Lordosis – types, causes, symptoms. Prophylaxis of lordosis

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Our spine shouldn’t be perfectly straight. A healthy spine has three gentle curves, two curves in the cervical and lower back that extend forward of the body known as lordosis, and one known as kyphosis in the upper back that curves outward. These curves help the spine to absorb shock, support the head, and keep the body stable. However, as they say, what is too much is unhealthy. When lordosis in the lower back or (less commonly) the neck becomes too pronounced, it is said to be hyperlordosis (deep lordosis, concave back) which can cause many problems such as low back pain, neck pain, numbness, weakness etc. Here is how to recognize if the curvature of our spine is excessive and how to correct it.

Lordosis – what is it?

Everyone’s spine bends slightly in the cervical, upper back, and lower back. These curves that make up the S-shape of the spine are called lordotic (neck and lower back) and kyphotic (upper back). They help the body:

1. absorb shock;
2. support the weight of the head;
3. position the head above the pelvis;
4. stabilize and maintain its structure;
5. flexibly move and bend.

Lordosis refers to our natural lordotic curve which is normal. However, if our curve bends too deeply inward, we are talking about lordosis. Lordosis can affect the lower back and neck. This can lead to excessive pressure on the spine, causing pain and discomfort. Lordosis can also affect the ability to move if it is too severe and left untreated.

Treatment depends on how severe the curvature of the spine is and how it gets worse. There is no medical concern if the lower back curvature turns around when you lean forward. We can probably deal with the problem with physical therapy and daily exercise. However, see your doctor if the curvature remains the same when bending.

See also: The corporate backbone – seven ways to stay healthy at your desk

Lordosis – types

Lordosis occurs in all age groups. This mainly affects the lumbar spine, but can also occur in the neck (cervical spine). Once in the lumbar spine, the patient’s posture may appear tilted, with more prominent buttocks and an overall exaggerated posture. Lumbar lordosis can also be painful, sometimes affecting movement.

Lumbar lordosis

Lumbar lordosis is the natural curve of the spine in the lumbar region. It is assumed that the lumbar lordosis should be between 28 and a maximum of 46 degrees.

The easiest way to check for this condition is to lie on your back on a flat surface. We should be able to get our hand under our lower back, leaving little room. A person with lordosis will have extra space between their back and the surface they are lying on. If the curvature of the spine is very severe, a C-shaped arch will be visible when the person is standing. When we stand aside, we will see a strongly protruding belly and buttocks in such a person.

Although low back pain is experienced by many people with lordosis, the pain does not come directly from the condition – in fact it often results from other surrounding factors such as weakness in the trunk, short hamstrings, and weak thighs.

Similarly to cervical lordosis, lumbar lordosis may become shallow, deeper or completely abolished due to incorrect posture or injuries.

Cervical lordosis

Cervical lordosis is cervical lordosis, and although it is less common than lumbar lordosis, many people also have a problem with it. There are several methods of measuring the physiological curvature of the cervical spine – the Cobb, Jackson, Harrison methods. The mean value of cervical lordosis measured by the Cobb method is from 10,5 ° to 13,9 °, by the Jackson method from 15,6 ° to 17,5 °, and by the Harrison method from 15,9 ° to 17,7 °.

In a healthy spine, the neck should look like a very wide C, with the curve towards the back of the neck. Cervical lordosis is when the spine around the neck does not curve as it should.

Excessive curvature causes the neck muscles to work even harder, which can cause neck pain, cramps, and reduced mobility. Discopathy, damage to intervertebral discs or joints, and inappropriate muscle tension, along with degenerative disease, may lead to shallowing, deepening or complete elimination of the natural cervical lordosis.

Deep lordosis

Deep lordosis, also known as hyperlordosis, is an increase in the natural curvature of the spine. Profound lumbar lordosis is one of the most common posture defects.

The deepened lordosis results from excessive tension in the following muscles:

1. spine extensor;
2. lumbar trapezius; 
3. iliopsoas muscle;
4. rectus muscle of the thigh. 

Their tension causes the weakening of the gluteal muscles, abdominal muscles and the hamstring muscles.

In turn, muscle imbalance usually results from poor movement habits and lack of physical activity. Deepened lordosis most often affects people who have obesity problems and women who often wear high-heeled shoes. In addition, people at risk of hyperlordosis include manual workers who carry heavy objects without stabilizers. A characteristic symptom of deepened lumbar lordosis is pelvic anterior tilt, abdominal bulging and buttocks bulging, observed in the sagittal space.

Reduction of lordosis

The reduction of lordosis, or the elimination of lordosis or hypolordosis, means the reduction of the natural curvature of the spine. It results from the stretching of the extensor of the back and the parallelogram of the lumbar muscles, shortening of the extensor of the hip joint. It is worth adding that shallowing of the lumbar lordosis is rare, and shallowing of the cervical lordosis is more common, resulting from a sedentary lifestyle and low physical activity.

Reduction of the cervical lordosis most often affects people working in front of a computer and often using a tablet or smartphone, because they have to assume a position with their head forward or tilted down.

