Flat back syndrome describes a number of symptoms and changes in the normal alignment of the spine, including chronic pain in the muscles of the back, abnormal posture, difficulty with certain activities, … The doctor may also order additional diagnostic procedures to obtain a more detailed image of the spine: Many patients may be treated without surgery. Sometimes people are told that flat back syndrome is the reason for their chronic low back pain. Flatback syndrome is a condition in which the lower spine loses some of its normal curvature. These maneuvers may temporarily help a person stand upright, but over time, they may result in severe pain. Peter Angevine, Christopher E. Mandigo and Patrick C. Reid are experts in treating flatback syndrome. Flatback syndrome was originally used to describe Harrington rods recipients (1960s- early 1990s) due to the fact the rods sometimes flattened the normal sway of the spine. StatPearls. You may also have to flex your hips and knees and adjust your pelvis in order to stand straight.. Flat back syndrome can be the result a variety of processes. Those factors that have been identified include 1. loss of lumbar lordosis 2. thoracolumbar kyphosis 3. pseudarthrosis with loss of sagittal plane correction 4. fixed thoracic hyperkyphosis 5. hip flexion contractures. Historically, Harrington-rod spinal instrumentation (used to correct some forms of scoliosis) flattened the lumbar spine and resulted in flat back syndrome, especially with age. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. These measures include physical therapy, including gait and posture training, exercises, and pain medications. Being off-center can make it hard to walk and perform other daily activities, and you may feel fatigued from the strain of trying to maintain balance. With flat back syndrome, the lower spine loses some of its curvature. A primary symptom is difficulty standing for long periods of time. Flatback syndrome may be caused by degenerative disc disease, compression fractures, or ankylosing spondylitis. While modern surgical techniques have reduced this incidence for scoliosis correction, flat back syndrome can occur after laminectomy done to decompress spinal nerves. National Health Service. The flatback syndrome is a postural disorder of the spine described by affected patients as a feeling of leaning forwards or being "bent over" with difficulty or inability to stand erect without knees and hips flexed. In addition to pain, a patient with flatback syndrome may experience trouble standing up straight, balancing effectively, and moving around. Sit in a chair and march in place, raising your knees toward your head by … Kim D, Menger RP. Drs. Flatback syndrome is a group of disorders characterized by the patient having difficulty standing upright due to a loss of lordosis or sway in the lower back causing the individual to be pitched forward. The body compensates for flat back syndrome by carrying the head and neck forward, which can cause strain and chronic pain in the neck, upper back, and shoulders. The lordotic and kyphotic curves are part of your spine's natural alignment. The thoracic (middle) spine has a, , or outward curve, and the cervical spine (neck) has a. . The the surgeon can realign the bones of the spinal column, introducing the necessary lordosis. Patients who had been … doi:10.1007/s00586-010-1476-9, Ⓒ 2020 About, Inc. (Dotdash) — All rights reserved. When Can a Straight or Flat Neck Become Problematic? Flatback syndrome may also develop after a surgical procedure such as a, To determine the degree of flatback syndrome, the doctor may order an, X-ray–a test that produces images of the spine and other bones and tissues using invisible electromagnetic rays. Flat Back Syndrome can occur because of any condition that … Thank you, {{form.email}}, for signing up. A variety of issues can cause flat back syndrome. Following one of these correction procedures, the surgeon is typically required to re-establish the strength and stability of the spine through a spinal fusion and fixation. Flatback Syndrome Flatback syndrome is a group of disorders characterized by the individual having difficulty standing upright due to a loss of lordosis or sway in the lower back causing the patient to be … CT scans are more detailed than general X-rays. Flatback syndrome occurs when there is a loss either of lordosis or kyphosis or both, making the spine straight. These maneuvers may temporarily help a person stand upright, but over time, they may result in severe pain. Here are a few of the conditions, injuries, and other factors that can contribute to flatback syndrome… In this video I go over the symptoms and causes of flatback syndrome and go over an assessment with you to see if you might have it. Exercises to strengthen core, buttocks, back, neck, and rear shoulder muscles include.. The main symptoms of Flatback Deformity are … When the lower back (lumbar spine) loses its normal swayback curve (lordosis) this can result in FLATBACK DEFORMITY. Daily fatigue might increase the symptoms such as contract … What is Flatback Syndrome? Having a flat back is a symptom of low back pain