What is Lumbar Lordosis?
The spine is supposed to curve in the upper and lower back, and in the neck. These curves make up the S-shape of the spine, and the curves of the neck and lower back are called “lordotic”, while the curve in the upper back is called “kyphotic”. These curves allow the body to absorb shock, align the head with the pelvis, support the head’s weight, stabilize the spine, and allow for moving and bending flexibly.
Lordosis is the normal curve, but sometimes it can curve too much, in a condition called “swayback”. This puts pressure on the spine, leading to pain. A curve can also flatten out, in patients with flat back. If a lordosis condition, such as swayback, isn’t too severe, it can be managed with physiotherapy and exercises.
A medical professional should be consulted if the lower back curve does not reverse itself when the patient bends forward. Lordosis of the lower back, or lumbar lordosis, is the most common type. To check for this, you can “lie on your back on a flat surface…able to slide your hand under your lower back, with little space to spare”. If there is extra space, then that is too much of a curve, especially if there is “a visible C-like arch when they stand”. The belly and buttocks will stick out, as well, when viewed from the side.1
Flat Back and Swayback
Loss of lumbar lordosis, flat back, or the straightening of lumbar lordosis is a problem. An exaggerated curve to the back, or swayback, can also be an issue. The most typical symptom of a lordosis issue is muscle pain. The muscles spasm and tighten as they are pulled in different directions. It is important to see a healthcare professional if there is tingling, numbness, electric shock pains, weakness, weak control of the bladder, or trouble maintaining control of the muscles, since these might indicate a more serious condition, such as a trapped nerve.
Lordosis can happen at any age due to trauma, poor posture, obesity, humpback (kyphosis), discitis, osteoporosis, spondylolisthesis, or achondroplasia (dwarfism). Sometimes children develop lordosis and outgrow it, unless their hip has been dislocated. It is not uncommon for lumbar lordosis to affect pregnant women.2 Lordotic and kyphotic curves can be normal, but scoliotic curves (scoliosis) are not.3
Swayback is also referred to as lumbar hyper lordosis, hollow back, and saddle back, and it can also be found in dancers or in people with rickets, a vitamin D deficiency. Other causes of this condition are “imbalances in muscle strength and length…such as weak hamstrings or tight hip flexors”.4 When the spine loses its lower curve, the condition is called flat back. The patients with this condition have trouble “standing upright or have ongoing back or leg pain”, with symptoms worsening throughout the day.
The condition was first recognized in patients who had Harrington rods installed to treat scoliosis. Decades after the surgery, patients ended up with “early degeneration of discs below their fusion”. These days, flat back can result from compression fractures, ankylosing spondylitis, degenerative disc disease, or lumbar post laminectomy syndrome.5
Lumbar Lordosis Fix
There are several ways to get rid of hyper lordosis, including losing belly fat, stretching the hip flexors, stretching the upper body, squatting correctly, and sitting less. Lumbar lordosis exercises include stretches such as the “warrior lunge stretch” and “daily shoulder dislocations” with a resistance band to combat slouching shoulders. The way to squat correctly is to push the abs out and the knees to the side to prevent arching.6
Some yoga exercises include arching the lower back (“cat pose”), stretching the lower back in “child pose”, and performing a “lunge pose”. The gluteus maximus can be strengthened with the “chair squat”, and the “single leg squat” could improve posture. The “front plank” can strengthen the abdominal muscles, as well.7
For those with the flat back condition, abdominals and hamstrings should be stretched, and hip flexion exercises could be performed.8 The “Superman”, “wall bends”, and “back arching” exercises may also be helpful.9 Other forms of treatment for flat back include physical therapy and spinal manipulation. Spinal injections may also be offered.
Surgery is a last resort.10 Stability ball exercises could assist patients with lumbar lordosis, but some patients may need medications, vitamin supplements, or braces. Many people can live with lordosis, but if the spine is unhealthy, over time there can be problems with the hip girdle, legs, and internal organs.
Having good posture and spinal health is important. To that end, patients can do shoulder shrugs, leg raise, yoga poses (such as “bridge” and “cat”), neck side tilts, and pelvic tilts on a stability ball. Although it is common to hear about sedentary jobs and problems from prolonged sitting, prolonged standing is also unhealthy. Sitting breaks in a chair with “sufficient back support” could be useful for some people. Treatment should be sought if there is difficulty performing daily tasks.11
Learn more about lordosis.