Abolition of Lordosis

The abolition of lordosis is nothing more than an extreme form of hypolordosis (deepened lordosis), i.e. a complete flattening of the physiological curvature of the spine. The abolition of lordosis can lead to cervical kyphosis, in which the curvature forms in the opposite direction to the natural one. Unfortunately, but the abolition of cervical lordosis is often a problem among adolescents and young adults. Along with the occurrence of abolished lordosis, there is also a reduction in thoracic kyphosis, which results from the body’s natural compensatory mechanism, which aims to set the eyesight horizontally.

Lordosis – the most common causes

Lordosis can affect people of any age. Certain conditions and factors may increase the risk of lordosis. The following diseases and ailments are mentioned among them.

1. Spondylolisthesis: Spondylolisthesis (lat. spondylolisthesis) is a condition of the spine in which one of the lower vertebrae moves forward onto the bone below. It is usually treated with therapy or surgery.
2. Achondroplazja: Achondroplasia (chondrodystrophy) is one of the most common types of dwarfism.
3. Osteoporosis: Osteoporosis (lat. osteoporosis, formerly called thinning of the bone) is a bone disease that causes the bone to lose its density, which increases the risk of fractures.
4. ObesityObesity is a condition that puts people at greater risk of serious diseases such as type 2 diabetes, heart disease and cancer. Some people with obesity tend to lean back to improve their balance. This has a negative effect on posture.

Possible causes that lead to the state of hyperlordosis are:

1. spine – The natural factors involved in spine formation greatly increase the likelihood of stretching or twisting the back or neck in some people.
2. Legs – Another strange body formation is when a person has a leg shorter than the other, which can cause an immediate hip imbalance and then put a strain on the back posture that the person needs to adjust. This can lead to permanent back damage.
3. hips – common problems in the hips are tight hip flexors which cause poor lifting posture, hip flexion contracture, which means lack of awareness of posture, and hyperphosis of the chest, which causes the person to compensate for the limited hip rotation.
4. muscles – one of the biggest factors is muscle imbalance. Since all muscles have a muscle that works unlike it, it is imperative that all muscles are protected, the opposite muscle is not stronger than the muscle at risk. In the case of lumbar lordosis, the abdominal muscles are weaker than the muscles of the lumbar spine and the hamstrings. Muscle imbalance causes the pelvis to tighten in front of the body, causing the spine to sway.

Other causes of lordosis include:

1. improper lifting – e.g. when dancers are performing a dance lift with their partner, they are very prone to perform a lift in the wrong posture, putting their hands up to lift the other dancer while keeping the spine in the wrong position, which can very quickly lead to hyperlordosis.
2. overexertion – more than 45% of anatomical sites of injuries in the aforementioned dancers are located in the lower back. This can be attributed to series of repeated dance training that could lead to minor injuries. If the damaged area does not have time to heal, the damage will increase. Sudden increases in the intensity of the dance or sudden changes in the dance choreography do not allow the body to adapt to the new load.

Also check: The seven worst diseases of bones and joints

Lordosis – symptoms

Lordosis often presents itself in an apparently mild manner: sore muscles. Due to the extreme curvature of the spine in the cervical and back, this abnormality often causes the muscles to over-adjust, throwing everything off balance. As muscles struggle to overcompensate, they can begin to tighten and contract. This will likely result in limited, painful movement in your neck, shoulders, and lower and upper back.

There are also a number of more serious symptoms of lordosis, potentially involving pinching of a nerve or prolapse of a vertebrae that require immediate medical attention.

1. Neurological symptoms: numbness or tingling; pain that resembles an electric shock;
2. Urinary incontinence: change in bowel or bladder control;
3. Muscle weakness: Weakness and / or difficulty maintaining muscle coordination.

Fortunately, not all forms of lordosis are serious. If we suspect lordosis is the cause of a spinal condition, we can verify this by lying down on a flat surface and examining the amount of space and degree of curvature between the lower back and / or the neck. If the curvature is large and remains rigid during later leaning forward, lordosis may need to be treated. However, we don’t have to worry so much if the curvature turns around as we lean forward. Being proactive is the key to managing lordosis. And contacting your doctor will help you take the first steps in this process.

Lordosis in children

Often, lordosis appears in childhood for no known reason. This is called benign youthful lordosis. This is because the muscles around your baby’s hips feel weak or tight. Juvenile benign lordosis usually resolves on its own as children grow up.

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

Other conditions that can cause lordosis in children are usually associated with problems in the nervous system and muscles. These conditions are rare and include:

1. cerebral palsy;
2. meningeal hernia: an inherited disease in which the spinal cord protrudes through a gap in the bones of the back;
3. muscular dystrophy: a group of inherited disorders that cause muscle weakness;
4. spinal muscular atrophy: an inherited condition that causes involuntary movements;
5. arthrogryposis: also known as congenital joint stiffness, a problem that occurs at birth where the joints cannot move as much as they normally would.

See also: How much should your child’s backpack weigh? You can calculate it

Lordosis in pregnant women

Many pregnant women experience back pain, symptoms of lordosis, protruding belly and buttocks. But according to researchers, research shows that lordosis during pregnancy is actually an adjustment of the spine to align the center of gravity.

