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Lumbar lordosis – This is a physiological or pathological bend in the lumbar spine characterized by a bulge. Every person has a physiological lumbar lordosis (it is also in the cervical region), and pathological lordosis differs from it in the degree of bulge of the bend. Most often, people are diagnosed with pathological lordosis of the lumbar region.
Natural lordosis is formed in a child during the first year, and pathological lordosis can occur at any age. Such disorders in the structure of the spine can be due to many reasons, including congenital and acquired pathologies, as well as diseases of the musculoskeletal system, joints, muscles, etc. Pathological lordosis has a negative impact not only on the appearance of a person, but also negatively affects work internal organs.
The disease manifests itself with back pain and problems with posture, it is treated both surgically and conservatively.
Causes of lumbar lordosis
It is impossible to consider the causes of lumbar lordosis in the context of pathology without understanding what constitutes a normal lumbar lordosis. The anatomical norm for each person is the presence of four bends: two anteriorly (lordosis of the lower back and lordosis of the neck) and two posteriorly (kyphosis of the sacrum and chest zone).
You can notice the first signs of the formation of lumbar lordosis, as well as all other curves of the spine, immediately after the birth of the child. But in infancy, these curves are very weakly expressed. As the child grows older, begins to stand up and take the first steps, lordosis becomes more noticeable. The spine will complete its formation when a person reaches the age of 16-18. However, the pathology of the lumbar curve can begin to form much earlier.
Three lumbar lordosis can be distinguished, depending on its shape:
Hyperlordosis – excessive pathological lordosis.
Natural or physiological lordosis.
Hypolordosis is the straightening of the natural curve.
Depending on the degree of fixation of lordosis, one can distinguish:
Fixed bend. In this case, even by an effort of will, a person cannot return the body to its normal position. Most often, this type of lordosis is formed due to the presence of volumetric formations in the spinal column, for example, with disc herniation. The disease usually manifests in middle age. The onset of the disease can be both acute and imperceptible to a person. The course of the pathology has an unfavorable prognosis, leads to severe pain and neurodystrophic changes in soft tissues.
Partially fixed bend. In this case, changes in the angle of lordosis are limited. The development of this form of lordosis most often leads to sciatica, or arachnoiditis of the spinal cord. The disease develops at a young age. The course of the disease is favorable.
Unfixed bend. In this case, the patient can, by an effort of will, return the spine to its normal position. This form of the disease most often results from bone tuberculosis, hip contracture, hip dislocation, or spondylolisthesis.
Having considered the anatomy of the human lumbar lordosis, we can proceed to the causes of pathological lordosis of the lumbar spine.
All etiological factors are divided into two large groups:
A variety of pathological processes in the spinal column, which lead to the formation of primary lordosis. Primary lordosis can occur in humans due to congenital malformations of the spinal column. In addition, the cause can be neoplasms in the vertebrae, their inflammation.
Another etiological factor in the development of the disease is spondylolisthesis. It is a displacement of the upper vertebra relative to the lower one due to trauma, tumor, congenital pathology, etc.
Dangerous in terms of the development of primary pathological lordosis, muscle torsion spasms or torsion dystonia, which are a manifestation of disorders in the functioning of the nervous system and are of a progressive nature. Also, inert tuberculosis can lead to the pathology of the vertebral bend.
Naturally, a pathological bend can occur as a result of spinal cord injuries, both open and closed.
Adaptive or compensatory reactions of the lumbar spine that occur in response to non-physiological conditions for it and lead to the formation of secondary lordosis, including:
Intra-articular and extra-articular ankylosis of the hip joint.
Congenital or acquired hip dislocation.
Stable restrictions on the mobility of the hip joint (contractures).
Diseases of the muscular and skeletal system.
Cerebral spastic palsy of the legs.
Poliomyelitis with involvement in the pathological process of the muscles of the legs and pelvis.
Carrying a child. Most often, lordosis that occurs during pregnancy resolves on its own after the baby is born and does not need treatment.
In addition, separately it is possible to single out factors that are predisposing to the formation of a pathological bend of the lumbar spine, among them:
Excess body weight;
Rapid increase in height during adolescence or childhood;
Wrong posture.
Lordosis, which is formed in childhood, can be corrected if the cause that caused it is eliminated in time. As for adults, the longer they have lordosis, the more difficult it is to get rid of it, and in some cases only surgery can help.
Symptoms of lumbar lordosis
The symptoms of lumbar lordosis will be considered in terms of the presence of an abnormal curvature.
