One of the biggest barriers I'm finding in the field, whether it's the patients and the therapists, is the importance of posture in trying to relieve a patient's back pain. Posture can be thought of in two ways. There's posture and the ability to make your posture neutral, which is basically an S shaped formation of your spine. The spine is not a flat structure. It is an S shape. You have an inward curve in the lumbar. You have an outward curve in your thoracic called the kyphosis. And you have another inward curve in your cervical region. So, trying to be able to promote this or be in this position is considered good posture.
There's also posture awareness, meaning knowing when to promote this posture. So, yeah, can you do it, that's great. But are you using it, or are we still just slouching when we're sitting. Are we still just slouching when we're bending and lifting. So there's posture and then there's the awareness of.
By and large, the posture, I look at it as like the Band-Aid for a paper cut or any other cut that you've had. We've all had these kinds of things before. If you have a paper cut you're going to realize it's bleeding and that you've got to take care of it. The first step you're going to do is to clean it out. Put some Bacitracin or Neosporin on it. And the last step is going to be to put a Band-Aid on it and leave it the heck alone.
Now, let's say you have a paper cut in your back. And let's say you've learned all the exercises, and you've used some ice or some heat to help with the symptoms. What if at that point you are sent home and you're still sitting crummy, you're still bending crummy, and you're still lifting crummy. You've basically almost reopened that paper cut. You've reopened the injuries to some degree. The patient often comes back the next day feeling minimally to no better, and that's usually why.
So, you have to first clean it or take care of it with the proper stretch or exercise. Then you have to leave it alone and hold it still especially with acute and sub-acute problems. So I usually think of it as like a Band-Aid. Without it, it can reopen, and it's a much longer stay in physical therapy and a much longer process of rehabilitation.