General back pain can be caused by an altered blood flow in a woman’s body and will most likely go away after birth.

Also check: Infectious diseases of the mother during pregnancy, affecting the development of the fetus

Lordosis – diagnosis

The doctor will look at the patient’s medical history, perform a physical examination, and ask about other symptoms to help determine if the patient has lordosis. During the physical examination, the doctor will ask the patient to lean forward and to the side. The specialist will check:

1. whether the curvature is elastic or not;
2. range of motion;
3. whether the spine is equal;
4. are there any abnormalities.

The doctor may also ask questions such as:

1. when did we notice excessive curvature of the back?
2. is the curvature getting worse?
3. does the curvature change shape?
4. where do we feel pain?

After narrowing down the possible causes, your doctor will order tests, including X-rays, MRI, bone scintigraphy, or a CT scan, to confirm the diagnosis.

Bone scintigraphy is performed to rule out possible fractures and infections and cancers, magnetic resonance imaging (MRI) is used to eliminate the possibility of spinal cord or nerve abnormalities, and computed tomography (CT) is used to obtain a more detailed image of the bones, muscles and organs in the lumbar region.

X-ray of the spine to look at the angle of lordotic curvature. The specialist will determine if we have lordosis based on the angle compared to other factors such as height, age and weight.

See also: Let’s not forget about preventive examinations! When and how often should they be done?

Lordosis – treatment

Most people with lordosis do not need treatment unless it is a serious case. Treatment of lordosis will depend on how severe the curvature of the spine is and the presence of other symptoms.

Treatment options include:

1. drugs to reduce pain and swelling (paracetamol, ibuprofen, naproxen);
2. daily physical therapy to strengthen the muscles and range of motion;
3. weight loss to help maintain correct posture;
4. special orthoses (braces) for children and adolescents;
5. surgery, in severe cases with neurological problems;
6. dietary supplements such as vitamin D.

Lordosis – prognosis

For most people, lordosis does not cause significant health problems. However, it’s important to keep your spine healthy, as the spine is responsible for most of our movement and flexibility. Untreated lordosis can lead to long-term discomfort and an increased risk of problems with:

1. backbone;
2. hip girdle;
3. nogami;
4. internal organs.

Lordosis – prevention

While there are no guidelines for preventing lordosis, certain exercises can be performed to maintain good posture and the health of your spine. A healthcare professional can help identify exercises that are safe and effective for people with lordosis. Your doctor may recommend a physiotherapist who specializes in these types of conditions.

Experts list a few exercises that may benefit people with abnormal curvature of the spine.

Prophylaxis of lordosis – stretching the hip flexors

To perform a hip flexor stretch, start by kneeling on a soft surface such as a yoga mat.

Next, place your right foot in front of your body so that your knee is bent at a 90-degree angle and your right knee is directly above your right foot. Then, bend your arms down and back without flexing your back, and keep your pelvis and spine in a stable and neutral position. The next step is to lean forward with your right hip, keeping your left knee on the ground and with your pelvis facing forward.

Hold this position for 30-45 seconds at a time and repeat 2-5 times for each hip.

If we’re comfortable, let’s bend our hip deeper to deepen the stretch.

Prophylaxis of lordosis – the position of the cat-cow

To perform the cat / cow yoga pose, start with your hands and knees placed on the floor or yoga mat.

Keep your knees hip-width apart and directly below your hips, with your toes tucked in. Then place your hands directly under your shoulders, facing forward and shoulder-width apart. Then use your abdominal muscles to bring your spine into a neutral position. Then breathe out and slowly bend your spine towards the ceiling, letting your head drop and hold this position for 10-15 seconds.

The next step is to inhale and relax your spine by pinching the shoulder blades down your back and holding this position for 10-15 seconds.

Finally, the spine must be brought back to a neutral position.

See also: Yoga for beginners – positions, asanas, yoga benefits

Lordosis prophylaxis – supine hollowing

To do supine hollowing, follow these steps:

1. Lie on your back with your knees bent and your feet flat on the floor about 3 cm from your buttocks.
2. Stretch your arms out to the sides at shoulder level.
3. Breathe deeply and relax your shoulders.
4. Pull your arms down and back without arching your back, and maintain this position during the exercise.
5. Perform a gentle Kegel exercise – flexing your pelvic floor as if you are trying to stop urination.
6. Pull the navel towards the lower back without spreading the hips or chest.
7. Do the Kegel exercise by pulling your stomach inward and repeat this while breathing normally.

If you are comfortable with this exercise, add the following steps:

1. Raise one leg about 7-15 cm above the ground without moving the torso.
2. Lift the toes of one foot off the floor. Then, take your foot 7–15 cm away from the buttocks without moving your torso.

Long-term standing can also change the curvature of our spine. According to one study published in the Asian Spine Journal in 2015, sitting significantly reduces changes in the lower back curvature. If we are standing a lot because of work or habits, try taking sitting breaks. We also need to make sure our chair has proper back support.