Low Back Pain is often times a mystery, especially in the early stages. In my 15 years as a chiropractor in San Francisco, I have discovered that one of the most important things that is often overlooked when diagnosing back pain, is posture. In the chiropractic world, your posture is often referred to as "the window to the spine." If we examine your posture ( see diagrams ) from the front , your ears, shoulders, and hips should be level. When your ears, shoulders and hips are level, the spine is usually straight. From the side, we should be able to draw an imaginary line from your ear lobe, through your shoulder, your knee, and the front of your ankle. This is the ideal position for the spine to be in. When in this position the spine can resist the forces of gravity and motion at optimum levels. But, because we do things like sit at a desk all day. Carry heavy backpacks on one side of our body. Carry children and lift and work in awkward positions, etc. , we tend to lose this normal alignment . Our posture will adapt to external forces just like a trees branches would if exposed to wind every day in the same direction. The thing is, this can lead to postures such as " Forward Head Posture", which can put increased loads on our cervical (neck) joints and discs, and cause our neck muscles to work much harder than they should just to hold our heads up. This leads to fatigue and chronic pain, as weel as many other probems ( see latest research ). But, in addition to this obvious effect, Forward Head Posture (FHP) can also lead to low back pain. When the cervical curve is diminished and the weight of the skull (about the weight of a bowling ball) is transfered anterior to the body where there is no support, it puts extra stress on the disc in the low back (lumbar spine). This can result in increased intradiscal pressure, reduced blood flow to the joints, muscles, tendons, and ligaments. This can also lead to inflammation and pain. But, you go to the doctor and everything checks out OK. How can this be ? Well, not all doctors are trained in biomechanics of the spine. In fact, the normal course of treatment would most likely be a pain pill or anti-inflammatory medication. The poor posture would not even be addressed. So the condition is left intact, and will continue to march forward, potentially leading to degenerative disc disease, stenosis, or spinal degeneration. Anyway, the importance of posture should not be overlooked. Make sure that if you have back pain you seek the advice of a chiropractor or therapist that is fluent in biomechanics of the spine, so that you can get the right kind of treatment.