Flat Back Syndrome Causes, Symptoms, Diagnosis and Treatment

If you suffer from this condition, you may know very well how many issues it can cause. But if you’re someone who doesn’t know much about it, you may be wondering the following. What is this medical condition and what are its causes and symptoms?
Flat Back Syndrome is a disorder in which the lower part of the vertebral column loses some of its normal anatomical curve. In people suffering from this condition, front to back imbalance in the vertebral column takes place. This front to back imbalance is also known as a sagittal imbalance.

The way through which it manifests itself is the following.

First, the spine is divided into three parts: lumbar spine, thoracic spine, and cervical spine. Normally, each section of the vertebral column has a specific curve.

The lower (lumbar) region of the vertebral column has an inward curvature which is known as lordosis. The curvature of the thoracic region is directed outside, which is known as kyphosis while the cervical region of the vertebral column also has lordosis.

If the normal curvature of the vertebral column in the lumbar region is lost, the centre of gravity may be shifted top far forward. Its effects can also be felt at the level of the hips and knees. People with this condition might also have difficulty standing upright.

Causes of Flat Back Syndrome

There may be many causes of this condition, some of which are:

  • Degenerative Disc Disease. Progressive age-related degeneration of the intervertebral discs which act as shock absorbers of the spinal column, may result in decreased height in the frontal part of the vertebral column. When disc degeneration occurs, the vertebral column starts leaning forward and the lumbar curve decreases. The patient thus suffers from pain and stiffness because of degenerative disc disease or because of spinal imbalance.
  • Lumbar Post Laminectomy. For the patients who have been treated with a lumbar laminectomy or any other lumbar surgery to treat nerve compression or spinal stenosis. This procedure may result in a decrease of lumbar lordosis and in some cases, cause spinal column instability and post laminectomy syndrome.
  • Vertebral compression. Osteoporosis is an age-related bone degenerative process which leads to weakness of spinal bones and compression fractures. Because of any spinal fracture, the height of the spinal column in the lumbar and thoracic region is decreased. It can take place in one or more bones in the vertebral column.
  • Ankylosing Spondylitis. It is a chronic disease involving an inflammatory process in the joints of the body.  It also happens in the joints of the vertebral column. This results in pain, swelling, and stiffness in the entire length of the vertebral column. In some patients of ankylosing spondylitis, a decrease in the lumbar region lordosis and an increase in the thoracic region kyphosis takes place. This causes the patient to have an increased forward posture.
  • After Scoliosis Treatment. Flat back syndrome sometimes takes place after the correction of scoliosis. This is due to rods being used to correct the abnormal curvature in the patients of scoliosis. These rods also have a tendency to cause the side effect of straightening the normal anatomical curvatures of the back.

Symptoms of Flat Back Syndrome

Obviously, the most common and first to be appreciated symptom of this disorder is the change in the shape of the back. However, there are other symptoms which may include:

  • The patient having the feeling of falling forward;
  • Persistent pain in the muscles and joints of the back;
  • Fatigue;
  • Hunching over often during the evening or night;

Many people with this condition require a walker or cane to help them walk. Because the posture of their body is such that they are leaned forward, their body weight is not centrally directed over their legs and pelvis. They might suffer from chronic pain, frustration, and disability. They might also struggle to stand upright.


How should you sleep in this condition?

When you are suffering from a flat back disorder, you must provide better support to your body while sleeping. Put a soft pillow beneath your lumbar region and pelvis. You must either place a flat pillow or no pillow under your head to avoid straining of your back muscles. Sometimes, stomach sleeping may also be recommended.


The diagnosis of this medical problem is made after taking the complete medical history of the patient and performing a physical examination.

Your doctor may also order relevant investigations to establish the correct diagnosis. The imaging studies which are commonly performed are X-Ray, CT scan, and MRI. An X-Ray is a long scan in an upright posture. It clarifies the entire length of the vertebral column in a single image.


MRI is an acronym that stands for magnetic resonance imaging. This imaging technique uses radio waves and a magnet to give a detailed and clear image of the spinal column. Nerves can also be viewed clearly through an MRI scan.

An MRI scan is performed to view the bundles of nerve fibres and their condition. Through this it can be seen whether they are affected or not by the abnormal curve of the vertebral column.

CT Scan

The CT – or computed tomography – scan utilizes a computer and X-Rays to view the detailed image of the body. A CT scan provides a more detailed image of the body than X-Ray.


The treatment in the initial stage consists of only lifestyle modification, i.e. weight reduction and inclusion of exercises in daily routine. Aerobic exercises are good for this purpose. They can be carried out along with weight-bearing exercises and muscle strengthening exercises. Spinal manipulation and physical therapy may also have a positive impact on the patient’s condition.

Medical Treatment Options

For some of the patients, endurance and conditioning programs may give good strength to muscles and thus symptoms are improved. However, for patients suffering from pinched nerves or arthritis, spinal injections for pain relief may be given.

Backrack™ Spinal Decompression Device

The Backrack is a unique, non-invasive spinal decompression device that has been designed by top specialists to treat the root cause of a flat back and restore the natural shape of the spine. It is:


·       Safe for at-home use

·       100% natural

·       Free from side-effects


So if you’re ready to take your recovery from flat-back-related back pain to the next level, join thousands of people who have already reclaimed their pain-free life thanks to the Backrack.

Surgical Intervention

Some patients have severe structural problems and aggravating signs and symptoms. In their case medical treatment cannot provide enough relief. Thus, surgical intervention is needed in such circumstances. The aim of a spine surgery in people suffering from flat back syndrome is to restore the spinal alignment and reduce pain.

The option of surgery to correct this medical condition is offered to patients for whom non-surgical treatment is not beneficial. It is also generally a last-resort option.

Surgery is also required for patients whose condition is becoming worse with the passage of time. It is also required for those who are suffering from nerve compression and have additional symptoms. Weakness, pain in arms and legs, numbness, and tingling sensations in the area of nerve supply are such conditions.

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