Lordosis: Causes, Treatments, and Risks

What is lordosis?

Everyone’s spine curves a little in your neck, upper back, and lower back. These curves, which create your spine’s S shape, are called the lordotic (neck and lower back) and kyphotic (upper back). They help your body:

  • absorb shock
  • support the weight of the head
  • align your head over your pelvis
  • stabilize and maintain its structure
  • move and bend flexibly

Lordosis refers to your natural lordotic curve, which is normal. But if your curve arches too far inward, it’s called lordosis, or swayback. Lordosis can affect your lower back and neck. This can lead to excess pressure on the spine, causing pain and discomfort. It can affect your ability to move if it’s severe and left untreated.

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Treatment of lordosis depends on how serious the curve is and how you got lordosis. There’s little medical concern if your lower back curve reverses itself when you bend forward. You can probably manage your condition with physical therapy and daily exercises.

But you should see a doctor if the curve remains the same when you bend forward. Read on to find out what lordosis looks like and how your doctor will diagnose for it.

Common causes of lordosis

Lordosis can affect people of any age. Certain conditions and factors can increase your risk for lordosis. This includes:

  • Spondylolisthesis: Spondylolisthesis is a spinal condition in which one of the lower vertebras slips forward onto the bone below. It’s usually treated with therapy or surgery.
  • Achondroplasia: Achondroplasia is one of the most common types of dwarfism.
  • Osteoporosis: Osteoporosis is a bone disease that causes a loss of bone density, which increases your risk of fractures.
  • Osteosarcoma: Osteosarcoma is a bone cancer that typically develops in the shinbone near the knee, the thighbone near the knee, or the upper arm bone near the shoulder.
  • Obesity: Obesity is an epidemic in the U.S. This condition puts people at a higher risk for serious diseases, such as type 2 diabetes, heart disease, and cancer.
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What are the types of lordosis?

Lordosis in the lower back

Lordosis in the lower back, or lumbar spine, is the most common type. The easiest way to check for this condition is to lie on your back on a flat surface. You should be able to slide your hand under your lower back, with little space to spare.

Someone with lordosis will have extra space between their back and the surface. If they have an extreme curve, there’ll be a visible C-like arch when they stand. And from the side view, their abdomen and buttocks will stick out.

Cervical lordosis

In a healthy spine, your neck should look like a very wide C, with the curve pointing toward the back of your neck. Cervical lordosis is when your spine in the neck region doesn’t curve as it normally should.

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This can mean:

  • There’s too much of a curve.
  • The curve is running in the wrong direction, also called reverse cervical lordosis.
  • The curve has moved to the right.
  • The curve has moved to the left.

What are the symptoms of lordosis?

The most common symptom of lordosis is muscle pain. When your spine curves abnormally, your muscles get pulled in different directions, causing them to tighten or spasm. If you have cervical lordosis, this pain may extend to your neck, shoulders, and upper back. You may also experience limited movement in your neck or lower back.

You can check for lordosis by lying on a flat surface and checking if there’s a lot of space between the curve of your neck and back and the floor. You may have lordosis if you can easily slide your hand through the space.

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Make an appointment with the doctor if you are experiencing other symptoms, such as:

  • numbness
  • tingling
  • electric shock pains
  • weak bladder control
  • weakness
  • difficulty maintaining muscle control

These may be signs of a more serious condition such as a trapped nerve.

Lordosis in children

Often, lordosis appears in childhood without any known cause. This is called benign juvenile lordosis. It happens because the muscles around your child’s hips are weak or tightened up. Benign juvenile lordosis typically corrects itself as your children grow up.

Lordosis can also be a sign of a hip dislocation, especially if your child has been hit by a car or fallen somewhere.

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Other conditions that can cause lordosis in children are normally related to the nervous system and muscle problems. These conditions are rare and include:

  • cerebral palsy
  • myelomeningocele, an inherited condition where the spinal cord sticks through a gap in the bones of the back
  • muscular dystrophy, a group of inherited disorders that cause muscle weakness
  • spinal muscular atrophy, an inherited condition that causes involuntary movements
  • arthrogryposis, a problem that occurs at birth where the joints can’t move as much as normal

Lordosis in pregnant women

Many pregnant women experience back pains and will show the signs of lordosis, a protruding belly and buttocks. But according to Harvard Gaze, research shows that lordosis during pregnancy is actually your spine adjusting to realign your center of gravity.

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Overall back pain may be due to altered blood flow in your body, and the pain will most likely go away after birth.

How is lordosis diagnosed?

Your doctor will look at your medical history, perform a physical exam, and ask about other symptoms to help determine if you have lordosis. During the physical exam, your doctor will ask you to bend forward and to the side. They’re checking:

  • whether the curve is flexible or not
  • your range of motion
  • if your spine is aligned
  • if there’re any abnormalities

They may also ask questions like:

  • When did you notice the excessive curve in your back?
  • Is the curve getting worse?
  • Is the curve changing shape?
  • Where are you feeling pain?
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After narrowing down the possible causes, your doctor will order tests, including X-rays of your spine to look at the angle of your lordotic curve. Your doctor will determine if you have lordosis based on the angle in comparison to other factors like your height, age, and body mass.

