Your posture type can significantly impact your physical and mental well-being, yet less than half of all Americans are concerned about their posture. That's an unfortunate reality, especially when poor posture is one of the leading causes of back pain that affects more than 80% of all Americans at some time in their lives.
Posture issues often present in childhood and worsen in adulthood. In fact, one study found that more than 65% of children and adolescents have improper posture.
Some types of posture are caused by congenital disorders, while others are caused by environmental and occupational factors that misalign our spines into abnormal, unattractive and often painful positions.
"Poor posture can be caused by physical factors such as muscular imbalances or skeletal anomalies. In most cases, though, common posture problems are simply the result of bad habits that we have developed over time, such as sitting or standing for long periods of time without moving, slouching when we sit, or wearing high heels often," says Dr. Sony Sherpa, a holistic practitioner who contributes to Nature's Rise. "Mental factors like stress and anxiety can contribute to poor posture since people often slump when feeling overwhelmed. Finally, being overweight or having bulky muscles in certain areas can create imbalances that result in poor posture."
The good news is that most types of bad posture can be treated – but first, you must know which posture type you have. This guide details five different types of posture and lists therapies that can help.
- Types of posture
- Kyphosis (including hunchback)
- Lordosis (including swayback)
- Forward head posture (including tech neck)
- Effects of bad posture
- How to assess your posture
- How to improve your posture
- How long does it take to correct posture
Types of posture
Good posture is defined as having a neutral spine, where your head and neck are positioned directly on top of your shoulders, and your shoulders positioned over your hips.
"Our bodies have three distinct curvatures: cervical (neck), thoracic (mid-back) and lumbar (low back)," explains Dr. Matt Tanneberg, DC, CSCS, who owns and operates Body Check Chiropractic & Sports Rehabilitation in Scottsdale, AZ. He works with elite athletes from the NFL, MLB, NHL, USA Track and Field, NCAA and high school. "Having the proper degree of curvature both at the apex and at the transitional areas between curves is essential in carrying yourself upright to have proper posture."
Proper posture allows your body to function without excess stress on your muscles, ligaments, tendons and joints, while poor posture increases stress that can lead to pain and injuries. Muscle memory sets in when you have habitually bad posture, causing you to stand and sit in abnormal positions.
When we're talking about posture, we're often referring to standing posture, but it's also important to maintain proper sitting posture as well as good posture during movement.
- Static posture: Your posture at rest, such as when sitting or standing
- Dynamic posture: Your posture in motion, such as when running and walking
With all that in mind, here are the most common types of poor posture.
Kyphosis is characterized by an exaggerated curve in the upper back. If the curve is too excessive, it can give you a hunchback appearance.
The thoracic spine spans from the base of your neck to the bottom of your rib cage (vertebrae T1 to T12). Normally, the thoracic spine has a gentle C-shaped curve between 20 and 45 degrees. If yours is greater than 50 degrees, you likely have kyphosis.
Kyphosis causes include:
- Slouching over screens, phones and workstations
- Repeatedly carrying heavy loads
- Physiological conditions such as arthritis and bulging discs
- Congenital conditions such as spina bifida and muscular dystrophy
“Many older adults will experience cervical kyphosis, which is characterized by a rounding of the upper back and forward posture of the neck,” says Dr. Brittany Ferri, an occupational therapist at Medical Solutions in Barcelona. “However, this is also getting more common in children, especially those who slump over while texting or playing video games.”
Kyphosis symptoms include:
- Neck, back and shoulder pain
- Problems maintaining balance
- Lordosis, where the lower back arches inward to compensate for kyphosis
- Hunchback appearance
“Kyphosis is a condition where the spine of the upper back has an excessive outward curvature, resulting in a hunched over posture. This can affect the alignment of other body parts, such as causing your shoulders to roll forward and your head to jut out,” says Lalitha McSorley, PT, a physiotherapist in Calgary. “Good posture includes keeping your spine straight and maintaining proper alignment of your head, shoulders, hips and feet when standing or sitting. With kyphosis, this alignment is disrupted. Kyphosis is not only aesthetically displeasing, but it can also cause pain in the back, neck and shoulders if left untreated. In some cases, it may also limit movement in certain directions.”
Lordosis refers to the natural curve of the cervical (neck) or lumbar (lower back) spine, though the term is often used interchangeably with hyperlordosis, which is an exaggerated curve of the spine.
- Cervical lordosis: Normal lordotic range of 20 to 35 degrees. A curve exceeding 35 degrees signifies cervical hyperlordosis
- Lumbar lordosis: Normal lordotic range of 40 to 60 degrees. A curve exceeding 60 degrees denotes lumbar hyperlordosis, also known as swayback
Hyperlordosis is an exaggerated inward curve, but another condition, known as hypolordosis, represents an exaggerated outward curve.
Lordosis is often caused by poor posture, though environmental influences, injury, congenital conditions and neuromuscular disorders can also cause it. Obesity is also a common factor and an increasing problem for younger generations.
