The woman has a severe and pitiful physical problem, which she has endured for eighteen long years. She is bent completely forward, utterly unable to straighten herself or to look upward. The phrase “bowed down” (KJV) or “bent over” (NKJV), found only here in the New Testament, is a medical term indicating a harmful curvature of the spinal vertebrae.

Her stooped posture aptly illustrates humanity's spiritual condition due to sin. Sin does not straighten a person up but bends him over so all he can see is the way of the world. The sinner, unable to look up into the face of God, cannot remedy his evil plight before being called (Psalm 40:12; Romans 5:6).

Her stooped condition is so severe that she has no power to straighten herself, and in this weak condition, she is thus unable to help herself. Unless Christ heals and saves, the condition will only worsen with time.