Postural Syndrome
Top Contributors - Matt Huey, Lucinda hampton, Kim Jackson and Narayani Nagare
Definition
Postural syndrome is a mechanical classification in Mechanical Diagnosis and Therapy (The McKenzie Method). It is defined as the pain which is caused by mechanical deformation of soft tissue or vasculature arising from prolonged postural stresses. These may affect the joint surfaces, muscles, or tendons, and can occur in sitting, standing or lying. Pain may be reproducible when such individuals maintain positions or postures for sustained periods. Repeated movements should not affect symptoms, and relief of pain typically occurs immediately following the correction of abnormal posture.
Classification
Postural syndrome is most commonly seen in a young population, however, it can be seen throughout the life span. In postural syndrome, pain is caused due to prolonged overloading of tissues because of maintaining sustained postures for a prolonged period of time. Hallmarks in classifying someone with postural syndrome are:
- No loss of motion. This patient will have full active range of motion of their spine with no pain during the movement or at end ranges.
- No loss of strength or other neurological signs. Performing testing of myotomes, dermatomes, reflexes, etc, will not produce any positive results.
- Symptoms are produced after a prolonged sustained position.
- Symptoms are local, no symptoms are produced in the extremities.
- Symptoms are relieved with a change in position.
- No directional preference is found and no repeated movements produce the symptoms.
Treatment
Patient education plays a crucial role in the management of postural syndrome. Interventions in the form of exercises are often not required since there is no loss of movement or function.
Education needs to be provided about avoiding sustained posture for prolonged periods. Use of lumbar roll can be beneficial while sitting. Patient is instructed to take regular breaks and make change in posture to prevent prolonged tissue overloading.
It can be a good time to get the patient to implement an exercise regimen during the breaks as well.
Evidence
The prevalence of postural syndrome is largely unknown, this is because the majority of people with this condition do not seek treatment. Often those who do seek treatment, do so out of concern for additional issues.
There is evidence to support that sitting in in a flexed position can trigger pain symptoms in the lumbar spine. Several studies have found that young, healthy individuals will report having lumbar spine pain with sitting for more than 15 minutes[1][2][3].
[4]References
- ↑ Petersson, M., & Abbott, A. (2020). Lumbar interspinous pressure pain threshold values for healthy young men and women and the effect of prolonged fully flexed lumbar sitting posture: An observational study. World journal of orthopedics, 11(3), 158–166. https://doi.org/10.5312/wjo.v11.i3.158
- ↑ Womersley, L., & May, S. (2006). Sitting posture of subjects with postural backache. Journal of manipulative and physiological therapeutics, 29(3), 213–218. https://doi.org/10.1016/j.jmpt.2006.01.002
- ↑ May, S., Nanche, G., & Pingle, S. (2011). High frequency of McKenzie's postural syndrome in young population of non-care seeking individuals. The Journal of manual & manipulative therapy, 19(1), 48–54. https://doi.org/10.1179/2042618610Y.0000000004
- ↑ Mann SJ, Lam JC, Singh P. McKenzie Back Exercises. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. https://www.ncbi.nlm.nih.gov/books/NBK539720/