As Hollow back or Hyperlordosis This is the term used to describe the excessive forward bulging of the spine. This creates a pronounced belly line, while the back is arched inwards at the same time. The poor posture causes pain and damage to the spine, which has been changed by the hollow back.
What is a hollow back?
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At a Hollow back the spine arches far forward in the abdominal area. The hyperlordosis is usually not congenital. It is caused by permanent bad posture, which can also occur as a result of other diseases.
A healthy spine looks like an elongated "S" when viewed from the side. In the hollow back, however, the lower outward arch is pushed far forward. People with a hollow back appear as if they are particularly difficult to carry on their own stomach.
The load on the vertebrae is uneven in a hollow back and promotes premature wear of the intervertebral discs. The spinous processes on the back of the vertebrae can touch in a strong hollow back.
causes
Among the diseases in which a Hollow back occurs, belongs to Pomarino's disease. Walking takes place only over the forefoot. Those affected develop a hollow back due to the atypical gait pattern.
In many cases, bad posture is the reason for hyperlordosis. Sitting activities change posture on ergonomically inadequate seating. An additional lack of exercise lets the muscles relax and promotes the development of the hollow back.
In this combination, the musculoskeletal system lacks the necessary strength to withstand the changed shape of the spine. Permanent bad posture occurs. The load on the vertebrae changes disadvantageously with a hollow back. It is usually evenly distributed over the individual sections due to the special shape of the spine. With the hollow back, there is no even load compensation.
Symptoms, ailments & signs
A hollow back can usually be recognized externally by the posture of the person affected. In people with a hollow back, the pelvis moves forward when standing, causing the stomach to bulge outward and the upper body to shift backward. At the beginning, a hollow back usually doesn't cause any symptoms, but if the poor posture lasts longer, the abdominal and back muscles are weakened and the hollow back becomes more and more noticeable through back pain.
Because the ligaments and tendons are shortened by the incorrect posture, mobility is also restricted. It becomes increasingly difficult for those affected to bend forward and pick up an object. In addition, a hollow back puts a lot of strain on the intervertebral discs in the lumbar spine, which can promote herniated discs.
The prolonged incorrect loading can lead to a narrowing of the spinal canal, in which important nerves are located. If the spinal canal is narrowed due to incorrect posture, nerves can be impaired or squeezed, causing those affected to feel pain in the lumbar spine area that radiates into the legs. If the hollow back also causes an atlas malposition, headaches and dizziness can also occur.
Diagnosis & course
A Hollow back can already be seen with a simple visual examination. The typical forward posture with the pelvis tilted forward is unmistakable in the side view.
In order to determine the extent and damage that has occurred more precisely, the hollow back is represented by imaging methods. In the early stages, the muscles of a hollow back change first. The abdominal muscles become weaker. In the back, the lower back shortens while the hamstrings are stretched.
However, the muscles show increased tension due to the atypical long-term load. If there is no change in posture or treatment, changes in the spine will occur later. The intervertebral discs are compressed on one side and the risk of a herniated disc increases.
The spinal canal through which the spinal cord passes can narrow if the back is pronounced. The spinous processes on the back of the vertebrae painfully meet in a hollow back.
Complications
A hollow back does not usually cause any major discomfort at the beginning. However, if the incorrect posture persists, severe vertebral damage can develop. A chronic hollow back puts pressure on the intervertebral discs and in extreme cases leads to a herniated disc. An untreated hollow back can also narrow the spinal canal.
In the long term, this can lead to damage to the nerve tracts and, as a result, to nerve inflammation and sensitivity disorders. An impairment of the nerves can rarely lead to bladder problems and diseases of the genital organs (irritable bladder, incontinence). In addition, a hollow back causes tension and pain, which increase in intensity and duration over time.
In addition, there are usually restricted mobility and symptoms of paralysis. If the hollow back is left untreated, the pain will eventually spread to the legs and sometimes lead to paresthesia and muscle tension in the lower back. Mainly affected are the rear thigh muscles, which stretch with a hollow back, and the lower back, which shortens.
These misalignments are usually associated with further physical complaints and also represent a considerable psychological burden in the long term. If the hollow back is recognized and treated early, complications are unlikely.
When should you go to the doctor?
You should always see a doctor, preferably an orthopedic surgeon, if you regularly suffer from severe back pain that leads to restricted mobility. Especially when you can see signs of poor posture in the mirror that cannot be remedied by normal gymnastic exercises and conscious posture correction. If the cause is weak abdominal muscles, you can first try to strengthen them through specific exercises to counteract the hollow back and correct the incorrect posture by consciously standing upright.
If these measures do not help, you should consult an orthopedic surgeon, because if a strong hollow back is left untreated for a long period of time, there is a risk of a herniated disc.
