According to abbreviationfinder, the excessive protrusion of the spine forward is referred to as hollow back or hyperlordosis. This creates a pronounced stomach line, while the back is arched inwards at the same time. The incorrect posture causes pain and damage to the spine, which has been altered by the hollow back.
What is a hollow back?
With a hollow back, the spine arches far forward in the abdominal area. Hyperlordosis is usually not congenital. It is caused by permanent incorrect posture, which can also occur as a result of other diseases.
A healthy spine looks like a long “S” when viewed from the side. With the hollow back, on the other hand, the lower outward arch is pushed far forward. People who suffer from a hollow back appear to have a particularly heavy burden to carry on their own abdomen.
With a hollow back, the load on the vertebrae is uneven and promotes premature wear of the intervertebral discs. The spinous processes on the back of the vertebrae can touch if the back is severely hollow.
Diseases in which a hollow back occurs include Pomarino’s disease. Walking is only done with the front foot. Those affected develop a hollow back due to the atypical gait pattern.
In many cases, incorrect posture is the reason for hyperlordosis. Seated activities change the posture on ergonomically inadequate seating. Adding to this, lack of exercise causes the muscles to slacken and encourages the development of a hollow back.
In this combination, the musculoskeletal system lacks the necessary strength to withstand the changed shape of the spine. It becomes a permanent failure. The load on the vertebrae changes disadvantageously with a hollow back. Due to the special shape of the spine, it is usually distributed evenly over the individual sections. With the hollow back, there is no even load equalization.
Symptoms, Ailments & Signs
A hollow back can usually be recognized externally by the posture of those affected. In people with a hollow back, the pelvis pushes forward when standing, causing the stomach to bulge outwards and the upper body to shift backwards. At the beginning, a hollow back usually does not cause any problems, but if the bad 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. Those affected find it increasingly difficult 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.
Long-term incorrect strain can lead to a narrowing of the spinal canal, in which important nerves are located. If the spinal canal narrows as a result of the incorrect posture, nerves can be impaired or squeezed, causing those affected to feel pain in the lumbar spine area, which radiates down to the legs. If the hollow back also causes a malposition of the atlas, headaches and dizziness can also occur.
Diagnosis & History
A hollow back can already be recognized with a simple visual examination. The typical forward-leaning posture with the pelvis tilted forward is unmistakable when viewed from the side.
For a more detailed determination of the extent and damage that has occurred, the hollow back is shown using imaging methods. In the early stages of a hollow back, the muscles first change. The abdominal muscles become weaker. In the back, the lower back shortens while the hamstrings are stretched.
However, the musculature shows increased tension due to the atypical permanent strain. Without a change in posture and treatment, changes in the spine will occur later on. The intervertebral discs are thus compressed on one side and the risk of a herniated disc increases.
The vertebral canal, through which the spinal cord runs, can narrow with a pronounced hollow back. The spinous processes on the backs of the vertebrae painfully meet in a hollow back.
A hollow back usually does not cause any major symptoms at the beginning. However, if the incorrect posture persists, severe vertebral damage can develop. A chronic hollow back primarily puts strain on the intervertebral discs and, in extreme cases, can lead to a herniated disc. Likewise, an untreated hollow back can lead to narrowing of the spinal canal.
In the long term, this can lead to damage to the nerve tracts and, as a result, to inflammation of the nerves and sensory disturbances. Rarely, an impairment of the nerves can lead to bladder problems and diseases of the genital organs (irritable bladder, incontinence). Accompanying this, a hollow back causes tension and pain, which increase in intensity and duration over time.
In addition, there are usually restricted movements and signs of paralysis. If the hollow back remains untreated, the pain will eventually radiate down to the legs and sometimes also lead to discomfort and muscle tension in the lower back area. The hamstring muscles are particularly affected, which stretch when the back is hollow, as well as the lower back, which shortens.
These malpositions are usually accompanied by other 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 orthopedist, if you regularly suffer from severe back pain that restricts your movement. Especially when you can see signs of bad posture even in the mirror, which cannot be remedied by normal gymnastic exercises and a conscious correction of posture. If the cause lies in weak abdominal muscles, you can first try to strengthen them with targeted exercises to counteract the hollow back and correct the incorrect posture by consciously walking upright.
