Flatback Syndrome: Why It’s Hard to Stand Straight?
The spine has two natural curves. It’s naturally shaped like an “S” to help with weight support and balance. On the lower back, known as the lumbar region, the inward curve is called lordosis. On the upper back, known as the thoracic region, the outward curve is known as kyphosis.
According to our spine surgeon in Palm Beach County, patients who exhibit no lordosis or kyphosis have a condition called flatback syndrome, which can lead to several complications and health problems.
Flatback Syndrome in a Nutshell
Flatback syndrome patients usually experience chronic back pain, fatigue, and difficulties with regular daily activities. The patients also tend to stoop the shoulders and back at the end of a long and tiring day.
However, our spine surgeon in Fort Lauderdale says that the biggest concern with flatback syndrome is the misalignment of the body’s center of gravity. So some patients experience problems in standing upright or have a sensation of falling forward.
When the “S” curve becomes straight or flat, one will experience instability and difficulty in maintaining an upright position. When one of the curves misaligns, then body balance may also be disrupted.
A person with flatback syndrome is also prone to overcompensate and use other muscles to stand straight. Doing this, however, may only worsen the problem. Some complications of this condition include spinal stenosis, sciatica, and other chronic conditions in the back, neck and shoulders, hips, and thighs.

Treating and Managing Flatback Syndrome
A minor flatback syndrome may be treated and managed with non-operative corrections like physical therapy, stretches, and regular exercise. Some recommended routines include planking, chest stretches, hamstring stretches, and leg raises while laying on the side. However, a physical therapist may also make personalized recommendations on suitable types of exercise after assessing the patient’s condition.
Another proven treatment is the use of lumbar extension traction. One study in the Journal of Physical Therapy cited the application of traction three to five times a week for 20 weeks. The patients showed significant improvements in their lordosis, as well as a decrease in their pain levels after an average of 70 treatments.
If these fail to work, however, spine surgery to correct flatback syndrome may be needed. Depending on the degree of the flatback, our spine surgeon in Fort Lauderdale might recommend osteotomy or posterior vertebral column resection.
Learn more about flatback syndrome from our spine surgeons in Palm Beach County and Fort Lauderdale
If you are experiencing difficulty in standing upright or having balance problems caused by flatback syndrome, our orthopedic spine specialist is ready to help. Dr. Matthew Hepler is an adult and pediatric spine surgeon in Palm Beach County, including Fort Lauderdale, and Delray Beach.
He treats all conditions of the cervical, thoracic and lumbar spine, and also provides spinal stenosis treatments. Additionally, he offers non-operative treatment options, such as pain medications, steroid injections, and physical therapy. He also offers operative treatments, including both minimally invasive techniques and complex reconstructions. If you would like to learn more about our orthopedic spine surgeon, please Contact Us.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.