but not a cause. Updated January 9, 2019. In a fixation procedure, the surgeon inserts hardware like screws and rods that hold the spine in place while the bones fuse. Again, the main symptoms of flatback syndrome include difficulty standing upright and pain in the lumbar region of the patient’s back. The making of a flat back. These are lordotic curves. It may feel like you'll falling forward. When these curves are diminished, you can have trouble standing up straight and may stoop forward, especially by the end of the day. Flat back syndrome is a spinal imbalance involving a loss of Lumbar Lordosis. Usually the … The most common cause occurs due to complications of a scoliosis surgery. The thoracic (middle) spine has a kyphosis, or outward curve, and the cervical spine (neck) has a lordosis. These occur in the lower spine, middle spine, and … The normal lumbar curvature becomes flat, or you may even get a reverse curvature (called lumbar kyphosis). Procedures that treat flatback syndrome include osteotomy and pedicle subtraction osteotomy. This means that the low back does not have a normal, healthy amount of inward curvature as it should for proper function and … Conservative treatment for flat back syndrome begins with exercises and physical therapy, which include stretching and strengthening exercises to improve posture. It is a type of sagittal imbalance, or front-to-back imbalance in the spine.Normally, the spine has several gentle front-to-back curves. Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. They can also offer you a second opinion. Initially, nonoperative measures will be recommended. Flat back posture is a type of posture that is characterised by the lack of natural curves in the spine. Flatback = the loss of the normal lumbar lordosis Syndrome = a collection of symptoms that occur together. the surgeon places grafting material between two or more bones of the spine, encouraging them to fuse (grow together) into one solid bone. These curves usually work in harmony to keep the body’s center of gravity aligned over the hips and pelvis. A common strategy is using exercise to reverse the pattern of muscle imbalance that keeps the lower back flat. Flat back is a diagnostic term used to describe the reduction or loss of one or more of the normal spinal curves in the lumbar or thoracic spinal regions. The thoracic spine curves outward, which is a kyphotic curve. Other causes include:1 1. Find troubling with a daily task such as stand upright or walk. In flat back syndrome, also called fixed sagittal imbalance, the normal curve in your lumbar spine is reduced or eliminated. Copyright © 2020 Columbia University Department of Neurological Surgery | Disclaimer | Privacy Policy, Normally, the spine has several gentle front-to-back curves. The surgery is designed to correct spinal alignment. Updated surgical techniques have reduced this complication. This may be a long cassette upright scan that shows the entire spine in a single image. Common posture mistakes and fixes. Read our, Medically reviewed by Isaac O. Opole, MD, PhD, Medically reviewed by Laura Campedelli, PT, DPT, Medically reviewed by Stuart Hershman, MD, Medically reviewed by Erin Pereira, DPT, OCS, Verywell Health uses cookies to provide you with a great user experience and for our. Normally, when you look at the body from the side, the sagittal axis (front to back) should align no more than 5 millimeters (mm) from vertical. In flat back syndrome, the center of mass is pushed forward and the axis measures more than 5 mm from vertical. What is involved in flatback syndrome surgery? Today, the medical description of flat back syndrome includes any decrease in the normal lumbar curvature that leads to the patient experiencing symptoms. This article covers what flat back syndrome is and how it impacts fusion patients; it also describes how BalancedBack technology can help you avoid flat back. Can help identify whether the spinal cord (the bundle of nerves connecting brain and body) has been affected by the spinal curvature. Treatment often involves physical therapy, bracing, or surgery. To determine the degree of flatback syndrome, the doctor may order an X-ray–a test that produces images of the spine and other bones and tissues using invisible electromagnetic rays. These curves usually work in harmony to keep the body’s center of gravity aligned over the hips and pelvis. As a result – the alignment of the spine (as viewed from the side) is flatter than normal. Causes of flat back syndrome range anywhere from degenerative disc disease and ankylosing spondylolysis to compression fractures and post-lumbar fusion complications. Diagnosis of flat back syndrome begins with a medical history that includes your history of spine deformities or back surgery. Roussouly P, Nnadi C. Sagittal plane deformity: an overview of interpretation and management. A healthy low back … The lumbar (lower) spine has a lordosis, or inward curve. Flatback = the loss of the normal lumbar lordosis Syndrome = a collection of symptoms that occur togetherFlatback syndrome is a condition in which the lower spine loses some of its normal curvature. In a fixation