Lordosis: Cervical and Lumbar | Hypolordosis and Hyperlordosis

The cervical and lumbar regions of the spine can have abnormal lordosis curves that can be treated with chiropractic care.

Cervical Hypolordosis and Hyperlordosis

The cervical region in the spine contains the neck vertebrae. Cervical lordosis refers to the curve in that part of the spine. It is normal 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. These lordosis issues can be inherited or due to stress, strain, poor posture, or injury. Early intervention is important to minimize complications.¹Hypolordosis 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 a flattening, causing 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 the body’s balance and posture.⁵

Lumbar Hypolordosis and Hyperlordosis

The entire spine has normal curves, leading to an S-shape. Excessive curvature is hyperlordosis. In the spine, this can lead to 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.⁶In lumbar hyperlordosis, the lower back is 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 in 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.⁹

Chiropractic Treatment for Lordosis

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. Patients may need to use special support pillows for neck stabilization, traction wedges, and orthotics (to maintain proper posture). The earlier a patient can be treated the better, in order to avoid spinal fusion surgery, which is permanent and risky. Post-surgical patients may be vulnerable to future injury because the spine would lose its flexibility.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 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 workplace can help reduce problems with lordosis. Some patients may need “passive traction with a neck collar”, isometric cervical exercises, or active traction. For the lumbar region, exercises like planks and reverse crunches may be helpful.¹⁵