Hyperlordosis: Treatment, Prevention, and More

What’s hyperlordosis?

Human spines are naturally curved, but too much curve can cause problems. Hyperlordosis is when the inward curve of the spine in your lower back is exaggerated. This condition is also called swayback or saddleback.

Hyperlordosis can occur in all ages, but it’s rare in children. It’s a reversible condition.

Keep reading to learn about the symptoms and causes of hyperlordosis and how it’s treated.

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What are the symptoms of hyperlordosis?

If you have hyperlordosis, the exaggerated curve of your spine will cause your stomach to thrust forward and your bottom to push out. From the side, the inward curve of your spine will look arched, like the letter C. You can see the arched C if you look at your profile in a full-length mirror.

You may have lower back pain or neck pain, or restricted movement. There’s limited evidence connecting hyperlordosis to lower back pain, however.

Most hyperlordosis is mild, and your back remains flexible. If the arch in your back is stiff and doesn’t go away when you lean forward, there may be a more serious problem.

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What causes hyperlordosis?

Bad posture is the most frequent cause of hyperlordosis. Other factors that may contribute to hyperlordosis are:

  • obesity
  • wearing high-heeled shoes for extended periods
  • spinal injury
  • neuromuscular diseases
  • rickets
  • sitting or standing for extended periods
  • weak core muscles

For pregnant women, a 2007 study found that hyperlordosis is the way that the female spine has evolved to adjust to the additional weight of the baby.

You can check your posture with a simple test:

  • Stand up straight against a wall. Keep your legs shoulder-width apart and your heels about 2 inches from the wall.
  • Your head, shoulder blades, and bottom should touch the wall. There should be just enough space to slip your hand between the wall and the small of your back.
  • With hyperlordosis, there will be more than one hand space between the wall and your back.
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When do you see a doctor for hyperlordosis?

Most cases of hyperlordosis don’t require special medical care. You can correct your posture on your own. You’ll need to do some regular exercises and stretches to help keep up good posture.

If you have pain or your hyperlordosis is rigid, see a doctor to determine the cause. Depending on the diagnosis, your doctor may refer you to a back specialist or a physical therapist. Sometimes hyperlordosis can be a sign of a pinched nerve, loss of bone in the spine, or a damaged disk.

Your doctor will do a physical examination. They’ll ask you when your pain started and how it has affected your daily activities.

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Your doctor may also take X-rays or other imaging of your spine to aid in diagnosis. You may also have a neurological exam and other tests.

What kinds of treatment are available for hyperlordosis?

Your treatment plan will depend on your doctor’s diagnosis. In most cases, treatment will be conservative. In rare cases, surgery may be required.

Conservative treatment may include:

  • over-the-counter remedies for pain, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve)
  • a weight loss program
  • physical therapy

Children and teens with hyperlordosis may need to wear a brace to guide spinal growth.

Exercises to try

Your doctor may refer you to a physical therapist. They may also give you a set of exercises to do on your own to help your posture.

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There are many kinds of exercises and stretches to choose from, depending on your age and your level of fitness. Yoga and chair yoga are good choices. The important thing is to develop an exercise routine that you can stick to. You should also be aware of keeping good posture when sitting, standing, or engaging in activities.

Here are some simple posture exercises that require no equipment:

  • Move your shoulders forward and up toward your ears and then back down, pushing out toward your back.
  • Stretch your arms out at your sides at shoulder height, and roll them in small circles.
  • Standing up, squat as though you were sitting in a chair.
  • Standing tall, place one hand over your ear. Rest the other hand and arm flat at your side. Lean in the direction opposite to the covered ear.
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What is the outlook for hyperlordosis?

Most hyperlordosis is the result of poor posture. Once you’ve corrected your posture, the condition should resolve itself.

The first step is to be aware of your posture during your normal daily routine. Once you know what it feels like to stand and sit properly, keep it up. You should see results right away, even if it seems awkward at first.

Develop an exercise and stretching routine that you do daily. Consult with your doctor if you’re not sure about the appropriate level of activity for you.

Post reminders to yourself to sit or stand straight. Ask your friends and family to tell you when they see you slouching or hunched over at your computer.

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Good posture takes vigilance until it becomes automatic.

What can you do to prevent hyperlordosis?

