Q. Can I tell how my spine is out of alignment?

Spinal deformity is broadly divided into five kinds.

• Scoliosis — seen from the front, a spine that should be straight curves into a C or an S. In the early teens there may be no pain, but it shows later as pain in the back, shoulder, lower back and knee
• Lumbar hyperlordosis (swayback) — the lumbar spine curves forward in a convex arch. The belly can look pushed out or the buttocks held back, with marked low back and hip pain
• Kyphosis (rounded back) — the thoracic spine curves backwards. Along with low back pain come neck and shoulder pain and headache, with forward head posture and rounded shoulders
• Rounded back with swayback — the thoracic spine curves excessively and the lumbar spine comes well forward. The figure becomes stooped, the surrounding muscle and ligament weaken, and pain comes throughout the body from neck to ankle
• Flat spine (flat back) — the whole spine is straightened out like a bamboo cane. The pelvis rotates backwards so the buttocks look flat, and neck and shoulder pain, headache and bowed legs appear together

There are also combined forms where two or more of these overlap. Whole-body pain or chronic fatigue whose cause is hard to pin down sometimes comes from here.