New York Spine Institute Spine Services

Understanding Lordosis

Understanding Lordosis

By: Michael Faloon, M.D. FAAOS

Dr. Michael Faloon received his doctorate in medicine and residency from Rutgers University-New Jersey Medical School and Seton Hall University. He completed his fellowship in spine surgery from New York Hospital for Special Surgery. His bachelor’s degree was completed at the University of Notre Dame.

While a slight forward curve in the spine is typical, excess curvature that progresses or causes pain may require medical intervention. Fortunately, numerous treatments are available for lordosis, depending on the cause and severity of the spinal curve. Learn about the diagnosis, symptoms and causes of lordosis, as well as possible treatment options you can pursue.

What Is Lordosis?

Lordosis is the medical term for the natural inward curve of the spine. It helps maintain your posture and absorb shock during movements like jumping and walking.

Slight lordosis is normal. The lumbar spine — the five vertebrae in the lower back — generally has a curve of 40 to 60 degrees, while a curve of 20 to 40 degrees is typical in the cervical spine — the first seven vertebrae in the neck. However, excess lordosis and curvature can cause misaligned posture, pain and discomfort. This condition is often referred to as “swayback.”

Two different types of lordosis exist, with cases ranging from mild to severe:

  • Lumbar: Lumbar lordosis is the most common type. It occurs in the lower region of the spinal column.
  • Cervical: Cervical lordosis occurs in the upper region of the spinal column.

Symptoms of Lordosis

Many people with lordosis don’t experience physical symptoms or pain. So, you may be unaware that you even have the condition until you receive a diagnosis. However, you or others might notice changes in your posture or appearance, such as:

  • Your hips and stomach area pushed forward.
  • Your neck and head leaning more forward.
  • Your rear end sticking out.
  • Additional space beneath your lower back while lying down.

More severe cases of lordosis can cause:

  • Pain or discomfort in the neck or back.
  • Sciatica, a pain that radiates from the lower back into the buttocks, legs and feet.
  • Numbness or tingling.
  • Difficulty performing regular movements or lying flat on the floor.
  • Loss of bladder or bowel control, though this is a rare occurrence.

Causes of Lordosis

Many cases of lordosis are idiopathic, meaning the cause is unknown. However, contributing factors might include:

  • Posture: The abdominal muscles provide support for the lumbar spine. Therefore, people with poor posture or weak abdominal muscles are often more likely to develop lordosis.
  • Trauma: Sports injuries, serious falls or other accidents can lead to spinal fractures that cause the vertebrae to curve.
  • Excess body weight: Extra weight in the stomach area can strain the lower back and pull it forward, which may lead to lordosis.
  • Spinal, bone or neuromuscular disorders: Certain conditions such as muscular dystrophy, cerebral palsy, spondylolisthesis and hip dysplasia can increase the risk of developing lordosis.

Who Is Likely to Get Lordosis?

While anyone can experience lordosis, the following groups are most likely to develop the condition:

  • Adolescents experiencing growth spurts and posture changes
  • Overweight individuals
  • Pregnant women
  • Children with nervous system and muscular conditions

Kyphosis vs. Lordosis

Both of these conditions cause abnormal spine curvature and posture changes, but they differ in the direction of the curvature. While lordosis is the inward curvature of the lumbar or cervical spine, kyphosis causes the spine to curve outward in the upper back. Commonly known as “hunchback,” kyphosis causes a hump on the upper back that curves at over 50 degrees. Both conditions differ from scoliosis, which causes the spine to curve to the left or right.

In some cases, kyphosis and lordosis involve similar treatment methods. For instance, physical therapy can help with both. However, these exercises can look different for each condition since they target different muscle groups and types of curvature. Additionally, severe cases of both kyphosis and lordosis can warrant bracing or surgery, depending on the cause and severity of the curvature.

How to Diagnose Lordosis

Doctors can typically identify lordosis with a physical examination. They’ll have you bend forward and to the side, looking at the following areas:

  • Your range of motion
  • Whether your spine is aligned
  • Whether the curve is flexible
  • Any unnatural curvature or other abnormalities

Additionally, they’ll examine your medical history and inquire about other symptoms. They may ask questions such as:

  • When did you start noticing the excess curve?
  • Is the curve changing shape or getting worse?
  • Are you experiencing any pain? If so, where?

After narrowing down the possible causes, your doctor will likely order an imaging test, such as an X-ray or a CT scan, to examine the angle of the curve and confirm the diagnosis. They can determine if you have lordosis by comparing this angle against factors like your body mass, age and height.

If you have symptoms of a medical condition or an injury that can increase the risk of lordosis, your doctor may perform additional testing to diagnose the underlying cause. You may also be screened for kyphosis, scoliosis and other conditions that affect the spine and back.

Treatment for Lordosis

For mild cases of lordosis that don’t cause pain or worsening curvature, a doctor usually doesn’t need to intervene. However, for lordosis that does require treatment, the cause and severity of the curvature can help determine the best approach. Standard treatment options include:

  • Physical therapy: Your doctor may refer you to a physical therapist who can guide you through safe, effective stretches for lordosis. While it can’t cure lordosis or reverse curvature, physical therapy can help improve physical function, alleviate pain and strengthen the back muscles to better support the spine. These exercises usually target the hips, glutes, abs and hamstrings to enhance your posture.
  • Back brace for lordosis: Your doctor may instruct you to wear a customized back brace to prevent further curvature and support your spine. They’ll tell you how frequently to wear your brace and how long you need it. For a child with lordosis, a doctor may have them wear a brace to stop the curve from progressing as they grow.
  • Surgery: While rare, severe or worsening cases of lordosis may require surgery. Spinal fusion might be necessary to reduce the curvature and straighten the spine. Your doctor or surgeon will explain which type of surgery you’ll need and the expected recovery time.

If your lordosis causes pain or discomfort, you can also try taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.

Find Relief From Lordosis With New York Spine Institute

If you suspect you or your child is dealing with swayback or lordosis, visit one of our locations at New York Spine Institute. As one of the tri-state area’s largest multi-specialty and orthopedic centers, we treat many different adult and pediatric spinal conditions.

Whether you require a back brace or physical therapy for mild lordosis — or surgical intervention for a more severe case — our experts are ready to work with you to find the most suitable treatment approach. Schedule a consultation with us today, and let us help you get to the bottom of your condition.