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Lordosis: Effective Treatment and Prevention

Lordosis places pressure on the spine and can cause an uncomfortable feeling that can cause permanent damage over time. However, the condition may be treated with medical intervention and specific exercises. Read on to understand more about the causes of lumbar lordosis and how to treat and prevent it.

Lordosis: definition

Lordosis refers to an inward curve of the spine, typically found either in the cervical or lumbar areas of the spine. A small degree of lordosis is normal. However, normal aging processes, poor posture, and certain developmental disorders can result in excess curvature, sometimes known as swayback.

Types of lordosis

There are five main types of lordosis, and treating each depends on the type and cause of the lordotic curvature.

Postural lordosis

Poor posture caused by lack of muscle conditioning or carrying excess weight in your abdomen can pull your back forward, placing pressure on the spine and exaggerating its natural curve. Weaker stomach and back muscles, coupled with excess weight, make it hard for the spine to have proper support. The curvature can be reversed with weight loss, strength training, and physical therapy.  

Congenital or traumatic lordosis

Trauma or injury to the connecting links of the spine can cause individual fractures and pain in the lower spine. Sports injuries can result in this type of condition. People who have been hit by a car or have fallen from a great height may have similar injuries. Some children have growth defects in their spine that cause the links to be weak and misaligned, creating exaggerated spinal curves. Repetitive, active stress of the links can result in a break in the bone connection and cause lordotic side effects. 

Post-surgical laminectomy hyperlordosis

Surgical procedures that involve removing parts of the vertebrae can cause the spine to become unstable and increase its normal curvature. Doctors often perform these procedures to access the spinal cord or the nerve roots in the spine. This type of spinal curvature is more common in children who have spinal cord tumors and have undergone procedures to remove them. 

Neuromuscular lordosis

This particular variant refers to many different medical conditions that result in spinal curvature problems. Each disorder has its own treatment options that can correct the damage to the spine.

Lordosis secondary to hip flexion contracture

Different disorders, such as infections, injuries, and muscle imbalance from various medical conditions, can cause one or both of your hip joints to contract. This causes your spine to be pulled out of alignment. Treatment for this type of lordosis depends on the underlying cause, either treating the infection or working through physical therapy to treat the aftereffects of an injury. 

Common causes of lordosis

There are many types of this condition, and each type can have more than one root cause. For example, an injury from a car crash could make it hard for someone to stay active, resulting in weight gain. Lordosis from cracks to the spine, in addition to the weight gain, could contribute to the pressure on and curvature of the spine.

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Lumbar lordosis can affect people of all ages. Older people, especially those who are sedentary and obese, are more susceptible to posture-related lordosis. Women with osteoporosis may also experience excessive spinal curvature.  

Other medical conditions that can contribute to painful curvature of the spine include spondylolisthesis, achondroplasia, and discitis. Preventing lordosis as a side effect of these conditions is something you should discuss with your doctor.

Symptoms of lordosis

The most obvious symptom of lordosis is a noticeable curvature in the spine. You may be able to see the curvature, or you might need an X-ray to diagnose the condition. Normal curvature of the spine at the neck, torso, and lower back allows your head to rest naturally in line with your pelvis. However, if your spine curves too much, it can result in poor posture and misalignment of your head over your hips.

The most obvious symptom of lordosis is a noticeable curvature in the spine. You may be able to see the curvature, or you might need an X-ray to diagnose the condition.

Lower back pain is another symptom of lordosis, although back pain can have many causes. If back pain is your only symptom, it doesn’t mean you have lordosis. Lordosis can also cause your butt to look more pronounced and make it difficult to move. For people with lordotic curves, you can see the curvature when the person is lying on their back, with a large curve noticeable between their lower back and the surface they’re lying on. If the curve is flexible (if the back reverses itself when the person bends forward), then there’s usually no cause for concern. However, if the curve is stiff and doesn’t reverse when the person sits up, then the lordosis is considered fixed and will need medical treatment.

