Postural Syndrome

A poor posture can lead to postural syndrome. This condition more often results in neck and upper back issues but can easily result in mid and low back issues as well. Typically, a forward leaning posture overloads the neck and back muscles and can even cause stress on spinal joints and disc tissues.

Signs & Symptoms

Patients or others (especially parents) often notice forward rounding, slouching, or forward protruding of the chin. There may be a forward lean while standing or walking. One might also note an increased curve in their upper back or an increased arch in their low back. This postural distortion is known as the kyphotic-lordotic posture. In the upper spine, this can result in neck, shoulder, and upper back pain typically felt intensely between the shoulder blades.

Patients regularly describe carrying their tension in their shoulders or back. Tension in the base of the neck can begin to produce headaches. Poor posture can also lead to a band of pain running across the base of the spine at the low back with a feeling of tension that just won’t quit. Pain is achy and muscular in nature and travels down along the sides of the spine or into the shoulders. It can often feel like the muscles just won’t turn off. In fact, most patients start to notice knots developing in the overused muscles. Pain is typically worse in certain positions or during repetitive activities. Patient’s often feel an increase in pain during actions that they regularly perform on a daily basis (work, school, device use, studies, etc.).

Causes of Postural Syndrome

The cause of postural syndrome lies in poor body positioning. The positioning results in muscle imbalance. Muscle imbalances are described by the conditions known as the cross syndromes. The syndromes are further divided into upper cross, lower cross, and mixed cross syndromes. These conditions develop as a result of muscle tone dysfunction due to overuse of some muscles and underuse of others. The cross part describes the position of the overactive vs the underactive muscles which exist diagonal to each other therefore forming a cross. Upper, Lower, or mixed describes the part of the body involved. The phenomenon is associated with static positions or repetitive movements.

Upper Cross Syndrome (UCS)

In upper cross syndrome, the deep neck flexors, serratus anterior, and lower trapezius fibers are underactive while the pecs, levator scapulae, and upper trapezius fibers become overactive. There can also be overactivity of the upper paraspinals and suboccipital muscles. This condition tends to cause overuse injury of the muscles in the neck and upper back. Activities like extended periods of being seated, computer work, looking down, and use of handheld devices are usually at the root of the problem.

Lower Cross Syndrome (LCS)

In lower cross syndrome, abdominal and gluteal muscles become weak and underactive while the hip flexors and low back muscles become tight and overactive. In fact, studies have shown that individuals who do not fire their abdominal muscles are much more likely to have low back pain. Muscle imbalance leads to stress particularly right at the base of the low back. Activities that require forward bending tend to drive this problem (working over a counter, car repair, construction, plumbing work, dentistry, etc.).

Mixed Cross Syndrome (MCS)

Mixed cross syndrome is simply the combination of both upper and lower cross syndromes in the same person. This unlucky individual has a mix of both symptoms. The causes are again related to daily activities and muscle imbalance due to overuse vs underuse.

Treatment of Postural Syndrome

Restoring normal muscle balance and changing bad habits are at the forefront of treatment. Often times, manipulation of the restricted segments of the spine can bring immediate relief. A good home rehab program will help to correct the wayward muscle patterns. Modalities targeting muscle tension like E-stim also bring substantial relief.

Prognosis of Postural Syndrome

Outcomes are often good to excellent in these cases. However, this depends on the associated damage possibly done to the joints and discs of the spine. Because postural syndrome can lead to more significant issues like disc bulges and arthritis, prognosis often depends on how early the issue is detected and corrected.