Could Sitting Up Straight Actually Aggravate Your Back Pain?  

IF you’re sitting there thinking, “Hold up, this goes against everything I’ve been told!” Well, you’re not alone. That’s often the reaction we get when folks start working with us. 

I’m Jia Li, a Doctor of Physiotherapy and the founder of PhysioX, a holistic physiotherapy practice in Needham, MA. Although we established our physical presence in 2022, we previously operated entirely online, helping those with back pain who had seen no results from previous physical therapy, chiropractic care, acupuncture, shots, or surgeries achieve lasting results.  

You might be skeptical, thinking, “This is getting more ridiculous! How could you possibly have helped all these people without any in-person interaction? By the time you finish reading, everything will start to make more sense as you’ll gain fresh insight into how our body actually works. Not only that, you’ll also discover an easy exercise in sitting that could change the way you move and feel. 

My journey began when my mother developed chronic back pain from manual labor. I tried all the textbook tricks – stretching, hip strengthening, core strengthening, posture – no results. In an effort to solve this puzzle, I started to seek knowledge from experts in different disciplines from various parts of the world. Little did I know, this journey would flip my understanding of the human body on its head.  

I began to realize graduate studies weren’t enough. The old method focused on one body part at a time. This insight originated from examining cadavers (dead bodies). A living breathing human is much more complex. Here is what I found: 

Every part of the body is interconnected, and the nervous system is in charge of coordinating it all together. It protects us and helps us survive. For instance, it makes us limp if we sprain an ankle so we can continue to walk. Now, let’s consider how this protective mechanism might work against you in the context of back pain. 

Imagine this, you threw out your back lifting a couch. Your back seized up, and every time you bend over, you feel pain. Your nervous system sends you this pain signal so you don’t continue to make things worse. You go see your doctor or PT, and they tell you to stop bending over, stop slouching, and to sit upright. You follow this advice, and eventually, you feel better. Two weeks go by, and you throw your back out again lifting groceries.  

In your frustrated state, you commit yourself to stop rounding your spine and always sit upright. You keep this up for months, maybe even years. You haven’t experienced another episode of back pain since. This strategy must be working! 

But something strange starts to happen to your nervous system. As you continue to avoid rounding your spine, your nervous system becomes more sensitive to that motion, thinking the motion is still dangerous. 

Eventually, your back muscles start to get stiff and uncomfortable while sitting, no matter how tall you sit. You start to skip vacations because you can’t endure long plane rides, and doing any exercise other than walking is out of the question. The issue is no longer the initial back injury, but an overactive nervous system trying to protect you unnecessarily. 

After working with hundreds of clients with longstanding back pain, I discovered that most people do not need “better posture” or “stronger core.” Rather, they simply needed to rewire their nervous system to accept that all the movements they have been avoiding are actually safe. 

Although it can be helpful in the beginning, this process does not require someone putting their hands on you. The only way to rewire your nervous system is through specific movements that you must perform yourself.  

Great, how do I start this rewiring process for myself? If you’ve read this far and everything made sense to you, then you have already started. Believing that it is safe to round/slouch is your starting point. But, you might be looking for a bit more than “just believe!” If so, try this simple drill we’ve used for hundreds of our back pain clients.  

Seated Slouch Breathing Drill 

  • Sit on the edge of your chair. Take a breath in through your nose and let out a big exhale with a giant sigh through your mouth while reaching towards the ground with your fingertips and allowing your head to drop downwards.  
  • Make this exhale very long. You will notice the longer you exhale, the further rounded your spine becomes and eventually you might even feel a stretching sensation happening in your back.  
  • Inhale slowly through your nose and imagine bringing the air into those tight areas of your back and it’s blowing up like a balloon from the inside.  
  • Repeat this 5 times and reach closer to the ground as you feel more comfortable. The stretching sensation may feel very strong in the beginning if it has been a while since you’ve moved in this way. Listen to your body and don’t push past what your body will allow.  

 This practice accomplishes two important things: 

  • The long exhales relaxes your nervous system and brings it to a rest and digest state (the state required for healing to happen). 
  • Lengthen your back muscles in ways you normally can’t get to with traditional stretching. 

When it comes to human movement, there are no hard rules. In many cases, it is the rules that we set for ourselves that prevent our bodies from moving as nature intended it.  

PhysioX has since expanded to treat other musculoskeletal pains, but our emphasis on rewiring the nervous system remains the same. We believe movement shouldn’t feel like a chore. It should be seamless. When your body flows effortlessly, the mind unwinds, and pain naturally dissipates. 



Dr. Jia is the founder of PhysioX, a holistic physiotherapy practice in Needham, MA, specializing in helping people retrain their nervous system to move like it did before all their injuries happened, so they can live their life uninterrupted by pain.