Flatback Syndrome: Symptoms, Treatment


The flatback syndrome refers to the condition where the spine loses its natural low back curve and become flat. Naturally, people have two curves in the spine, which allow the arms and neck to stay balanced. When flatback syndrome happens, people often have trouble standing upright. If the people with flatback syndrome develop a leaning-forward posture, the curve is called kyphosis. Otherwise, the curve is called lordosis. Besides the standing problem, people with the flatback syndrome often experience ongoing pain in the back and legs too. As time goes by, the symptoms tend to become more serious.


Diseases such as degenerative disc disease, compression fractures, and ankylosing spondylitis and surgical procedures such as laminectomy and lumbar spinal fusion are all possible reasons for the flatback syndrome to arise.


Typically, people with flatback syndrome have difficulty in standing upright and they often experience chronic pain that may affect their daily routine activities. In order to maintain an upright posture, people with the disease may feel severe pain over time as well.

Other main symptoms of flatback syndrome may include the following:

  • Fatigue
  • A sensation of falling forward or backward
  • Stooping at the end of the day
  • Pain in the back
  • Pain and tightness in the buttocks and thighs
  • Tripping easily


To determine whether a person has the flatback syndrome or not, the doctor usually at first takes a complete medical history and conducts a physical examination. Then, additional tests will be ordered by the doctor so as to give a detailed diagnosis, which may include the following imaging tests:

  • X-rays test. With the help of invisible electromagnetic energy beams, X-rays test can produce a detailed image of the spine and other bones and tissues. The result can help the doctor to check whether the spine is in alignment.
  • Magnetic resonance (MR) imaging scan. This test used a magnet and radio waves to get detailed images of the spinal cord. With the clear images, the doctor can easily tell if the spinal cord has been affected by the spinal curvature.
  • Computed tomography (CT) scan. This imaging test also aims at helping the doctor to better visualize the situation with clear images of the body.


Depending on the severity, causes, and degree of the flatback syndrome, different individuals usually need to take different treatment methods. In the past, spine surgery that aims at correcting the side-to-side curves and spinal fusion were often done to help the symptoms of the flatback syndrome. But now, thanks to the advances made in terms of medical operation, doctors today can use non-operative methods and scoliosis correction operations to help the patient with the condition.

Non-surgical treatment

For many patients with flatback syndrome, they may be treated without surgical procedures. The doctor may recommend the following treatment methods:

  • Physical therapy. For people with flatback syndrome, they are often advised to engage in proper exercises so that their posture can get improvements. A physical therapist can tailor gait and posture training programs for patients with the disease.
  • Pain medications. In order to ease the pain, the patient with flatback syndrome may take some over-the-counter pain relievers. But, if these medicines do not work, the patient can then turn to the doctor and get some prescribed medications.

Surgical treatment

If the non-surgical treatment does not have any effect, the doctor may recommend surgery. Today, doctors are often able to correct scoliosis in the surgical procedure as well as keep the normal curves of the spine as much as possible. Under the condition that the misalignment in the spine is severed, it is necessary to do surgery so that the pain can be relieved, and the spine can be aligned again. This way, the situation will not get worse.

  • Osteotomy and pedicle subtraction osteotomy. This surgical procedure is to remove bone from the back of the lumbar spinal column. In doing so, the bones in the spinal column can realign.
  • Spinal fusion and fixation. A fusion procedure uses grafting materials. By putting these grafting materials between two or more bones of the spine, they can fuse into a solid bone. In the fusion process, hardware such as screws and rods will be inserted so that the spine is right in place while the bones fuse.

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.