Flat back syndrome is also called fixedsagittalimbalance.
With this condition, thenormal curvein your lower spine is reduced or absent.
A major symptom is difficulty standing for long periods of time.
Illustration by Zoe Hansen for Verywell Health
Flat back syndrome can be present at birth.
This article looks at flat back syndrome, its causes, and diagnosis.
It also discusses treatment options.
Yourlumbar spinein your lower back and yourcervical spinein your neck curve inward.
Yourthoracicspinein your upper back curves outward.
These curves are part of your spine’s natural alignment.
They help you balance and maintain your center of gravity.
When these curves are diminished, you’re free to have trouble standing up straight.
You may stoop forward, especially at the end of the day.
You may even feel like you’re falling forward.
To stand up straight, you might have to flex your hips and knees and adjust your pelvis.
In a person with flat back syndrome, the lumbar spine doesn’t have its natural curvature.
You may feel tired from the strain of trying to stay balanced.
In the past, this was common after surgery to correctscoliosis, an abnormal curvature of the spine.
The devices implanted during these surgeries could cause flat back syndrome, especially with age.
Updated surgical techniques have reduced this complication.
You will also undergo a physical exam, including:
A gait exam assesses how well you walk.
This is done because your gait might have changed to compensate for the loss of spinal curvature.
Finally,X-rayimaging will help your doctor see how your spine is aligned.
Other possible sources of your symptoms will need to be considered before the diagnosis can be confirmed.
Treating Flat Back Syndrome
Treatment for flat back syndrome usually begins with exercise and physical therapy.
This typically includes stretching and strengthening exercises to improve posture.
The goal is to reverse the pattern of muscle imbalance that keeps the lower back flat.
Hold the stretch for about 30 seconds at a time.
Repeat three to five times once or twice a day.
Your physical therapist can recommend exercises and other forms of treatment.
This may include bracing to provide better support.
Some patients may need surgical correction.
It can be present at birth or it can happen as a result of surgery or a medical condition.
People with flat back syndrome carry their head and neck too far forward.
This can cause pain and difficulty balancing.
Flat back syndrome can be diagnosed with a medical history, physical exam, and X-ray imaging.
Treatment typically includes physical therapy and exercise, though sometimes surgery is necessary.
Columbia University Irving Medical Center.Flatback syndrome.
2018 Mar;61(2):251-257. doi:10.3340/jkns.2017.0181
