Anatomy
The back is made up of box-shaped vertebrae that are held in place partly by the shape of the bones, partly by ligaments and partly by the large and small back and abdominal muscles.
The spine seen from the side
A. Vertebra prominens
B. Vertebra coccygea I
C. Promontorium
D. L I
E. Th I
F. Axis
Cause
Strain on the back during the bone-building period can cause one or more of the box-shaped vertebrae to become wedge-shaped, as the front edge of the vertebra is less robust than the back edge. This causes a curvature (forward bending) of the back, which is visible from the side. A back disorder that affects approximately 4% of the population. Due to the vertebrae forming a wedge shape, a curvature (forward bending) of the back occurs. The cause is unknown, but the condition is partly hereditary.
The condition is most common between the ages of 15 and 17. Boys are 3-4 times more likely to be affected than girls. The condition is often recognised in connection with sports, but the sport itself is not the cause of the disease.
Symptoms
Spinal curvatures located high in the back (thoracic Scheuermann, kyphosis, high round back) often cause few or no symptoms. Spinal curvatures localised low in the back (thoracolumbar or lumbar Scheuermann, flat lower back) cause back pain in most people. The discomfort usually subsides after a few months (1 year), but the increased curvature is persistent.
After puberty, a high round back (kyphosis) is usually only a cosmetic problem, whereas flat back disorders increase the risk of strain-related pain in adulthood.
Examination
Spinal misalignment is often initially mistaken for ‘bad posture’. Diagnosis is made by general medical examination, possibly supplemented by X-ray (at least 3 adjacent vertebrae with at least a 5 degree wedge shape, Schmorl’s impressions, flattening of the discs, irregular end plates). In some cases, an MRI scan is recommended.
Treatment
The vast majority of cases can be treated with exercise to maintain back mobility, counteract the curvature tendency and strengthen abdominal and back muscles. In addition, ergonomic instruction including advice on a firm-bottomed bed. In a few cases, a corset can be used (under the supervision of the orthopaedic surgery department). In rare cases, surgery can be performed.
During the few months (one year) that the condition is active, back-straining sports should be avoided. After the age of 18, sports can be practised without restriction, but powerlifting and similar should be avoided if there is a low mb. Scheuermann.
Regular 30-minute walks (3-5 times a week) reduces lower back pain and almost doubles the time interval for low back pain recurrence requiring treatment (Pocovi NC., et al. 2024).
Complications
In some cases, the spinal misalignment may have other causes (e.g. infections, congenital bone changes, arthritis, bone diseases, metabolic disorders)