How to treat lordosis

Most people with lordosis don’t require medical treatment unless it’s a severe case. Treatment for lordosis will depend on how severe your curve is and the presence of other symptoms.

Treatment options include:

  • medication, to reduce pain and swelling
  • daily physical therapy, to strengthen muscles and range of motion
  • weight loss, to help posture
  • braces, in children and teens
  • surgery, in severe cases with neurological concerns
  • nutritional supplements such as vitamin D
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What’s the outlook for lordosis?

For most people, lordosis does not cause significant health problems. But it’s important to maintain a healthy spine since the spine is responsible for much of our movement and flexibility. Not treating lordosis could lead to long-term discomfort and an increased risk of problems with the:

  • spine
  • hip girdle
  • legs
  • internal organs

How to prevent lordosis

While there aren’t guidelines on preventing lordosis, you can perform some exercises to maintain good posture and spine health. These exercises can be:

  • shoulder shrugs
  • neck side tilts
  • yoga poses, like Cat and Bridge pose
  • leg raises
  • pelvic tilt on a stability ball
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Prolonged standing may also change the curve of your spine. According to one study, sitting significantly decreases changes in the lower back curve. If you find yourself standing a lot, due to work or habits, try taking sitting breaks. You’ll also want to make sure your chair has sufficient back support.

When to see a doctor for lordosis

If the lordotic curve corrects itself when you bend forward (the curve is flexible), you do not need to seek treatment.

But if you bend over and the lordotic curve remains (the curve is not flexible), you should seek treatment.

You should also seek treatment if you’re experiencing pain that interferes with your day to day tasks. Much of our flexibility, mobility, and daily activities depend on the health of the spine. Your doctor will be able to provide options for managing the excess curvature. Treating lordosis now can help prevent complications later in life, such as arthritis and chronic back pain.

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Spine Health. PROCEDURE 13 — FLEXION IN LYING The patient lies supine with the knees and hips flexed to about forty-five degrees and the feet flat on the couch. He bends the knees up towards the chest, firmly clasps the hands about them and applies overpressure to achieve maximum stress. The knees are then released and the feet placed back on the couch. The sequence is repeated about ten times. The first two or three flexion stresses are applied cautiously, but when the procedure is found to be safe the remaining pressures may become successively stronger, the last two or three being applied to the maximum possible. Fig. Flexion in lying. Effects: Flexion in lying causes a stretching of the posterior wall of the annulus, the posterior longitudinal ligament, the capsules of the facet joints, and other soft tissues. As the movement takes place from below upwards the lower lumbar and lumbo-sacral joints are placed on full stretch at the beginning of the exercise as soon as movement is initiated. Thus, the procedure is very i...
Spine Health. PROCEDURE 12 — ROTATION MANIPULATION IN FLEXION The sequence of procedure 11 must be followed completely to perform the required pre-manipulative testing. If the manipulation is indicated a sudden thrust of high velocity and small amplitude is performed, moving the spine into extreme side bending and rotation. Fig. Rotation manipulation in flexion. Effects: There are many techniques devised for rotation manipulation of the lumbar spine. When rotation of the lumbar spine is achieved by using the legs of the patient as a lever or fulcrum of movement, confusion arises as to the direction in which the lumbar spine rotates. This is judged by the movement of the upper vertebrae in relation to the lower — for example, if the patient is lying supine and the legs are taken to the right, then the lumbar spine rotates to the left. It has become widely accepted that rotation manipulation of the spine should be performed by rotation away from the painful side. This has applied to derangement as well as dysfunction, because hitherto n...
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...
TYPICAL TREATMENT PROGRESSION — THE POSTURAL SYNDROME The days referred to in the treatment progression are related to treatment sessions which do not necessarily take place on consecutive days. This also applies for the treatment progressions of the dysfunction and derangement syndromes. Day one Assessment and conclusion/diagnosis. Postural discussion ensuring adequate explanation of the nature of the problem. The patient must understand the cause of pain. I usually give the simple example of pain arising from the passively bent forefinger. We must satisfy ourselves and the patient that the pain can be induced and abolished by positioning. If it is not possible to induce pain during the first treatment session, the patient must be instructed mow to abolish pain by postural correction when next it appears. Commence with postural correction exercises and give postural advice; do not try to teach too much the first visit. Discuss the importance of maintenance of the lordosis while sitting prolonged, and demonstrate the u...
Back Pain History Taking an accurate history is the most important part of the initial consultation when one is dealing with any medical or surgical problem. Unfortunately, when the mechanical lesion is involved there is still lack of understanding regarding the nature of the questions that should be asked, the reasons for asking them, and the conclusions to be drawn from the answers. I will set out step by step the stages that should be developed in history taking, and the questions that should be asked at each stage. Practitioners will already have their own method of history taking, and I do not suggest at all that they should alter their routine. However, I believe that the following questions must be included, if one is to reach a conclusion following the examination of patients with mechanical low back pain. INTERROGATION As well as the usual questions regarding name, age and address, one should enquire as to the occupation of the patient, in particular his position at work which provides us ...