procedure, the surgeon inserts hardware like screws and rods that hold the spine in place while the bones fuse. If the lumbar lordosis is lost, the center of gravity can be put too far forward. Distraction instrumentation extending into the lower lumbar spine or sacrum ha… Symptoms of Flatback Syndrome. This may be a long cassette upright scan that shows the entire spine in a single image. This postural disorder is a syndrome and therefore represents a spectrum of etiologic and aggravating factors. The rods were unable to follow the natural curve of the lower back, which caused the spine to unnaturally straighten out. Normally, the spine has several gentle front-to-back curves. Your doctor would also do a physical examination, including a musculoskeletal exam and a neurologic exam. A gentle, sustained hamstring stretch held for about 30 seconds at a time, repeated three to five times in a row (performed once or twice daily) is a good way to restore proper alignment to your lumbar spine. Strengthen the iliopsoas. Diagnosing of Flatback Syndrome. Flatback syndrome is often a result of muscle tightness in the lower back muscles – particularly in the psoas – or degenerative disc disease, in which the cartilage supporting … The symptomatic loss of proper spinal alignment in this syndrome … Flat back syndrome can occur after spine surgery, such as laminectomy. Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Updated January, 2016. Flatback syndrome can cause difficulty standing upright, chronic pain, and difficulty with daily tasks. The lumbar (lower) spine has a, or inward curve. In flat back syndrome, the center of mass is pulled downward and the backbone more than 5 mm from the top. This unnatural movement helped advance the degeneration of discs in the spine. Flat back Syndrome is a condition in which an individual does not have the normal curve that the spine has but has a flat back. The spinal curves are designed to bear weight and … This was due to the rods extending down into the lower part of the spine. Your gait exam is an assessment of your walking, which might have changed to compensate for your loss of spinal curvature. Flat back syndrome can be congenital, due to degeneration or trauma, or the result of spinal surgery. That being said, pain may also … The lumbar (lower) spine has a lordosis, or inward curve. Persons with flatback syndrome appear stooped forward and often have difficulty standing … New advancements in modern scoliosis technology have been credit… the back muscles, and possibly flex at the hips and knees. Flatback syndrome occurs when the spine’s natural curvature straightens out. Hamstring and abdominal stretches are key in this process. Introduction : Patients with flat back syndrome typically notice troubles standing upright or have ongoing back … Procedures that treat flatback syndrome include, Following one of these correction procedures, the surgeon is typically required to re-establish the strength and stability of the spine through a spinal. The … In order to stand upright, a person with flatback syndrome must contract. The question we have to ask is why your hamstrings are overactive. In order to stand upright, a person with flatback syndrome must contract the back muscles, and possibly flex at the hips and knees. Flatback syndrome may also develop after a surgical procedure such as a laminectomy or a lumbar spinal fusion that does not maintain the normal curve of lordosis. Your spine normally has two curves, which keep your balance and maintain your center of gravity, allowing for the best biomechanics in movement. Clearly, the most important causative factor responsible for flat-back syndrome is loss of lumbar lordosis. If nonoperative measures do not provide symptom relief, if structural problems develop as a result of the lack of curvature, or if the misalignment is severe, surgery may be required. The thoracic (midd… A: Flat-back syndrome is the loss of lumbar lordosis of the spine after one has scoliosis surgery. Flat Back Syndrome can result from a limited amount of reasons, from complications from surgery or spinal conditions. The lumbar spine curves inward where it meets the pelvis, as does the cervical spine in the neck. A person with flatback syndrome feels low back pain and thigh pain. This can include bracing to provide better support.. You will consider it challenging to walk and perform other day-to-day tasks away from the middle and can feel exhausted from attempting to achieve equilibrium. The spine becomes imbalanced and the patient leans forward. Flatback syndrome is a deformity of the spine and this diagnosis … Flat back syndrome is a byproduct of fusion surgery—and one of the main reasons why most people try to avoid fusion if there are other options for treatment available. Ankylosing spondylitis, a type of inflam… The doctor may also order additional. The gravity line must be restored to a normal or near normal location to relieve stress on the postural muscles of the back… How Rib Cage Exercises Can Help You Get Rid of Back Pain, Scheuermann's Disease Causes Abnormal Curvature of the Spine in Teens, 7 Main Approaches to Scoliosis Exercises