Poor Sagittal Balance

The term “Sagittal Balance” refers to the relationship between the natural forward and backward bending curves of the spine. Normally, the spine has two such front-to-back curves. The lumbar (lower) spine has an inward curve called lordosis. The thoracic (middle) spine has an outward curve called kyphosis.

When all is in correct alignment, the two curves perfectly compliment each other, so that the body’s centre of gravity acts correctly down the spine. If, however, one of those curves becomes either too pronounced or too flat, the spine will be out of balance – this is called poor Sagittal Balance, or sagittal imbalance.

Types of Sagittal imbalance include:

  • Flatback syndrome: In this condition, the lumbar spine loses its normal lordosis. The outward curve of the thoracic spine is therefore the only curve, and the center of gravity juts too far forward.
  • Kyphosis: In this condition (sometimes called hyperkyphosis), the normal kyphosis of the thoracic spine increases to such a degree that the back appears hunched.

Sagittal imbalance typically causes lower back pain, an inability to continually look straight ahead when upright and sometimes a difficult walking. In more serious cases, chronic pain, fatigue, and difficulty with daily tasks can be experiences. In some cases, Sagittal imbalance may be associated with conditions that can put pressure on spinal nerves, leading to weakness, numbness, or pain..


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