Baastrup Syndrome- kissing spine syndrome



 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:

  • Inflammation

  • Formation of interspinous bursae (fluid-filled sacs)

  • Fibrosis, sclerosis, or even cystic changes

  • Pain with lumbar extension


🔄 Pathophysiology

  • When intervertebral discs degenerate (shrink), vertebrae come closer.

  • Lumbar hyperlordosis (excessive curve) makes the spinous processes tilt toward each other.

  • Repeated contact irritates the area, causing localized back pain.


📋 Physiotherapy Treatment Plan

🎯 Goals

  1. Reduce pain and inflammation

  2. Correct posture and reduce lordosis

  3. Increase spinal flexibility in flexion

  4. Strengthen core and gluteal muscles

  5. Prevent recurrence with ergonomic advice


🪑 Phase 1: Pain Relief (Acute Phase)

Intervention Details
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
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
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

  • Use lumbar support when sitting

  • Avoid sleeping on stomach

  • Use firm mattress

  • Avoid back extensions (e.g., cobra pose)

  • Regular low-impact exercise (e.g., walking, swimming)


What to Avoid

  • Lumbar hyperextension exercises (superman, back bends)

  • Prolonged standing without lumbar support

  • Heavy lifting or twisting of the spine

  • Poor posture in sitting and standing


📊 Summary Table

Phase Goals Key Interventions
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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