Flat back syndrome occurs when the normal lumbar curve of the lower back is lost, causing the spine to become straight or flat. This puts the spine in an imbalanced position and causes the patient to lean forward. Causes of flat back syndrome include degenerative disc disease, post-laminectomy syndrome, vertebral compression fractures, and ankylosing spondylitis. Initial treatment focuses on appropriate exercises to strengthen core muscles and improve flexibility, including exercises to maintain pelvic position, hamstring stretches, and strengthening of hip flexors. Low-impact aerobic exercises like walking and water therapy can also help.

2. Flat back syndrome is an abnormal
condition where the spine loses its
natural low back curve to become
flat. The spine becomes imbalanced
and the patient leans forward.
Reduction of normal lumbar lordosis
can produce fixed sagittal imbalance
resulting in flat back deformity.
FLAT BACK

3. • Progressive degeneration of the intervertebral
discs or the shock absorbers of the spine may lead
to a loss of height in the front part of the spine.
Degenerative
disc disease
• Patients previously treated with a laminectomy or
other lumbar surgery to decompress the spinal
nerves to treat stenosis.
Post
Laminectomy
Syndrome
• Compression fractures are often the result of
weak spinal bones due to osteoporosis.
Vertebral
Compression
Fractures
• Chronic inflammatory disease that causes
stiffness and arthritis throughout the entire spine.
Ankylosing
Spondylitis
CAUSES OF FLAT BACK

4. Many patients with
lumbar flat back
syndrome may be
treated without
surgery. Initial
treatment typically
includes and
appropriate exercise
routine to include
aerobic fitness, weight
bearing exercise, and
core muscle
strengthening.
Main areas of exercise for
flat back
• Exercise to maintain
normal pelvic position – for
optimal all alignment of
the spine and for
encouraging anterior pelvic
tilt on the sagittal plane
• Hamstring flexibility and
lengthening exercises, to
improve anterior pelvic tilt
• Strengthening hip flexors
• Exercise to improve general
lower back vertebral
mobility
EXERCISES FOR FLAT BACK

5. Types
• Walking - walking for exercise is very gentle on the back, and walking
two to three miles three times per week is very helpful for patients.
• Stationary bicycling - riding a stationary exercise bike allows patients to
engage in exercise without vibrating the spine.
• Water therapy - Doing exercise in the water provides for effective
conditioning while minimizing stress on the back because the buoyancy
of water counteracts the gravitational pull that can compress the spine.
When 'unweighted' in water, a patient becomes more mobile, and
stretching and strengthening exercises are less painful.
Time
• Elevating the heart rate for at least 20 minutes
AEROBIC EXERCISES

6. Benefits of Low-Impact Aerobic Exercise
• Aerobic exercise increases the flow of blood and nutrients to back structures
which supports healing, and can decrease the stiffness in the back and joints
that lead to back pain.
• The patients are also more likely to stay functional (e.g. continue working and
carry on with recreational activities), whereas those patients with chronic low
back pain who do not engage in aerobic exercise are more likely to experience
the gradual loss of functional capabilities.
AEROBIC EXERCISES

7. Helps to build
strong muscles to
support neck and
back.
Increase flexibility
and movement if
the joints of the
body and spine.
5 to 10 counts, 3
times a week.
SPINAL FLEXIBILITY AND STRETCHING EXERCISES

8. LYING &
PRONE
POSITION
S&F EXERCISES

9. HANDS &
KNEES
POSITION
S&F EXERCISES

10. NECK
FLEX
EXERCISES

11. NECK
STRENGTH
EXERCISES