Cervical Hypolordosis and Hyperlordosis
The cervical and lumbar regions of the spine can have abnormal lordosis curves which could be treated with the help of a practitioner of chiropractic care. The cervical region in the spine contains the neck vertebrae. Cervical lordosis refers to the curve which is present in that part of the spine. It is normal for the cervical lordosis to have a wide C-shape to it. Problems arise when the curve becomes too deep, straightens out, or faces the wrong way. As a result, people can have poor posture, poor head positioning, fatigue, and other symptoms and complications which are associated with misalignment. These lordosis issues can be inherited or due to stress, strain, poor posture, or injury.
Early hypolordosis intervention is important to minimize complications. Treatment is most effective and successful when the issue is caught and corrected early on before it is allowed to increasingly worsen.1 Hypolordosis means that the normal curve of the spine is reversed. This can be due to trauma or degenerative conditions, such as arthritis.2 With cervical hypolordosis, the normal anterior curve moves posteriorly, creating an unnatural flattening in the shape, which in turn causes pain and neuropathy.3 In cervical hyperlordosis, a patient will have a forward head posture.4 Osteoporosis can also cause problems with cervical lordosis, due to the loss of bone density. Obesity may be a factor in that it affects how the body handles balance and posture.5
Lumbar Hypolordosis and Hyperlordosis
The entire spine has normal curves, leading to a natural S-shape. Excessive curvature is hyperlordosis. In the spine, this can lead to the conditions called “hollow back”, “swayback”, and “saddle back”. General causes of this can be pregnancy, visceral fat, and tight lower back muscles. It can lead to lower back (lumbar) pain.6 In lumbar hyperlordosis, the shape of the lower back has become arched too much, causing muscle spasms and pain. It is a condition that is common in dancers. Tight hip flexors, overuse, uneven muscles, and leg length differences can trigger lumbar hyperlordosis. Dancers who dance on bad dance floors, lift improperly, or who dance during a growth spurt can also develop this condition.7
In lumbar hypolordosis, or “flatback”, there is too little curve present in the shape of the spine. This creates stress on the discs and vertebra, leading to shortened hamstrings and a posterior pelvic tilt. Symptoms can include disc degeneration, trigger points, joint inflammation, and headaches.8 Weakness and numbness in the hands, as well as breathing problems (from poor posture) can result. Symptoms will likely worsen and cause further issues to develop if the patient does not seek treatment.9
Chiropractic Treatment for Lordosis – Hypolordosis
Chiropractic treatments for hypolordosis can include manipulation and stretching exercises.10 Hyperlordosis can be treated with spinal manipulative therapy (SMT) as well, positional traction, and possibly the use of head weights and braces.11 Chiropractors will not only provide treatments to help the patients regain proper posture, but they will recommend home care for patients. Home care could include recommended stretches and exercises to help ease the spine back into the proper posture. Patients should only do these exercises on the same day as a chiropractic adjustment if they are given approval by the chiropractor, as overworking the body too quickly will not necessarily speed up the healing process.
During times of rest, patients may need to use special support pillows for neck stabilization, traction wedges, and orthotics. The orthotics, which are specially customized shoe inserts, would help the patient to maintain proper posture while standing and walking. Other types of shoe inserts and supports could be used, but orthotics are the most specifically personalized to the patient’s body type. The earlier a patient can be treated the better, in order to avoid a more invasive method of treatment, like spinal fusion surgery, which is permanent and risky. Post-surgical patients may be in a position of increased vulnerability to future injury because the spine would lose its natural flexibility to the fusion.12
In terms of home therapy, some patients may wish to use exercise balls for sitting, and perform exercises that strengthen the hip extensors. Chiropractors often prescribe exercises and equipment for at-home strengthening to maximize the benefits of treatments.13 To correct hypolordosis in the back, it is important that muscles regain strength and flexibility. Trigger points also need to be treated.14 Ergonomic changes in the home, as well as the workplace, can help reduce problems with lordosis. Many patients have to sit at a desk and work at a computer for hours, so the most ergonomically sound furniture is recommended to avoid injury from prolonged sitting. Patients are also encouraged to regularly get up and stretch to break up the time that they spend sitting. Some patients may need passive traction from wearing a neck collar, isometric cervical exercises, or active traction. For the lumbar region, exercises like planks and reverse crunches may be helpful.15
References:
3, 10 escholarshare.drake.edu
4, 11 ncbi.nlm.nih.gov
5, 12 www.drkarencann.com
6, 13 en.wikipedia.org
8, 14 lowerbackpain-help.com
9, 15 livestrong.com