Lordosis is the medical term for a forward-curved spine in the cervical spine (neck) or the lumbar spine (lower back). A natural lordotic curve in the lower back puts the spine at a 30- to 40-degree curve and a 40- to 60-degree curve in the neck. That normal curvature naturally places the head over the pelvis and works as a shock absorber to distribute body stressors with movement.
Exaggerated lordosis is sometimes called swayback, saddleback, or hyperlordosis. It develops if the spine curves too much and pushes posture out of alignment. Too little lordosis can also occur, sometimes called flatback or hypolordosis.
Changes to normal lordosis include injuries, obesity, pregnancy, and various health conditions, including joint and congenital (present at birth) disorders. Lordosis, even with too much or too little curvature, typically does not cause symptoms. But if the curvature or flatness is severe, you may feel pain and need treatment.
This article will cover how to identify the signs and symptoms of lordosis in the neck and lower back, posture correction and pain relief, causes, and more.
A primary characteristic of lordosis is an inward curve of the cervical spine or lumbar spine. With hyperlordosis, that curvature is even more exaggerated. Additional characteristics may apply based on the location of the excessiveness of the curve.
With hypolordosis, there is less of a curve in the lower back or a flattening of the lower back. This can lead to a narrowing of the openings through which the spinal nerves exit, pinching the nerves.
A healthy cervical spine creates a wide C-like appearance, with the curve of the C facing inward. Cervical lordosis affects the normal curvature of the spine in different ways.
That curvature might be excessive or running in the wrong direction. A curve in the wrong direction is called a reverse cervical lordosis. The curvature may also be pushed more to the right or left.
Symptoms of cervical lordosis may include:
Even without active symptoms, cervical lordosis can be dangerous. This is because it makes you more susceptible to a back or neck injury after an accident, slip, or fall.
Lumbar spine lordosis is more common than cervical lordosis. An extreme lumbar curvature will create a visible C-like arch when you stand. With that curvature, a side view of the body will show the buttocks and the stomach area sticking out.
The easiest way to check for lumbar spine lordosis is to lie on your back on a flat surface. With this curvature, there will be spacing when you slide your hand below your lower back.
Symptoms of lumbar spine lordosis may include:
Treatment for lordosis depends on the extent of the curvature and whether there is pain or other symptoms.
If you are not experiencing pain with lordosis and the curvature isn’t severe, you can correct your posture. This typically involves exercises, stretches, and practicing good posture.
Good posture is how you hold your body when moving, sitting, or standing. It can help prevent injuries, pain, and other health problems.
The goal of good posture is a neutral spine. You can achieve that by standing or sitting with your shoulders back, your head in line with your spine, and your stomach pulled in.
If you have pain or a rigid spine, you should see a healthcare provider to determine the cause. Depending on the cause, you may be referred to physical therapy or a back specialist.
A pinched nerve, a damaged disk, or bone loss in the spine could cause lordosis. These conditions require further evaluation and treatment to prevent spine and nerve complications.
Some causes of chronic back pain are progressive, which means they will get worse over time. The longer chronic back pain goes untreated, the harder it may become to manage. Some causes will also put you at risk for spinal arthritis, herniated discs, and other painful conditions.
Chronic back pain can lead to anxiety and depression due to the heavy toll living with it takes on your mental and emotional health.
Lordotic changes can affect people of all ages. Some people might have a higher risk for lordotic curve changes.
Several bone and spine disorders can lead to lordotic spine changes. Conditions that have been linked to lordotic spine changes include:
Spondylolisthesis is a condition that causes spine instability. It causes one vertebra (spinal bone) to slip forward over the one below it. It can lead to lordosis of the lower back.
Poor posture or weak abdominal muscles can lead to changes in the lumbar and cervical spines. Poor posture often leads to lordosis in the lower back or neck.
Excess weight can cause bones and muscles to lean backward, forcing the body to work harder to keep itself balanced. An unbalanced body and spine can lead to lordotic changes and other bone, joint, and muscle problems.
An accident, fall, or other spine injury could cause a spinal fracture that increases the curvature of the spine. This can occur in people who play contact sports or who are involved in automobile accidents. Lordosis can also occur after a spinal surgery that makes the spine unstable.