If these measures do not help, you should consult an orthopaedist, because if a severe hollow back is left untreated for a long period of time, there is a risk of a herniated disc.
In the case of symptoms such as paralysis, sensory disturbances or nerve inflammation, it is necessary to see a doctor immediately, especially if there are accompanying bladder and incontinence problems. Persistent muscle tension despite sufficient exercise can also be an indication of a malposition that must be corrected with targeted physiotherapeutic measures. Likewise, a visible bad posture, which often causes back problems, should always be examined and treated by a doctor.
Treatment & Therapy
The treatment of a hollow back depends on the stage of the impairments that have occurred. In the early stages, it is sufficient to treat the hollow back with simple back training measures. The patient learns correct posture and simple exercises to counteract the hollow back.
In the case of sedentary work, care must be taken to ensure that the seat meets the requirements for ergonomic design. The longer the patient has been suffering from a hollow back, the more careful you have to proceed. The therapy aims to stretch the shortened muscles again. This is the only way to achieve correct posture again.
Accompanying pain therapy is carried out in order to enable the necessary movements and to give the patient relief. If the changes caused by the hollow back have progressed so far that movement therapy no longer brings about any improvement, some of the symptoms can be treated surgically.
This includes the expansion of a narrowed spinal canal or herniated discs. In any case, in the case of a hollow back and the consequences, the conservative treatment methods must first be exhausted.
Outlook & Forecast
With a hollow back, the prognosis is unfavorable without treatment and targeted training. The complaints gradually increase in intensity and the damage develops into irreparable impairments. Significant improvements in the symptoms that have occurred can be achieved with early and comprehensive treatment. The back is strengthened with physiotherapy exercises. The development of muscles and corrections in posture lead to a visual change in the skeletal system over time. Regularly checking your posture while sitting, walking or standing can alleviate the symptoms.
In some cases, a 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. This requires the cooperation of the patient. 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 poorer the chances of recovery. In severe cases, an operation must be performed or a permanent stabilization measure for the back must be worn. Although these treatment options provide pain relief, full recovery cannot be expected with these methods. The treatment plan aims to prevent a further increase in the symptoms.
In most cases, a hollow back can be prevented with little effort. Good posture, ergonomically shaped seats and recreational sports should be important even for children. Adults who spend a lot of time sitting down because of their job find recreational sports to suit their personal taste. In many cases, the statutory health insurance companies offer their members preventive back schools so that a hollow back cannot develop in the first place.
In most cases, those affected with a hollow back have only a few options for aftercare. The disease must be recognized and treated by a doctor at an early stage so that there are no further complications or 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 further deterioration of the symptoms.
The affected person should therefore contact a doctor as soon as the first symptoms or signs of the disease appear. In most cases, the symptoms of a hollow back can be alleviated by measures of physiotherapy or physiotherapy. The person concerned can also carry out some exercises at home, whereby the information from the back school should also be used in everyday life.
Postures that could reinforce a hollow back should be avoided. In some cases, surgery may also be necessary to relieve the symptoms. After such an operation, bed rest should be observed in any case. The body should not be unnecessarily burdened. As a rule, a hollow back does not reduce the life expectancy of the person concerned.
You can do that yourself
A hollow back is almost always the result of a permanent bad posture. Initially, the disorder hardly causes any symptoms, but in the medium term an impairment of the quality of life is to be expected. Especially when severe vertebral damage develops. A chronic hollow back puts particular strain on the intervertebral discs and, in extreme cases, causes a herniated disc. There is also a risk of narrowing of the spinal canal if the hollow back is not treated professionally. Those affected should therefore consult a specialist, preferably an orthopaedist, at the first sign of a hollow back.
In the early stages, a hollow back is treated conservatively. Physical therapy is usually prescribed to the patient and a number of behavioral adjustments are recommended. Regular participation in physiotherapy and the implementation of the necessary behavioral adjustments are the most important self-help measures. Patients usually have to complete certain gymnastic exercises regularly, often daily at the beginning. If you are not disciplined enough to practice on your own on a regular basis, you should join a gym and get guidance there.
In addition, changes in the workplace are usually required. If you work sitting down, you should have the desk adjusted to the right height for you and pay attention to 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. It is best to use a thick yoga mat as a base.