Poor posture is often an underlying cause of back pain. For every inch the head moves forward, its weight on the neck and upper back muscles increases by 10 pounds. A head weighing 12 pounds held forward 3 inches from the shoulders equals 42 pounds of pressure on those aforementioned muscles, the equivalent of three watermelons resting on the neck and back. This added force can cause muscle fatigue and joint pain as the day wears on.

Maintaining the natural curve in your lower back helps prevent posture-related back pain. This curve works as a shock absorber, distributing weight all along your spine. Sitting or standing stooped over with a rounded back and not holding the neck up often causes pain. Imagine a plumb line hanging from ceiling to floor. It should run through your ear, shoulder, hip bone and just in front of your outer ankle if you’re standing straight. When you’re sitting, the plumb line should run through your ear, shoulder and hip. When you stand and sit properly, your spine and body have less strain and stress.

Good posture is a matter of awareness. Correct your posture throughout the day. Lift your chest bone up. Hold your stomach muscles in. Keep a gentle curve in your lower back. Make sure your hips don’t tilt forward or backward. If you sit most of the day, put a small pillow behind your lower back to support your spine

Core exercises strengthen the muscles in your abdomen, back, hips and pelvis. The stronger your core, the less likely you are to strain your back or neck. Yoga and Pilates help strengthen your core and increase flexibility. It sounds old fashioned, but balancing a book on your head can improve your posture. Try to hold the book for 10 seconds to start, working up to 60 seconds at a time.

Do the following exercises lying on your back with your knees bent and feet on the floor, hip width apart (hold each 3 seconds and repeat 10 times):

• Head press. Place arms at sides, palms facing up. Tip chin toward throat; hold. Sink the back of your head into the floor.
• Elbow press. Place both hands behind your head. Press elbows down into the floor.
• Chest lift. Place arms at sides, palms facing up. Press shoulder blades down into the floor; at the same time lift your sternum toward the ceiling.
• Bridge. Tighten abdominal muscles, then raise buttocks off the floor until your hips are in line with your knees and shoulders. Don’t tilt your hips.

Do these exercises while lying on your stomach on the floor  (hold each 3 seconds, repeat 10 times):

• Press up. Place palms at shoulder level. Using arms, push upper body up, doing the work with your arms and leaving hips and legs on the mat.
• Superman. Extend both arms straight over head. Keeping your right arm and left leg straight, lift both one to two inches toward the ceiling. Repeat with the left arm and right leg.

These stretches can be done anytime during the day:

• Chin tuck. This exercise can help reverse forward-head posture by strengthening the neck muscles. You can do it sitting or standing. Roll your shoulders back and down. Look straight ahead and place two fingers on your chin. Slightly tuck your chin and move your head back. Hold for 3 to 5 seconds, then release. Repeat 10 times. If you’re in a parked car, press the back of your head into the headrest for 3 to 5 seconds. Do 15 to 20 repetitions.
• Goalpost squeeze. Sitting upright, lift your arms up into a goalpost position with your elbows bent at a 90-degree angle, even with your shoulders. Relax your shoulders down, then pull the elbows towards the back of the room. Imagine you’re squeezing a marble between your shoulder blades as you work the upper back. Release. Repeat 10 times.
• Reverse high five. While standing, shrug your shoulders up towards your ears, then relax them. Turn the palms to face the back of the room. Press your hands back as if you’re trying to give someone a double high five. Pulse 10 times.
• Chest opener.  Clasp your hands behind your back and push down towards the ground while reaching the arms away from the back. Open your chest and lift your head up; feel a stretch across your chest. Hold for five breaths, then release.

You should see a difference in your posture in three to six weeks if you do these exercises three times a week. If any of the exercises feel too difficult or cause pain or strain, discontinue them until you see a doctor or physical therapist.