What the media says about posture and pain is the opposite of what science says.
Recently, I saw a New Yorker article on Instagram where the reporter interviewed several people, including a chiropractor and a founder of a posture corrector device company, about the dangers of certain postures and what their products can do to solve the problem. I stopped reading about one-third of the article and checked its date: March 22, 2021.
2021—not 2001. It’s 2021 and people are still talking about how to fix posture and how certain postures can mess up our back. It is not just “The New Yorker.” Look up the keyword “posture” in any major publications like “The New York Times” and “The Guardian,” and you’ll find ads that promote products and courses that sell you the idea that there is something wrong with you.
I can see leading pain researchers like Dr. Peter O’Sullivan and Dr. Bronnie Thompson facepalming.
I thought about how much more work Keith Meldrum and Joletta Belton have done to help clinicians and the public understand what people with chronic pain are going through. Would their work backfire if the prevailing message about posture and pain are running rampant on the Internet?
I guess if you were to tell the story over and over again for generations, people would believe it with little question. This is very similar to how the mass media affects our beliefs about our health, such as our posture.
I recently watched two documentaries, “Reel Bad Arabs: How Hollywood Vilifies a People” (2006) and “Reel Injuns” (2009), that made me think about how much influence mass media has on our narratives about not only people but also our health. These films describe how more than a century of negative stereotypes of Arabs and Indigenous Americans in film, TV, and advertising had shaped our common misperceptions about these groups of people. These portrayals and narratives do not reflect the reality of who they are.
It’s what we also see in health and fitness advertising and TikTok videos.
The research about pain is out there, but its message is not reaching out as far and wide as the messages mass media has created for decades. Are journalists not looking deep enough or at the right places for this source of information? Where’s the responsibility in reporting and fact-checking? I thought journalism is about “seek truth and report it” and “take responsibility for the accuracy of their work.”
For example, researchers in a German study in 2018 could not find significant differences that distinguish who has low back pain or not based on the angle of the anterior pelvic tilt and lordosis.
A 2016 systematic review of ten studies failed to find a strong relationship between kyphosis and back pain.
Likewise, in a 2020 systematic review of 41 systematic reviews concluded that there is some evidence of an association between various spine postures and low back pain, but only for a short period of time and the “findings are not consistent.” Because these studies have different methods of examining posture and pain, the results are “conflicting.”
“Despite the availability of many reviews, there is no consensus regarding causality of physical exposure to [low back pain],” the researchers concluded.
This misinformation about posture and pain isn’t only just for journalists and patients. Many physical therapists and massage therapists also find such misinformation make their job harder. For Dr. Jason Silvernail, who is a U.S. Army physical therapist, he has been drowning in it for more than 16 years.
“Keep the neuroscience of pain at the forefront, pay attention to the great research coming out on manual therapy mechanisms, and for crying out loud, don’t give patients a giant nocebo by telling them they have fascia restrictions, inhibited muscles, or joints out of place,” said Silvernail in an online forum, SomaSimple, in 2005. “Because then I have to explain to them that that’s not accurate. And that’s exhausting.”
He said it’s less about what therapists do to their patients and more about how you explain why they have pain. Depending on the patient, therapists can explain it to them in a more academic way like Stanford University professor Robert Sapolsky or make up a narrative like pain researcher Dr. Lorimer Moseley.
“Frankly, I’m tired of correcting the messes people make by transmitting these ideas to patients about pain and function that don’t have any relation to modern pain science,” Silvernail said.
On the other hand, are researchers and research-informed practitioners using the right strategies to share such information? If so, why is this myth about posture (like pregnancy massage myths) still hanging around since the 19th century?
Maybe that article in The New Yorker is not journalism but an ad, like the type that you read in a magazine that looks like a story but has a disclaimer on the bottom that says, “This is a paid ad.”
I take heart that there is some progress in media reporting about pain in the last few years, such as a story in “Independent.ie” by Dr. Mary O’Keefe and in “The Conversation” by Dr. Christian Worsfold.
But these more accurate stories are dwarfed by an ocean of campaigns that are selling the public the idea that they need to fix their posture.
Science journalism is hard, and so is building a house or learning to salsa. Fighting misinformation is part of what journalists do to keep politics and public figures in check, and science and health reporting is no different.
If science and public health advocates, like us here at Massage & Fitness Magazine, want to see change in public understanding about pain and posture, we need a better strategy to reach out to the media and the public, not just echo chambers among clinical peers on social media.
Otherwise, we would likely see the same “how to improve your posture” narratives repeat and carry over to the next decade and century—much like stereotypes we carry about people.
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A native of San Diego for nearly 40 years, Nick Ng is an editor of Massage & Fitness Magazine, an online publication for manual therapists and the public who want to explore the science behind touch, pain, and exercise, and how to apply that in their hands-on practice or daily lives.
An alumni from San Diego State University with a B.A. in Graphic Communications, Nick also completed his massage therapy training at International Professional School of Bodywork in San Diego in 2014.
When he is not writing or reading, you would likely find him weightlifting at the gym, salsa dancing, or exploring new areas to walk and eat around Southern California.