Lordotic changes in children often have no known cause. Some develop because of muscle problems in the hip. These types of lordosis usually resolve as a child grows and develops stronger bones and muscles. Lordosis might also be a sign of a hip dislocation due to an injury or fall.
Childhood lordosis is sometimes associated with a congenital (present at birth) problem with the vertebrae or a congenital disorder that causes structural or functional problems.
Pregnancy can lead to postural changes, including lordosis. Lordosis can occur in the second and third trimesters of pregnancy.
As the uterus grows, the body shifts its center of gravity. The excess weight puts pressure on the muscles of the lower back, while the growing uterus causes the abdominal muscles to stretch and weaken. The imbalance created between the lower back and abdominal muscles pushes the pelvis forward, creating lordosis.
Lordosis and back pain that occurs during pregnancy will typically resolve after childbirth.
Lordosis does not require treatment unless the curvature or symptoms are severe.
Treatment options for lordosis include:
For childhood lordosis, the child’s healthcare provider may recommend a back brace to prevent the curve from progressing as the child grows.
A chiropractor is a licensed healthcare provider who focuses on treatments to help heal the neuromusculoskeletal system—the bones, nerves, muscles, tendons, and ligaments. A chiropractor can treat neck and back problems with spinal adjustments to maintain the spine’s alignment.
Research shows that chiropractic adjustments might improve cervical lordosis. For example, one 2022 study reported on chiropractic adjustments practiced over six and a half weeks, with a 17-month long-term follow-up in a 10-year-old child.
The child responded well to treatment and achieved complete symptom resolution. Cervical lordosis was corrected to age-appropriate symmetry and remained there at the 17-month follow-up.
Posture exercises stretch the muscles in the hips, thighs, lower back, and neck to improve a lordosis curve.
Such exercises include:
Think of this stretch as your head being pulled upward by strings, like a marionette puppet. To perform the stretch:
To perform this stretch:
To perform this stretch:
To perform this stretch:
To perform this stretch:
To perform this stretch:
Things you can do during pregnancy to manage lordosis include:
You should see a medical provider if you have back pain that does not resolve with at-home treatments such as over-the-counter (OTC) pain relievers, rest, exercise, and heat and cold therapy.
Your healthcare provider will examine your back and spine. They will ask you when your pain started and how it is affecting you daily. They may also request imaging, including X-rays, to confirm and assist in determining the diagnosis.
If you have reported weakness, numbing, or tingling that radiates to the legs from the lower back or the cervical spine into the middle or lower back, your healthcare provider may want to do a neurological exam and more sensitive imaging studies, such as a magnetic resonance imaging (MRI) or a computed tomography (CT) scan.
You should see a healthcare provider right away if your hands and feet feel numb or tingly or if you have experienced saddle anesthesia (numbing and tingling in the buttocks, perineum, and groin). These could be signs of severe spinal cord problems.
Saddle anesthesia is a symptom of a very serious condition called cauda equina syndrome (CES). CES causes nerve root compression in the lower spinal cord. It requires emergency treatment to prevent permanent paralysis.
Lordosis refers to a forward curve in the spine in the neck or lower back. The curvature can either be excessive (hyperlordosis) or less than normal (hypolordosis). Lordosis becomes excessive if the spine curves too much, pushing the posture out of its normal alignment.
For most people, lordosis does not cause symptoms or require treatment. For others, it may cause pain. Children with lordosis may outgrow the condition.
Poor posture, injuries, congenital disorders, obesity, osteoporosis, spondylolisthesis, and pregnancy are causes of lordosis.
Cervical lordosis causes the head to lean forward, while lumbar lordosis pushes the hips forward, causing the buttocks to stick out. Lumbar lordosis also puts extra space in the lower back, which is seen when lying down.
Symptomatic lordosis or a lordotic curve that extends further than usual or causes a rigid spine needs treatment. Treatment includes physical and water therapies, medicines to manage pain and swelling, bracing to support the spine, and surgery if the curve is severe enough or causing nerve problems.
Posture exercises might help correct the lordotic curve. You should see a healthcare provider if you have severe pain and swelling, numbness and tingling in the hands and feet, or saddle anesthesia.
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