“Children who are slightly or very overweight may have weak core strength and abs, which leads their pelvis to move forward and their lower back to excessively arch. This is what causes lordosis,” says Dr. Ferri. “It may also be a common posture for anyone who wears high heels frequently, since they place the lower body in a more forward state that we need to compensate for.”
Lordosis symptoms include:
- Lower back and neck pain
- Muscle spasms
- Limited mobility and flexibility
- Pain radiating to the hands and feet
- Aesthetic issues such as a forward-jutting head, pot belly and protruding posterior
Learn more about lordosis and how to fix it.
When your neck hyperextends toward the front of your body, it's called forward head posture, or FHP. Other names include forward neck posture, forward head syndrome, anterior head carriage and upper crossed syndrome.
The condition is typically caused by poor posture: looking down for extended periods and occupations such as hairstyling, cooking, writing and massage therapy. When FHP is caused by looking down at smartphones, laptops and other screens, it's called text neck or tech neck.
Forward head posture symptoms include:
- Chronic neck, chest and upper back pain
- Headaches, including tension headaches and migraines
- Jaw pain
- Eye strain
- Tilted head
Flatback is the term for a loss of lordosis, the spine's natural curve, lending a flattened appearance to your lower back.
Flatback causes include:
- Rheumatoid arthritis
- Ankylosing spondylitis
- Degenerative disc disease
- Post-laminectomy syndrome
- Vertebral compression fractures
Flatback symptoms include:
- An abnormally straight back
- Chronic back pain
- Fatigue and stooping
- A sensation that you're falling
- Issues with standing upright
- Pain in the thighs and groin
If you have flatback, it's best to consult a doctor to identify the underlying cause and outline a treatment strategy.
Scoliosis is characterized by a sideways or lateral curvature or twisting of the spine. It's often idiopathic, where the precise cause is unknown, though some cases are caused by congenital and neuromuscular conditions such as cerebral palsy, muscular dystrophy and spina bifida.
Scoliosis symptoms include:
- Leaning to one side
- Uneven shoulders, waist and hips
- A rib cage that juts forward on one side
- Uncentered head
- Misfitting clothing
Like flatback, it's best to discuss scoliosis with your doctor to identify the underlying cause, if possible, and to develop an effective treatment plan.
Effects of bad posture
The previous overviews listed common symptoms associated with each type of posture. However, left unchecked, poor posture can lead to a host of potentially serious health problems, including:
- Chronic pain, including back pain, neck pain, chest pain and headaches
- Respiratory distress, as poor posture can reduce lung capacity (National Library of Medicine)
- Balance issues and difficulty standing or walking
- Loss of flexibility and mobility
- Fatigue and weakness
- Increased injury risk
- Lack of muscle control
- Numbness and tingling in the extremities (compressed, damaged nerves)
- Bulging, herniated discs or disc degeneration
- Humped neck or back
- Rounded back and shoulders
- Tight hamstrings
- Neck wrinkles
- Incontinence (Harvard Health)
- Constipation, heartburn and slowed digestion (Harvard Health)
- Heart issues
- Decreased height
- Chronic stress
“Poor posture can lead to breathing difficulties, compression of organs, muscle weakness that leads to increased weight gain, changes in sensation (numbness, tingling) and joint problems, especially in the spine, such as degenerative disc disorder,” says Dr. Ferri.
In addition, poor posture can lead to body image issues such as lack of confidence and depression. Bad posture is also associated with a higher mortality rate.
“The long-term effects of bad posture can be quite damaging, both to our physical and mental health,” says McSorley. “Other than the obvious pain and discomfort associated with poor posture, there can be much more serious consequences if not addressed. Bad posture can lead to a decrease in circulation and nerve function, which can affect our organs such as the heart and lungs. It can also cause mental exhaustion due to the strain on our muscles and joints.”
If you have a posture condition, effective treatment means preventing long-term complications and fostering improved, prolonged quality of life.
How to assess your posture
Here are five ways to assess your posture.
1. Wall test
- Stand against a wall with knees bent and feet slightly away from the wall
- Touch your back against the wall at each "S" (skull, scapulae, sacrum)
- Whichever "S" is most challenging to touch to the wall will reveal where there might be postural deviations
2. Mirror test
Stand sideways in front of a full-length mirror to see if it looks like you have an excessive curve or flattening anywhere along your spine. Check if your head or neck juts forward. Face the mirror to see if one side of your shoulders or hips seems to be higher than the other.
“Someone with good posture will have subtle curves in the spine but nothing too excessive. A natural spinal curvature will be slight kyphosis in the upper spine (thoracic area) with slight lordosis in the lower spine or lumbar region,” says Dr. Ferri. “When looking at someone’s posture from the side, you should notice a vague ‘S’ shape.”
3. Posture analysis apps
Some mobile apps use your phone's camera and other sensors to analyze your posture. Though they’re not as accurate as medical imaging, these apps can help clue you in to potential posture problems. Some apps include postural exercises and scheduled reminders.
