Lordosis is the medical name for an exaggerated inward curve of the spine, often in the neck or lower back.

Lordosis usually does not cause symptoms. However, if it is severe, it can cause pain and may require surgery.

In this article we will look at what lordosis is, what causes it, how doctors diagnose it, and how they treat it.

Lordosis refers to an exaggerated inward curve of the spine. Some people call the condition swayback.

Lordosis most often occurs in the lower back, in which case it is called lumbar lordosis.

If it occurs in the neck, the medical name for it is cervical lordosis.

The spine can also curve outward, in a hump shape, and this is called kyphosis. It typically affects the middle or upper back, rather than the lower back or neck.

Sometimes, having another type of spinal curve causes the body to develop lordosis, to compensate for the existing imbalance.

Symptoms

The defining characteristic of lordosis is an exaggerated inward curve of the spine.

Depending on the location, lordosis can cause the buttocks and stomach area to stick out. A person with lordosis may find it difficult to lie flat on the floor, due to the curve in their back.

In many cases, lordosis alters a persons appearance but causes no symptoms. However, severe lordosis may cause:

• back or neck pain
• pain that radiates into the legs and feet, which is called sciatica
• tingling or numbness

Rarely, lordosis may cause a person to lose control of their bladder or bowels or experience sudden, severe leg pain or weakness. If this happens, seek medical attention immediately.

Causes and risk factors

Doctors do not always know why lordosis develops, but there are certain causes and risk factors.

These can help a doctor classify lordosis, as follows:

• Traumatic lordosis: This is caused by an injury to the spine, such as a fracture. Osteoporosis, which weakens the bones, may increase the risk of these fractures.
• Congenital lordosis: This can stem from an inherited condition such as achondroplasia, which affects cartilage growth. It can occur due to a problem with the development of the spine during childhood.
• Postural lordosis: This is caused by uneven posture. Having overweight or weakness in the abdominal muscles can increase the risk, as both factors strain the lower back.
• Neuromuscular lordosis: Several neuromuscular conditions can cause lordosis, including muscular dystrophy and cerebral palsy.
• Postsurgical lordosis: This results from back surgery that makes the spine less stable, such as a laminectomy or selective dorsal rhizotomy.
• Secondary lordosis: This results from having another condition possibly another type of spinal curve, such as kyphosis or scoliosis, or a condition that affects the hip joints.
• Obesity: Carrying excess weight can cause the bones and muscles to lean backward to improve balance.
• Osteoporosis: Age and other factors can cause bones to weaken and become brittle, which may lead to curvature of the spine.
• Spondylolisthesis: This causes one vertebra to slip forward, over another, and it can cause lordosis, usually in the lower back.

Diagnosis

A doctor can usually identify lordosis with a physical examination. They may also use an X-ray, MRI, or CT scan to confirm the diagnosis. A scan can indicate the extent of the curve in the spine.

If the person has symptoms of an injury or a medical condition that can cause lordosis, the doctor may perform additional tests to diagnose the underlying cause.

Treatments

If the curve in the spine is mildly exaggerated, a person may not require treatment. Often, if there is no pain and the curve does become more pronounced, a doctor does not need to intervene.

When lordosis does require treatment, the right approach depends on the cause of the curvature. For example, postural lordosis caused by muscle weakness or overweight may improve with physical therapy and weight management.

If a child has lordosis, a doctor may recommend a back brace to prevent the curve from progressing as the child grows.

If lordosis causes pain, nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (Advil), may help.

A person with severe lordosis may require surgery, during which a surgeon attaches metal rods to the bones in the spine, which permanently fuse into a straighter position.

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