Mr. K sat in the hospital bed clutching his chest. Over the last few weeks, he had episodes of sudden chest discomfort with tingling going down his left arm. He had been through numerous tests including a stress test, a CT scan of the chest and a specialized CT scan of the heart to evaluate the blood supply to the heart (CT coronary angiography). All the results were normal.

Instead of the relief associated with normal results, he was getting more concerned as no one understood the reason for his chest discomfort. As a home remodeler, he hadn't been able to work for the last few weeks. The episodes were debilitating to the point that he couldn't talk for those few minutes, let alone going up and down ladders.

As the cardiologist on call for the hospital, the nurse called me as Mr. K had another episode that failed to improve with medicines. As he narrated his episodes, he mentioned the episodes were worse while driving his truck but did not change with walking. I recognized a familiar pattern because I had experienced something similar few years ago. I asked him to bend his neck backwards and turn towards his left. This maneuver made the pain worse and he immediately went to bending his neck forwards which helped ease the pain. I stepped behind him and gradually pulled his shoulders backwards. This started easing his pain and tingling.

In that moment, we had our diagnosis - cervical radiculopathy. A nerve in his neck was pinched or irritated. This is often related to awkward neck postures. By the time he saw a spine surgeon, the pain was already improving with neck and upper back exercises. So, the spine surgeon advised physical therapy. Instead of losing weeks to recovrery from surgery, he was back at work the following week with a posture corrector device.

5 Steps to a Better Posture

Step 1: Assess Your Current Posture

• Stand in front of a full-length mirror.
• Observe your body alignment from head to toe.
• Check if your ears, shoulders, hips, knees, and ankles are in a straight line.
• Look for any asymmetry or imbalances in your posture.
• Take note of any areas that appear rounded, hunched, or misaligned.

Step 2: Identify Postural Imbalances

• Perform a wall test by standing with your back against a wall.
• Check if your head, shoulders, and buttocks touch the wall.
• Assess if there's a gap between your lower back and the wall.
• Note any difficulty in maintaining this position.
• Identify areas of tension or discomfort while holding this posture.

Step 3: Strengthen Postural Muscles

• Consider incorporating exercises that target the core, such as planks and bridges.
• Perform shoulder blade squeezes to strengthen upper back muscles.
• Practice chin tucks to improve neck alignment.
• Consider including exercises that focus on hip and glute strength.
• Gradually increase the duration and intensity of these exercises.

Step 4: Improve Flexibility and Mobility

• Stretch chest muscles to counteract rounded shoulders.
• Perform neck rotations and side bends to improve cervical mobility.
• Use foam rolling techniques on the upper back to release tension.
• Practice hip flexor stretches to improve lower back posture.
• Consider incorporating yoga or Pilates to enhance overall flexibility and body awareness.

Step 5: Implement Postural Habits

• Set up an ergonomic workstation to support proper posture.
• Use a posture corrector device for short periods to reinforce good alignment5.
• Take regular breaks to stand, stretch, and reset your posture.
• Practice mindfulness throughout the day to check and correct your posture.
• Gradually increase the time spent maintaining proper posture in daily activities.

By following these steps, you can work towards improving your posture and potentially reducing back and neck pain. Remember that posture correction is a gradual process that requires consistency and patience.