Spinal Problems Curvature

The spine has a natural curvature that helps distribute the stress of body weight as the body moves. The curvature of spine segments is:

  • Inward (lordotic) for the cervical (neck) and lumbar (lower back) regions
  • Outward (kyphotic) for the thoracic region and sacrum.

The spine’s curves help you carry your upper body in a balanced way. If the curvature becomes abnormal, it creates an imbalance that can cause pain and permanent postural changes.


Scoliosis is a sideways curvature of the spine. The spine may curve into either a “C” or an “S” shape. The most common type of spine scoliosis is idiopathic (of unknown cause) scoliosis, which develops in adolescents during their growth spurt.

Adult (or degenerative) scoliosis can develop later in life as joints in the spine degenerate.


Kyphosis is an outward curving “C”-shape in the spine. The thoracic spine (upper to mid back) has a natural outward (kyphotic) curve; however, if that curve is more than 40 to 45 degrees, it is considered abnormal kyphosis. This condition is common in older women who have osteoporosis, and is sometimes called “roundback” or “dowager’s hump.”

Although kyphosis is most common in the thoracic spine, it can also occur in the cervical or lumbar spine.


Both the cervical spine and lumbar spines naturally curve inward. However, if either location curves too far inward, the conditions are called excessive cervical lordosis or lumbar lordosis (“swayback”). Lordosis is most common in the lumbar spine and places extra stress on the entire spine.


Flatback syndrome or fixed sagittal imbalance is an overall loss of the natural curves of the spine that results in a straight spine. This condition gives a person the appearance of being stooped forward. The person often has a hard time standing up straight due to a shift in the center of gravity. Flatback syndrome can be a side effect of spinal fusion surgery or surgery to correct scoliosis.

Detection and Treatment

Treatment is most effective if abnormal spinal curvature is detected early, especially in children. Signs to watch for include:

  • Elevated hips
  • Leaning to one side
  • Prominent shoulder blade(s)
  • Uneven shoulders
  • Uneven waist.

The most common treatments for children are close observation and orthopedic bracing. Occasionally surgery may be necessary. In adults, treatment depends on the underlying cause of the curvature in the spine. Physical therapy and exercise are often central components of treatment, with surgery becoming an option in severe cases, especially if the curvature is affecting nerves.


An, H. (n.d.). Kyphosis: Description and diagnosis. Retrieved March 12, 2010, from http://www.spineuniverse.com/conditions/kyphosis/kyphosis-description-diagnosis

Cedars-Sinai Staff. (n.d.). Flatback syndrome. Retrieved March 12, 2010, from http://www.csmc.edu/5723.html

Civista Health Staff. (n.d.). Curvature of the spine. Retrieved March 12, 2010, from http://www.health-news-and-information.com/4civista/libv/i52.shtml

University of Maryland Medical Center Staff. (n.d.). A patient’s guide to anatomy and function of the spine. Retrieved March 1, 2010, from http://www.umm.edu/spinecenter/education/anatomy_and_function_of_the_spine.htm