Combined Effects of Postural Education, Therapeutic Massage, Segmental Stretching, and Motor Control Exercise in a 19-Year-Old Male with Chronic Back Pain and Kypholordotic Posture: A Case Report

Introduction: Sagittal spine malalignment has been linked with a number of health consequences including pain, disability, and suboptimal quality of life. Case Presentation: We present a 19-year-old male with 3 years history of chronic back pain associated with kypholordotic posture. Upon examination, lumbar hyperlordosis and thoracic hyperkyphosis were mainly associated with muscular imbalance around the chest, upper back, and lumbopelvic-hip region. The patient received treatment comprising postural education (PE), therapeutic massage (TM), segmental stretching exercise (SSE), and motor control exercise (MCE) twice a week for 8 weeks. The patient demonstrated a significant improvement in lumbar lordotic (83.80 to 76.30) and thoracic kyphotic (65.20 to 60.60) curves as measured by flexible ruler, back pain (7.0 cm to 1.0 cm) as measured by visual analogue scale, spine ranges of motion (flexion: 5.2cm to 7.5cm; extension: 3.5cm to 4.7cm) as measured by modified Schober’s test, and functional disability (46.7% to 20.0%) as measured by modified Oswestry disability index. Conclusions: The results showed that the combination of PE, TM, SSE, and MCE was effective in improving sagittal spine alignment, back pain, spine range of movement, and function.