Other symptoms include pain, numbness, and tingling in the lower back. You may also experience muscle spasms and fatigue, including in the arms and legs. Some people with lordosis have trouble controlling their bowels or bladder.

Who’s at risk of developing lordosis?

While some accidents and injuries can lead to vertebral damage, other chronic medical conditions can also cause spinal curvature. It’s important to work with your doctor to reduce the possibility of developing lordosis if you have a chronic medical condition that could cause it.

Individuals who have had back surgery or who have poor posture, congenital defects, or neuromuscular problems may have a greater chance of developing lordotic issues. 

Ways to treat lordosis

Your doctor will review your medical history and conduct a physical exam to assess you for lordosis. Let your doctor know when the curve became noticeable, if it’s getting worse, and if you’re experiencing any pain or difficulty moving.

The doctor will ask you to bend forward and to the side, so they can see whether the curve is fixed or flexible. The doctor will look at your spine’s alignment and check it for abnormalities. If you have pain, numbness, or a tingling feeling in your lower back, then the doctor may refer you to a neurologist.

Treatment options depend on your range of motion and if the spine is aligned properly. The doctor may feel along your spine, checking for abnormalities. The results of the medical exams will determine the course of treatment.

Let your doctor know when the curve became noticeable, if it’s getting worse, and if you’re experiencing any pain or difficulty moving.

More conservative treatment for lordosis may include medication to prevent pain and swelling and physical therapy to help improve the range of motion in your spine and back. Part of the physical therapy may also include core strengthening exercises that you can perform on your own.

For children and teenagers affected by lordosis, back braces can help correct the growth of the curve. For many people, reducing body weight, especially in the abdomen, may be required.

If the lordosis is severe and results in more drastic symptoms that affect daily life or cause bladder or bowel control issues, then you may need surgical intervention such as artificial disk replacement or spinal instrumentation. Your doctor may recommend a procedure called kyphoplasty.

Ways to prevent lordosis

You can prevent excessive spinal curvature in many different ways. Poor posture is the most common culprit of an excessively curved spine, and it’s often exacerbated by obesity, especially if you carry your weight in the middle (apple-shaped body) instead of your thighs and hips (pear-shaped). People who are sedentary, especially those who work hunched over a computer, also run a greater risk of developing lordosis.

When you are seated, the lumbar muscles tighten to stabilize and support the spine. Lack of exercise is another contributor, so incorporating strength training is critical to ensuring that your back muscles are strong enough to support your spine. Weak muscles are less able to support the spinal column and allow excess curvature. Basic pelvic tilt and core exercises can help stabilize your spine and improve the results of physical therapy.

When to see a specialist

If your doctor recommends surgical intervention, they’ll often refer you to a neurologist or a surgeon. They may also refer you to a physical therapist to help teach you better posture or improve your flexibility and range of motion.

If the pain of lordosis begins to affect your everyday life, or if you’re unable to complete normal physical tasks due to a limited range of motion, then you should speak with your doctor.

If you or your child has been hurt in a car accident or had a fall or sports injury, you may wish to have an X-ray to ensure there are no fractures to the vertebrae that could cause lordosis later on.

Early diagnosis, as well as understanding symptoms that indicate lordosis, may help reduce its effects. Treating the condition early may help reduce the severity of the spinal curvature and may be able to reduce the pain and stiffness associated with it.

Conclusion

Lordosis can have many causes, and treating the condition may include physical therapy as well as specialist care for the root cause. It is reversible in some cases or correctable to the point that it doesn’t get worse or cause more pain. It’s important to have healthy pain management therapy during this process.

https://www.sciencedirect.com/topics/medicine-and-dentistry/lordosis

https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html

http://www.childrenshospital.org/conditions-and-treatments/conditions/l/lordosis/symptoms-and-cause

https://www.nationwidechildrens.org/conditions/lordosis

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