You can often prevent hyperlordosis by practicing correct posture. Keeping your spine correctly aligned will prevent stress on your neck, hips, and legs that could lead to problems later in life. Here are some more tips to help prevent this condition:

  • If you’re concerned with weight management, start a weight loss program. Talk to your doctor if you need help getting started.
  • If you sit a lot during the day, take small breaks to get up and stretch.
  • If you have to stand for a long time, periodically shift your weight from one foot to the other, or from your heels to your toes.
  • Sit with your feet flat on the floor.
  • Use a pillow or rolled towel to support your lower back when sitting.
  • Wear comfortable, low-heeled shoes.
  • Stick to an exercise program of your choice.
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Spine Health. PROCEDURE 15 — FLEXION IN STEP STANDING In this procedure the patient stands on one leg while the other leg rests with the foot on a stool so that hip and knee are about ninety degrees flexed. Keeping the weight bearing leg straight the patient draws himself into a flexed position, firmly approximating the shoulder and the already raised knee (both being on the same side). If possible the shoulder should be moved even lower than the knee. The patient may apply further pressure by pulling on the ankle of the raised foot. The pressure is then released and the patient returns to the upright position. The sequence is repeated about six to ten times. It is important that the patient returns to neutral standing and restores the lordosis in between each movement. Fig. Flexion in step standing. Effects: This procedure causes an asymmetrical flexion stress on the affected segments. It is applied when there is a deviation in flexion, which may occur in dysfunction as well as derangement. Both in dysfunction and derangement th...
Spine Health. PROCEDURE 17 – SELF-CORRECTION OF LATERAL SHIFT Having corrected the lateral shift and the blockage to extension, it is now essential to teach the patient to perform self-correction by side gliding in standing followed by extension in standing. This must be done on the very first day, so that the patient is equipped with a means of reducing the derangement himself at first sign of regression. Failure to teach self-correction will lead to recurrence within hours, ruining the initial reduction, and the patient will return the next day with the same deformity as on his first visit. I have discarded the technique of self-correction as described previously and instead I now teach patients to respond to pressures applied laterally against shoulder and pelvis. Initially, therapist’ assistance is required. Patient and therapist stand facing each other. The therapist places one hand on the patient’s shoulder on the side to which he deviates, and the other hand on the patient’s opposite iliac crest. The therapist applies pressure by squeez...
Back pain Prevention The majority of patients responding to basic extension and flexion principles of treatment have been educated in the means of achieving pain relief and restoring function. They have carried out the self-treatment procedures and have to a large extent become independent of therapists. Following successful treatment it requires little emphasis to convince patients that if they were able to reduce and abolish pain already present, it should also be possible to prevent the onset of any significant future low back pain. Of all the factors predisposing to low back pain only postural stresses can be easily influenced and fully controlled. We must develop this potential ingredient of prophylaxis to the full. The patient must understand that the risks of incurring low back pain are particularly great when the lumbar spine is held in sustained flexed positions; and that when the lordosis is reduced or eliminated for prolonged periods, he must at regular intervals and before the onset of p...
TREATMENT OF EXTENSION DYSFUNCTION By far the most common form of ⚡ dysfunction ⚡ is that involving loss of extension. Having already explained and taught the postural requirements, we must now instruct the patient in the methods required to regain lost extension. We must explain to him the reasons for the need to recover the extension movement. The patient must realise that without an adequate range of extension it is not possible to sit with a lordosis, even when a lumbar support is used. For some patients it is imperative that the range of extension be improved, otherwise they will be unable to sit correctly. It is my experience that, following adequate explanation, patients will co-operate with the treatment and work hard at their recovery. They will perform exercises that cause discomfort or even pain, as long as they understand the reasons for doing so. Fig. Recovery of loss of extension, using the procedure of extension in lying. Exercises In order to systematically stretch the lumbar spine in extension, I...
Spine Health. PROCEDURE 11 — SUSTAINED ROTATION/MOBILISATION IN FLEXION The patient lies supine on the couch, and the therapist stands on the side to which the legs are to be drawn, facing the head end of the couch. The patient’s far shoulder is held firmly on the couch by the therapist’s near hand, providing fixation and stabilisation. With the other hand the therapist flexes the patient’s hips and knees to a rightangle and carries them towards himself, causing the lumbar spine to rotate. With the patient’s ankles resting on the therapist’s thigh the knees are allowed to sink as far as possible and the legs are permitted to rest in that extreme position. The lumbar spine is now hanging on its ligaments in a position which combines side bending and rotation. By pushing the knees further towards the floor the therapist applies overpressure to take up the remaining slack in the lumbar spine. Depending on the purpose for which the procedure is used, the position of extreme rotation is maintained for a shorter or longer period. Fig. Sustained rotation/mob...