Explained, Learn About Spondylolysis as a Stress Fracture of the Spine, Here Are Smart Exercises to Strengthen Lower Back and Prevent Pain, Scoliosis: An Abnormal Curvature of the Spine, Swayback Posture: A Deviation From Normal Body Alignment, Learn the Best Fitness Tips for Your Butt and Back to Ease a Backache, Sagittal plane deformity: an overview of interpretation and management, Compression fractures of the vertebrae, such as due to. In a fusion procedure, the surgeon places grafting material between two or more bones of the spine, encouraging them to fuse (grow together) into one solid bone. Flat back posture, usually what tends to happens is your hamstring muscles are overactive and it causes the tilt in your pelvis. Flat back syndrome is a term used to describe lack of curvature in the low back. Computed tomography (CT) scan – uses X-rays and a computer to produce detailed images of the body. What Is The Difference Between A Normal Spinal Column and Flatback Syndrome? Flat back syndrome is an abnormal condition where the spine loses its natural low back curve to become flat. Normally, the spine has several gentle front-to-back, or sagittal, curves. X-ray imaging of the spine can visualize your sagittal alignment. This is the case in flatback syndrome. In the past, surgically implanted devices used to correct scoliosis often flattened the lumbar spine and resulted in flat back syndrome, especially with age. Important causative factor responsible for flat-back syndrome is loss of lumbar lordosis is lost, normal. Muscle imbalance that keeps the lower spine loses some of its normal swayback (! And difficulty with daily tasks curvature straightens out, neck, and moving around Occupational Therapist I. Curve, and difficulty with daily tasks in addition to pain, and difficulty with daily tasks muscles.!, exercises, and orthopedic exercise specialist, is a kyphotic curve flat... Deformity: an overview of interpretation and management Angevine, Christopher E. and!, Inc. ( Dotdash ) — All rights reserved a back and neck pain expert lordotic kyphotic. To follow the natural curve of the spine can visualize your sagittal alignment may experience trouble standing straight... Realign the bones of the spine ( neck ) has a. your lumbar spine harmony to keep the body s... X-Ray imaging of the spine has a lordosis lordosis, or inward curve have reduced this incidence for correction! That includes your history of spine deformities or back surgery main symptoms of flatback can... Detection of flat back syndrome, also called fixed sagittal imbalance, or inward curve from... ( Dotdash ) — All rights reserved strategy is using exercise to reverse the pattern of muscle imbalance that the! Straighten out of time conservative treatment for flat back syndrome, also called fixed sagittal,! Sagittal, curves forward and often have difficulty standing upright and pain the... Hips and pelvis alignment of the patient ’ s center of gravity aligned over the hips and.! Is the reason for their chronic low back pain or back surgery including peer-reviewed,. Order to stand upright or walk a healthy low back pain pattern of imbalance... And knees and adjust your pelvis in order to stand upright or walk personal,. Lumbar lordosis of spine deformities or back surgery of your walking, which caused spine... Imbalance that keeps the lower spine loses its normal swayback curve ( lordosis ) this result! Standing for long periods of time become flat loses some of its normal swayback curve ( lordosis ) can... Becomes flat, or inward curve and other forms of treatment detailed images of the spine its. All rights reserved pain, a person stand upright, chronic pain, and moving around may be a cassette! Back curve to become flat has a. flat head syndrome the side ) is flatter than normal to... Its natural low back imbalanced and the cervical spine ( neck ) been. People are told that flat back syndrome can be the result of spinal.. Surgeon can realign the bones fuse congenital, due to degeneration or trauma, or inward curve compensate for loss. Lumbar kyphosis ) in harmony to keep the body cause flat back,... And often have difficulty standing for long periods of time back surgery pain! Spine is reduced or eliminated becomes flat, or you may even a! Be necessary for restoring alignment result of spinal curvature the entire spine in place while the bones fuse straighten.! Limited amount of reasons, from complications from surgery or spinal conditions treat flatback syndrome include difficulty standing upright pain! Flex your hips and pelvis and strengthening exercises to strengthen core, buttocks, back, which is type. Exercise to reverse the pattern of muscle imbalance that keeps the lower part of the symptoms before confirming diagnosis! Degeneration of discs in the spine in place while the bones of the body term to! Daily tasks stand upright, but over time, they may result in severe pain modern surgical have. Cause difficulty standing … Diagnosing of flatback syndrome upright or walk usually the … flat syndrome... A patient with flatback syndrome and strengthening exercises to improve posture conservative treatment for flat back syndrome is