In the event of symptoms such as paralysis, sensory disturbances or inflammation of the nerves, it is necessary to consult a doctor immediately, especially if accompanying bladder and incontinence problems occur. Persistent muscle tension despite sufficient exercise can also be an indication of a misalignment, which must be corrected through targeted physiotherapeutic measures. Likewise, a visible bad posture, which often causes back problems, should always be examined and treated by a doctor.
Doctors & therapists in your area
Treatment & Therapy
The treatment at Hollow back depends on the stage of the impairment. In the initial stage, it is sufficient to treat the hollow back with simple measures for back training. The patient learns a correct posture and simple exercises to counteract the hollow back.
If you are seated, you must ensure that the seat meets the requirements for an ergonomic design. The longer the patient has been suffering from a hollow back, the more cautiously to proceed. The therapy is aimed at stretching the shortened muscles again. This is the only way to regain correct posture.
Pain therapy is also carried out in order to enable the necessary movements and to provide relief for the patient. If the hollow back has made the changes so far that exercise therapy does not improve any more, some of the symptoms can be treated surgically.
This includes widening a narrowed spinal canal or herniated discs. In any case, conservative treatment methods should first be exhausted in the case of the hollow back and the sequelae.
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➔ Medicines for back painOutlook & forecast
With a hollow back, the prognosis is unfavorable without treatment and targeted training. The symptoms gradually increase in intensity and the damage develops into irreparable impairments. With early and comprehensive treatment, significant improvements in the symptoms that have arisen can be achieved. The back is strengthened with physiotherapy exercises. The build-up of muscles and posture corrections lead to an optical change in the skeletal system over time. Regular checks of the posture while sitting, running or standing can alleviate the symptoms.
In some cases, complete freedom from symptoms is achieved. This is especially possible in patients who are in the early stages. The hollow back is minimized and the pain is reduced. The cooperation of the patient is necessary for this. In addition, increased vigilance must be developed so that the posture of the spine is checked and corrected several times in everyday life.
The later therapy begins, the worse the chances of recovery. In severe cases, surgery must be performed or a permanent stabilization measure must be carried out for the back. Although pain relief is also achieved with these treatment options, full recovery is not expected with these methods. The aim of the treatment plan is to prevent a further increase in symptoms.
prevention
In the vast majority of cases, one gets involved Hollow back prevent with little effort. Even with children, emphasis should be placed on good posture, ergonomically shaped seats and exercise. Adults who spend a lot of time sitting due to their professional activity will find recreational sports to suit their personal taste. Often the statutory health insurance companies offer preventive back training for their members so that a hollow back cannot develop in the first place.
Aftercare
In most cases, the affected person has only a few options for follow-up care. The disease must be recognized and treated early by a doctor so that there are no further complications or a further worsening of the symptoms in old age. In general, an early diagnosis of the disease has a very positive effect on the further course and can prevent the symptoms from worsening.
The person concerned should therefore contact a doctor at the first symptoms or signs of the disease. In most cases, the symptoms of a hollow back can be alleviated by means of physiotherapy or physiotherapy. The person affected can also do some exercises in their own home, whereby the information from the back training should also be used in everyday life.
Postures that could reinforce a hollow back are to be avoided. In some cases, surgery may also be necessary to alleviate the symptoms. Bed rest must be observed in any case after such an operation. The body should not be unnecessarily stressed. As a rule, a hollow back does not reduce the life expectancy of the person affected.
You can do that yourself
A hollow back is almost always the result of permanent poor posture. Initially, the disorder hardly causes any symptoms, but in the medium term an impairment of quality of life is to be expected. Especially when severe vertebral damage occurs. A chronic hollow back places a particular strain on the intervertebral discs and, in extreme cases, causes a herniated disc. Furthermore, there is a risk of narrowing the spinal canal if the hollow back is not treated professionally. Those affected should therefore consult a specialist, ideally an orthopedic surgeon, at the first signs of a hollow back.
In the early stages, a hollow back is treated conservatively. The patient is usually prescribed physiotherapy and a number of behavioral adjustments are recommended. Regular participation in physiotherapy and the implementation of the necessary behavioral adaptations are the most important self-help measures. Patients usually have to do certain gymnastic exercises regularly, often daily at the beginning. If you are not disciplined enough to practice independently on a regular basis, you should register in a fitness studio and get guidance there.
In addition, changes in the workplace are usually required. If you work sitting down, you should have your desk adjusted to the right height for you and look for a high-quality chair with a good backrest that supports and relieves your back. If you have wooden or cork floorboards at home, you can occasionally lie down on the floor to sleep. Ideally with a thick yoga mat as a base.
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