built in, but sometimes it isn’t enough. So whether your chair has no lumbar support or doesn’t have quite enough, I recommend using a lumbar roll. This is my favorite lumbar roll that I use and recommend to all my clients. Place it at the small of your back right below your waist.

Next, make sure the rest of your back is on the backrest of the chair. The lumbar roll is not meant to simply push you forward! That would only make your neck pain and headaches worse. Be sure to use your back rest! 

As a side note, I hear a lot of people opting to not use a back rest or sit on an exercise ball to help with posture. In my professional opinion, these things only tend to make your posture worse and don’t strengthen your core like people think they will.

This is because of gravity. The muscles of the spine that hold us upright all day, every day get tired. That combined with your focus being on your work, not your posture, means that you’re going to slouch. Slouching all day puts more strain on your neck muscles and leads to neck pain and headaches. So use your back rest!

Once your back is properly supported, make sure your feet are supported on the floor. Yes, you can cross your legs, just make sure your feet aren’t dangling.

From here, bend your elbows. This is where your keyboard should be. It is much closer than where many people have their keyboards. This is important because if your keyboard is too far away, you’ll start leaning forward to type and see your monitor. 

See the picture below for and “optimal” upright posture setup.

If you have a standing desk (which I highly recommend), the same principles apply. You won’t have to focus as much on the low back support and foot support, but definitely pay attention to the height of your desk by bending your elbows to line up your keyboard.

To make this all simple, remember two things:

1. Support your spine in an upright position.
2. Bring everything to you so you stay in that upright position.

Posture tip #2: Frequently change your position

Remember, the best posture is one that is always changing! Every 45-60 minutes get out of the position you are in. I really love standing desks for this reason. At the push of a button, you can super easily change from a standing to sitting position, or vice versa.

There are many ways to frequently change your position:

1. If you’re sitting, stand up. Move in place for 30-60 seconds or do some neck circles.
2. If you’re standing, sit down. 
3. Go fill up your water bottle.
4. If you’ve been filling your water bottle, go to the bathroom.
5. Take lunch away from your desk. 

The most common thing that gets in the way of people changing positions is getting engrossed in their work and forgetting to move. I totally get it. Try setting a timer on your phone, watch, or calendar to prompt you to move. You can also put a sticky note on your monitor to remind you to move. Schedule 5 minute movement blocks on your work calendar. Try a few different strategies and see what works best for you!

Putting it all together

To wrap it up, know that posture, neck pain, and headaches are definitely all connected. Heads are heavy and when your head is in front of the line of gravity more often than not, it puts a lot of strain on the neck muscles, which can cause neck pain and headaches.

Remember that there is no perfect posture! The best one is one that is always changing. 

Have you tried these posture tips and are still experiencing neck pain and headaches? Please reach out! We would love to chat with you in more detail, hear your story, and see how we could help.

Submit this contact form and we will reach out to you, or you can book a free discovery call with one of our physical therapists.