4. Friends and family
Ask friends and family members to observe you standing and sitting. It's tempting to maintain proper posture when you know someone is watching, so ask them to discreetly snap a few photos of you sitting and standing when you're not paying attention. Review the photos to see if it appears as though you have a posture condition.
5. Doctors and imaging
The best way to know for certain if you have a posture issue is to see a doctor, chiropractor or physical therapist. Medical professionals can assess your posture, and they can confirm the diagnosis (along with its severity) with imaging such as X-rays and MRIs.
How to improve your posture
The best way to improve your posture depends on which type of posture you have, since each has its own recommended treatment regimen.
"Fortunately, with proper assessments and exercise strategies, all types of posture problems can be corrected to reduce pain and improve appearance," says Dr. Sherpa.
Typically, the most effective posture improvement requires a combination of multiple of the following therapies.
Exercises, stretches and yoga
Exercises, stretches and yoga strengthen postural muscles and lend the flexibility needed to maintain proper posture throughout the day.
“Stretching helps to improve range of motion, flexibility and strength, allowing one to maintain proper posture without strain or fatigue,” says McSorley. “Additionally, exercises like yoga or Pilates can help build the muscles that support the spine in order to better maintain good posture.”
Find recommended posture exercises, stretches and yoga for:
“It is important for people to tailor their exercise routine specifically to their own needs,” says McSorley. “Working with a physical therapist can help you develop an exercise program that is right for you and your body.”
Posture correctors provide physiological feedback that helps align your spine and train your muscles to hold proper posture while sitting, standing and in motion.
"Posture correctors offer support to our injured muscles and joints. When used appropriately, they can help ease pain and support movement," says Dr. Sherpa.
McSorley says that posture correctors can be tools to help correct bad posture and help maintain good posture once it’s corrected.
“Posture correctors work by providing gentle compression and support to the shoulders, neck and upper back,” she explains. “This helps to realign the spine and improve posture without having to strain or exhaust oneself.”
Keep in mind that posture correctors aren’t meant to do everything for you. Rather, they’re designed to guide your body and help you become more mindful of your posture so, eventually, you’re able to maintain good posture without wearing a corrector.
“Posture correctors can help by improving awareness. They place the spine in a more ergonomic, healthy position and make it more uncomfortable to slip into those improper, misaligned positions,” says Dr. Ferri.
Some posture apps guide you through exercises, stretches and yoga. Others assess your posture and provide tips for improving it. Still others remind you to adjust your posture throughout the day, while some desktop apps – slouch detectors – use your camera to monitor your position and alert you when you slump.
Discover the best posture apps.
Incorporating ergonomic best practices at work can help you prevent occupational posture problems. Invest in ergonomic chairs and desks, consider a standing desk to alternate between sitting and standing, and properly position your computer screen to avoid forward head posture.
If you spend a lot of time on your cell phone, bring your phone up to eye level rather than look down at it to help prevent tech neck. Avoid wearing high-heeled shoes and instead opt for comfortable low-rise shoes.
Stay mindful of your posture throughout the day. Constantly evaluate how you're sitting and standing. Are your shoulder blades pulled back and down? Are you slumping or slouching in your chair? Are you leaning forward while you stand and work? Postural awareness can go a long way toward improving your posture over time.
“It’s important to improve your awareness of your posture by looking in a mirror often to check your natural resting position, checking in with your body and how it feels periodically, setting an alarm on your phone to remind you to straighten up, and taking frequent stretch breaks,” says Dr. Ferri.
Doctors, chiropractors and physical therapists
Medical professionals can help you outline an effective treatment strategy to improve your posture. They can monitor your progress and increase or decrease intensity depending on how your body responds to treatment. Moreover, they can help identify underlying causes that could cause serious health issues down the road. If you're concerned about your posture, seeking medical advice before you self-treat is always a good idea.
“Correcting bad posture requires more than just a few simple stretches or exercises. It is important to identify the underlying causes of poor posture in order to make lasting changes,” says McSorley. “In some cases, physical therapy may be necessary to correct kyphosis, as well as lifestyle modifications such as sitting in proper ergonomic chairs or using a standing desk to help encourage better posture.”
How long does it take to correct posture
Ultimately, your posture correction timeline depends on your condition, its cause and its severity. In many cases, you can begin to see results in just a few weeks of treatment. Permanent fixes can take months and, in some cases, a year or more. The proper treatment plan and consistency are critical to success.
That said, proper posture is a lifelong pursuit.
“It is intended to be a consistent practice that you are always adjusting and paying attention to,” says Dr. Ferri. “But you should begin to see the fruits of your labor in a few months if you are consistent with exercising, stretching and adjusting how you sit and stand.”
Many people struggle with poor posture, but you don't have to fall victim to its long-term health consequences. Consult a medical professional and outline a treatment plan that includes a combination of exercises, stretches, yoga, posture correctors, ergonomics and awareness, and you can begin to decrease pain, stand taller, look slimmer, increase confidence and feel better.