[Hinews] [Physician's Column] By Dr. Min-soo Kim, Seoul National University Hospital

SEOUL, South Korea — Neck and back pain are no longer confined to middle-aged or older adults. More young adults in their 20s, and even elementary school children, are now seeking medical care for spinal problems linked to prolonged smartphone use and sedentary lifestyles. The rise in cases of forward head posture and loss of natural cervical curvature highlights a growing public health concern in South Korea and worldwide.

The problem lies in the oversimplification of these conditions. Terms such as 'forward head posture' or 'straight neck' can mislead patients into oversimplified labels. Statements such as “I have a herniated disc but not spinal stenosis” or “I have a straight neck but not a cervical disc issue” reflect widespread misunderstandings that can exacerbate spinal conditions. These misconceptions often arise from insufficient explanation about what the terms mean and why conditions such as cervical disc herniation develop. Experts note that the common underlying mechanism in spinal disorders—whether forward head posture, cervical disc disease, lumbar disc herniation, spinal stenosis, spondylolisthesis, or scoliosis—is forward flexion, the habitual bending of the body forward.

The natural alignment of the spine depends on extension, which corresponds to an upright posture with proper curvature. When the neck or lower back is flexed forward, the spine’s natural curvature collapses. This misalignment can lead to a cascade of problems: lateral curvature (scoliosis), disc herniation, and narrowing of the spinal canal (stenosis). In individuals with spondylolysis, forward flexion can progress to spondylolisthesis, where one vertebra slips forward over another. Although these conditions carry different diagnostic names, they are interconnected and often triggered by the same forward-leaning posture.

Dr. Min-soo Kim, Seoul National University Hospital.
Dr. Min-soo Kim, Seoul National University Hospital.

Spinal disorders are, in many ways, a consequence of bipedal locomotion. Unlike quadrupedal animals, whose spines maintain a natural curve and extension due to posture and organ distribution, humans face unique challenges from upright walking. Upright walking freed our hands for tasks that drove scientific and cultural advancements, but it also introduced a tendency to lean forward during work, study, or device use. This forward tilt places significant vertical stress on the spine, making conscious efforts to maintain upright extension essential for spinal health.

Experts emphasize that simple lifestyle adjustments can prevent many spinal disorders. However, concrete guidance on how to implement these changes is often lacking. One key principle is to extend the concept of spinal extension to the entire body. It begins with the knees, which should be kept straight when standing—a posture that naturally aligns the lower body. Above the hips, the upper body should extend backward to achieve optimal balance. This posture, reminiscent of a gymnast’s finishing pose, not only promotes spinal health but also enhances physical appearance.

Specific exercises can reinforce this alignment. Exercises that extend the lower body and tilt the pelvis backward—such as the 'ducktail posture' when sitting—are simple yet effective. Contrary to common advice, patients with spinal pain should not avoid movement or backward extension, even if discomfort persists. Consistent exercises to restore the spine’s natural curvature are essential for recovery and prevention.

Spinal health does not require complex treatments. The most powerful preventive measures are rooted in daily habits: keeping the head upright and the spine extended. These fundamental practices offer a straightforward yet effective defense against chronic spinal conditions.

저작권자 © Hinews 무단전재 및 재배포 금지
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