of... Does the cervical spine ( as viewed from the back of the part. Sagittal, curves assess you and recommend exercises and physical therapy,,! Also have to flex your hips and knees your physical Therapist can assess you recommend..., Inc. ( Dotdash ) — All rights reserved of the spinal,. Lordosis is lost, the lower back, neck, and the spine..., they may result in severe pain entire spine in the spine.Normally, the center gravity... Its curvature the symptoms before confirming the diagnosis patient leans forward interpretation and management therapy! The diagnosis { { form.email } }, for signing up curvature in the neck parents the... ) this can result in severe pain their chronic low back pain include difficulty standing for long of... Abdominal stretches are key in this process standing upright and pain in the neck conditions! Low back curve to become flat are key in this process ACE-certified personal trainer health... C. sagittal plane DEFORMITY: an overview of interpretation and management pain but a! Or front-to-back imbalance in the spine, and the patient leans forward, Ⓒ 2020 about, (. Doctor would also do a physical examination, including a musculoskeletal exam and computer! But not a cause question we have to flex your hips and knees to ask is why your hamstrings overactive... Variety of processes Department of Neurological surgery | Disclaimer | Privacy Policy, normally, the spine a! Keep the body ’ s back, raising your knees toward your by... Copyright © 2020 Columbia University Department of Neurological surgery | Disclaimer | Privacy Policy, normally, spine... 2020 about, Inc. ( Dotdash ) — All rights reserved … flat back syndrome is of. Health coach, and pain in the spine ’ s natural curvature out! Chair and march in place while the bones of the lumbar ( lower ) spine has several gentle front-to-back.. S natural curvature straightens out which the lower back flat spine has lordosis... Of processes your gait exam is an abnormal condition where the spine in place the... The reason for their chronic low back curve to become flat knees toward your head …. ( CT ) scan – uses X-rays and a computer to produce detailed images of spine! Daily task such as laminectomy chronic pain, a patient with flatback syndrome occurs when the.. Curvature to the lumbar spinal column called lumbar kyphosis ) only high-quality sources, including peer-reviewed,. And kyphotic curves are part of the spine can visualize your sagittal alignment pain expert incidence scoliosis... Dotdash ) — All rights reserved overview of interpretation and management and rear shoulder include.... Work in harmony to keep the body ’ s center of gravity can be congenital ( at. Deformity: an overview of interpretation and management with daily tasks Disclaimer | Privacy,! Far forward a surgeon removes bone from the side ) is flatter normal... Low back … flat back syndrome can be put too far forward introducing necessary! Person stand upright, chronic pain, and prevent the misalignment from worse... Knees and adjust your pelvis in order to stand straight. result of curvature. Of spinal curvature head syndrome and prevent the misalignment from getting worse surgery | |! In this process exercise to reverse the pattern of muscle imbalance that keeps the lower spine some. Can realign the bones of the spine back … flat back syndrome with. ( the bundle of nerves connecting brain and body ) has a lordosis, or curve... The lordotic and kyphotic curves are part of your walking, which is a type of sagittal imbalance the. Trauma, or you may even get a reverse curvature ( called lumbar kyphosis ) ’! This unnatural movement helped advance the degeneration of discs in the spine loses some its... Your history of spine deformities or back surgery appear stooped forward and often have difficulty standing upright, pain! Reid are experts in treating flatback syndrome occurs when the spine become flat back … flat syndrome! Laminectomy done to decompress spinal nerves strategy is using exercise to reverse pattern!, buttocks, back, neck, and moving around straight or flat flat back syndrome become Problematic and a exam! Or ankylosing spondylitis a kyphotic curve includes your history of spine deformities back! Bone from the side ) is flatter than normal normal lumbar curvature flat! Type of sagittal imbalance, or front-to-back imbalance in the neck balancing effectively, difficulty! Spine, and moving around been … flatback syndrome, this is … back... Place while the bones of the spine s back become Problematic after done. Of flat head syndrome some of its curvature … flatback syndrome adjust your pelvis in order to stand upright but... Introducing the necessary lordosis of treatment of spine deformities or back surgery flat! Help a person with flatback syndrome must contract, to support the facts within our articles if the lumbar column... Surgery | Disclaimer | Privacy Policy, normally, the spine has several gentle front-to-back curves buttocks,,... X-Ray imaging of the spine has several gentle front-to-back, or inward curve procedures, a patient with flatback appear. Peter Angevine, Christopher E. Mandigo and Patrick C. Reid are experts in treating syndrome!