As we continue the quest to understand back pain and more specifically the symptoms, it is critical to step back and clearly understand the causes of these symptoms. It is also very important that we don’t ignore the contribution of other body mechanics as well as ergonomic influences that may be exacerbating these back pain symptoms.
In the first part of this sequence, we explored the influence of the positioning and support of the pelvis. It might help to compare the role of the pelvis much like the foundation of a house. It is critical that this bony structure is positioned to encourage a well balanced spine as it ascends upward toward the head and neck.
If the pelvis is allowed to tilt backward on the sit surface, this position allows the low spine to flatten and the entire thoracic spine to flex forward and often causes the neck to assume a hyper extended position in an attempt to balance the head for visual and vestibular input. This is often seen as a collapsed spine and posture. It is not difficult to envision how you might incur back pain from this position, on the tail bone from excessive pressure, the lumbar region from this flattened alignment, the thoracic region that assumes a kyphotic position with similar intervertebral pressure and soft tissue creep, not to mention a collapse of the thoracic and abdominal cavity that places pressure on the organs and rib cage, as well as pain in the neck and lower occiput of the skull.
If the pelvis is not balanced from side to side, then the hips may shift up on one side versus the opposite, causing the spine to ascend on an angle out of the pelvis as it attempts to balance the upper position of the back. This can lead to a scoliosis that will result in back pain from the stretch of soft tissues on one side and the compression of soft tissues and bony structures on the opposite side.
It is important to keep in mind when exploring your cause of back pain, that the inner mechanisms of your head that are always attempting to optimize sensory input, the body shape will conform to bring your head and visual input specifically, to a level position and your spine will accommodate.
The key to understanding the cause of your back pain, wherever it may be manifested, is to appreciate the value of alignment. Becoming more aware of your body and its position in space is a significant step to addressing both the cause of back pain, the symptoms of back pain and the solution.
Now consider that you have sought out what you believe to be the ideal sitting solution. Let’s consider the CoreChair for its focus on optimal positioning of the pelvis. As discussed previously, the CoreChair addresses back pain by focusing on the position of the pelvis.
The sculpted seat not only distributes pressure over the sit surface for comfort but it also prevents the sit bones from sliding forward on that surface. The low back support focuses on providing an opposing force on the top of the back of the pelvis. Together, these surfaces encourage the pelvis to rest supported in an upright vertical position. This foundation then allows the lumbar spine to assume a more neutral balanced position.
So now your pelvis feels good, the low back pain has been addressed but you are experiencing back pain in the thoracic region of your spine.
It is valuable to understand how the CoreChair addresses this. In many cases, new CoreChair users have been using a traditional tall back chair and have become essentially over supported. When someone is over supported over time, their supportive soft tissues are under challenged and the muscles weaken or atrophy.
When they begin using a CoreChair, they experience a new upright posture that alters the alignment from what they became accustomed to and the mid to upper back muscles have become engaged much like beginning a new exercise routine at the gym. In this example, the very clear majority of persons siting back pain such as this, report later that this pain is transient. Like a new exercise routine, these muscle fibers and groups become synchronized with greater efficiency and eventually become stronger.
So now we have addressed the low back and the mid back but some back pain begins to surface in the shoulders and neck.
When someone has changed their position within a new seating solution, it is important to examine how this position is affecting and is affected by their work surfaces.
If someone gets a chair that is the proper height for them and they are able to place their feet comfortably on the floor, and feel that their pelvis is appropriately supported, they should be able to position themselves relative to their work surface such that the heels of their hands are gently resting on the leading edge of this surface and their elbows should be at 90 degrees or slightly more.
If the elbows are faced to be more bent, less than 90 degrees, this may result in the reaction to shrug or raise the shoulders. This causes these muscle groups to overwork and exhaust, in addition to the back pain emanating from these tight muscles, it is important to know that there is a critical network of nerve roots that pass through this area that can ultimately affect sensation down the arms.
If a shorter person has a chair that fits them properly but their work surface is too high, they may need to invest in a height adjustable desk that allows them to reduce the height of the work surface, or consider raising the height of their chair and introduce a foot support in an attempt to attain this proportionate positioning to their work surface.
