Baastrup Syndrome (Kissing Spine Syndrome)
🧠What Happens in the Spine?
In Baastrup Syndrome, the spinous processes of adjacent vertebrae come into contact due to degeneration, loss of disc height, or excessive lumbar lordosis. These bones were never meant to touch, so repeated contact causes:
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Inflammation
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Formation of interspinous bursae (fluid-filled sacs)
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Fibrosis, sclerosis, or even cystic changes
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Pain with lumbar extension
🔄 Pathophysiology
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When intervertebral discs degenerate (shrink), vertebrae come closer.
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Lumbar hyperlordosis (excessive curve) makes the spinous processes tilt toward each other.
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Repeated contact irritates the area, causing localized back pain.
📋 Physiotherapy Treatment Plan
🎯 Goals
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Reduce pain and inflammation
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Correct posture and reduce lordosis
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Increase spinal flexibility in flexion
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Strengthen core and gluteal muscles
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Prevent recurrence with ergonomic advice
🪑 Phase 1: Pain Relief (Acute Phase)
Intervention | Details |
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Modalities | Heat therapy or TENS to relieve pain |
Manual Therapy | Gentle soft tissue mobilization, myofascial release along lumbar paraspinals |
Rest Positioning | Supine with knees bent or supported to reduce lordosis |
Postural Education | Train patient to avoid excessive extension (e.g., standing swayback) |
Activity Modification | Avoid prolonged standing, excessive back extension |
🧘 Phase 2: Flexibility and Core Activation (Subacute)
Exercise | Purpose |
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Cat-Camel Stretch | Improves lumbar mobility (focus on flexion) |
Pelvic Tilts (Supine) | Encourages posterior pelvic tilt, reduces lordosis |
Child’s Pose / Knees-to-Chest | Promotes lumbar flexion |
Transverse Abdominis Activation | Deep core support |
Isometric Gluteal Contractions | Improves pelvic stability |
💪 Phase 3: Strengthening and Postural Correction (Rehab Phase)
Exercise | Focus |
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Bird Dog (Neutral Spine) | Core stability, anti-extension |
Bridge (Posterior Tilt Focus) | Glutes and hamstring strengthening |
Wall Slides | Engages glutes and quads, reduces back load |
Modified Planks | Improve abdominal endurance |
Functional Training | Teach spine-neutral techniques for lifting, sitting, etc. |
📚 Patient Advice
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Use lumbar support when sitting
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Avoid sleeping on stomach
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Use firm mattress
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Avoid back extensions (e.g., cobra pose)
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Regular low-impact exercise (e.g., walking, swimming)
⛔ What to Avoid
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Lumbar hyperextension exercises (superman, back bends)
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Prolonged standing without lumbar support
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Heavy lifting or twisting of the spine
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Poor posture in sitting and standing
📊 Summary Table
Phase | Goals | Key Interventions |
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Acute | Pain relief | TENS, posture, rest positions |
Subacute | Mobility + light strength | Cat-cow, pelvic tilts, stretching |
Rehab | Strength + posture | Core work, glutes, functional movement |
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