Among the main signs of the disease are:
Patient’s posture disorder. They are connected with the fact that the spine is a single whole and if any violations occur in one of its departments, this will certainly affect the state of the support column as a whole.
Fatigue in humans increases, occurs earlier than in healthy people.
Pain in the lumbar region. They become stronger after physical exertion, or after a person has been in an uncomfortable position for a long time.
Limitations in the mobility of the spine during exercise or simply during movement.
If the pathology exists for a long time and has a high degree of severity, then this will negatively affect the work of internal organs. First of all, problems will begin in the work of the heart, intestines, kidneys, lungs, stomach. Violations are associated with the fact that their normal location relative to each other changes, since the spine does not cope with its main function.
The appearance of a person with pathological lumbar lordosis changes.
There are several options for how the patient’s posture will be disturbed:
The back becomes round. In this case, the thoracic kyphosis increases, and the lumbar curve decreases. While walking, such people constantly bend their legs, tilt their heads forward to maintain balance, as the center of mass of the body shifts backwards. A characteristic image of the patient: arms lowered along the body, protruding belly, sunken chest. Doctors call this posture kyphotic.
The back is flat. The cervical bend gradually smoothes out, the thoracic kyphosis becomes smaller, and the lumbar lordosis increases, the pelvis is displaced backwards. A characteristic image of the patient: sunken chest, protruding shoulder blades, bent knees, lowered head and chin.
The back is round. All physiological curves of the spine are strengthened. Characteristic appearance of the patient: legs slightly bent at the knees, protruding shoulder blades, adducted shoulders, raised shoulder girdle, protruding belly, protruding head. This posture in orthopedics is called kypholordotic. According to statistics, it is this type of posture that most often develops in people with pathological lumbar lordosis.
The back is flat. All physiological curves of the spine are reduced, and lumbar lordosis is the strongest. The characteristic appearance of the patient: protruding shoulder blades, anteriorly displaced chest, forward lower abdomen.
Complications of lumbar lordosis
Complications of lumbar lordosis lead to problems in the functioning of many vital organs. The fact is that the load on the muscles, on the ligaments and on the bones in case of spinal disease is redistributed incorrectly. In this case, the ligaments are stretched too much, and the muscles are constantly tense. From this, a person experiences severe fatigue, gets tired even after small physical exertion, and constant pain will lead to nervous breakdowns and sleep disturbance.
If you do not get rid of the pathological lumbar lordosis in a timely manner, then the following complications are likely to develop:
The formation of a hernia of the spinal column, with multiple hernias most often appearing.
Prolapse of the vertebral discs (their prolapse).
Inflammation of the iliopsoas muscle. This pathological process is called “psoitis”.
Instability of the vertebrae with their excessive mobility.
Dystrophic changes in the joints of the spine with the subsequent development of deforming arthrosis.
Diagnosis of lumbar lordosis
Diagnosis of lumbar lordosis is the responsibility of an orthopedist. After listening to the patient’s complaints and examining him, the doctor will refer the patient to undergo x-rays. Also in the arsenal of a specialist there are methods that, already during the initial examination, will determine the degree of mobility of lordosis, as well as the presence of neurological disorders. The mandatory examination program includes palpation of the muscles of the back and the spine itself. The doctor also evaluates the condition of the organs of the chest cavity using special tests.
Radiography is performed in two projections (direct and lateral). To establish the degree of pathology during the execution of images, the patient can be forced to straighten up and bend as much as possible. Based on the obtained images, it will also be possible to judge the presence of violations in the form and structure of the vertebrae, as well as the correctness of their relative position.
Treatment of lumbar lordosis
Treatment of lumbar lordosis is the responsibility of an orthopedist or vertebrologist. First of all, it is necessary to eliminate the cause that led to the formation of a pathological bend.
The patient goes through orthopedic procedures, he is required to undergo kinesitherapy rehabilitation. Useful therapeutic massage, a good effect gives manual therapy. A complex of physiotherapy exercises is compiled on an individual basis. Swimming and water aerobics are very useful, but the back should not be too overloaded.
Doctors sometimes prescribe a multivitamin to help maintain bone health. They should contain phosphorus, magnesium, calcium, B vitamins, vitamin D and vitamin A.
As for drug therapy, it is usually symptomatic. It is possible to take painkillers, which, if necessary, relieve inflammation – these are Ibuprofen, Diclofenac, Movalis.
Also, to reduce pain, wearing a corset or bandage is shown. Surgical intervention is carried out in case of detection of primary lordosis.