When you look at the spine from the back, it appears straight. But if you observe it from the side, you’ll notice it has some natural curvatures, including natural lordosis curves in the lower spine and upper spine. They appear in a healthy spine.
What is Lordosis?
The inward curvature of the lower back (lumbar spine) and upper back (cervical spine) is termed as “lordosis” or a normal “lordotic curve”. Namely, these curvatures are known as lumbar lordosis and cervical lordosis, respectively. These curves are present naturally in our spine because of different thickness of the vertebrae at their front and in the back portion.
These curves have a number of functions:
- Support the head on the body
- Maintain the structure of the body and stabilise it
- Help in movement and bending
- Act as a shock absorber by distributing the stress occurring during movement
- Align the head over the pelvis
The other types of curves that occur in the spine are kyphotic (inward curve of the thoracic spine) and scoliotic (the sideway curve that results from various negative factors, and which can also be observed from the front of the body if it’s extremely severe, also called scoliosis).
When Lumbar Lordosis Becomes a Problem
There are two types of conditions associated with lordosis that can result in pain or other complications.
Hyperlordosis (hyper = too much) is the excessive or exaggerated inward curve. It is also called saddle back, swayback or hollow back. The major contributing factor to this is the anterior pelvic tilt (tilting forward of the pelvic bone).
Hypolordosis (hypo= too little) is the flattening of the back, having lesser curvature than is necessary for normal movement. This can result in compression of the intervertebral disc in the front and may end up in causing pinched nerves. Hypolordosis is more common than hyperlordosis.
Causes of Lordosis Issues
Hyperlordosis is caused by:
- Obesity, which causes overweight people to lean backwards, resulting in poor posture.
- Imbalance in muscle strength and length may also lead to lordosis, such as tight muscles of the lower back, or weak abdominal muscles.
- Muscular dystrophy.
- Common in dancers and gymnasts.
- Kyphosis (humpback) may force the lower back to compensate for imbalance created by a curve occurring at higher level.
- Vitamin-D deficiency in children can cause rickets, which results in a lumbar lordosis.
- Spondylolisthesis, a spinal condition in which one of the lower vertebras slips forward onto the bone below.
- Discitis, which is the inflammation of the vertebral discs.
- Osteoporosis, or decrease in bone density.
- Achondroplasia, a disease involving the cartilage.
Causes of Hypolordosis are:
- Sitting with a bad posture.
- Trauma, more commonly with whiplash injury.
- Congenital (acquired at birth).
Both hyperlordosis and hypolordosis can result in back pain, which can be moderate to severe, especially during movement. The pain is usually muscular, because the muscles concerned with the back are pulled in different directions during movement due to the faulty curvature of the back.
The pain may also be felt in the surrounding areas like the neck, shoulders, and upper back. In lumbar hyperlordosis the pain may be felt in the hips, buttocks, or legs. Limited movement in these areas might also accompany the pain.
If a nerve is pinched or trapped due to lordosis, the patient might experience tingling, numbness, electric shock-like pain, weakness, weak bladder control. Consider seeking medical advice if these symptoms occur, as these indicate a more serious condition which demands immediate care and treatment.
How can you check for Lordosis?
You can do that by lying on a flat surface or the floor and checking if there’s a lot of space between the lower back and the surface. Excessive lordosis might not be apparent until the age of early or mid-twenties.
How to Treat Lordosis?
Unless the lordosis is severe, medical management is not required. It can be treated conservatively, depending on the severity of the condition and presence of any other symptoms. Some options include:
- Pain medications, to reduce pain as well as swelling. These include over-the-counter pain killers like Ibuprofen. (Consult your health provider before taking any medicine.)
- Daily exercises, or physical therapy, to strengthen muscles and improve mobility as well as flexibility. Treatment involves strengthening the hip extensors on the back of thighs and stretching the hip flexors on the front of the thighs. These muscles help in the movement of the pelvis.
- Weight loss in case of obesity. This will help improve the posture and thus help reduce the lordosis.
- In young children and teens, a special kind of braces or support can be used to maintain good posture.
- Nutritional supplements such as vitamin-D if there is deficiency in the body.
- Lordosis does not require surgery, unless it is a severe case, which doesn’t occur quite often.
If lordosis is not treated, it can result in long term pain and discomfort. There can also be an increased risk of problems involving the spine, pelvis, and legs.
Can Lordosis Be Prevented?
Some exercises and yoga can be performed to maintain a good posture. It is also significant to have a proper posture while sitting, standing as well as during work. Prolonged standing can also result in lordosis, so it is important to take short breaks if your work involves standing a lot. Also ensure you have sufficient back support while sitting on a chair.