Hyperlordosis: Definition, Signs, Symptoms, Causes, Diagnosis and Treatment

It is an excessive extension of the lumbar region and is commonly called a hollow back or saddleback (after a similar condition that affects some horses).

These two regions of the spine (lumbar or cervical area) have a natural curve, but sometimes these curves become exaggerated, most often in the lumbar region.

These conditions are often the result of poor posture and can often be reversed by learning correct posture and using proper exercises.

Lumbar hyperlordosis is a condition that occurs when the lower back (lumbar spine or lower back) experiences stress or excess weight and bows to the point of muscle pain or spasms.

Lumbar hyperlordosis is a common postural position where the natural curve of the back’s lumbar region is slightly or dramatically accentuated.

Commonly known as a balanced stance, it is common in dancers. Imbalances in muscle strength and length are also a cause, such as weak hamstrings or tight hip flexors (psoas).

An essential feature of lumbar hyperlordosis is a forward pelvic tilt, which results in the pelvis resting on the upper thighs. Other health conditions and disorders can cause hyperlordosis.


Achondroplasia (a disorder in which the bones grow abnormally and which can result in short stature such as dwarfism), spondylolisthesis (a condition in which the vertebrae slip), and osteoporosis (the most common bone disease in which density is lost bone and increases the likelihood of fracture) are some of the most common causes of hyperlordosis.

Other causes include:

  • Obesity.
  • Hyperkyphosis (a curvature disorder of the spine in which the thoracic curvature is abnormally rounded).
  • Discs (inflammation of the intervertebral disc space caused by infection).
  • Benign juvenile lordosis.

Other factors may also include rare diseases, such as Ehlers Danlos Syndrome (EDS), where the hyperintense and generally unstable joints (for example, joints are much more flexible, frequently to the point of partial dislocation or complete) are pretty standard throughout the body.

With such hyperextensibility, it is also quite common (if not the norm) to find that the muscles surrounding the joints are a significant source of compensation when such instability exists.

Common causes of lumbar hyperlordosis include lower back muscles, excess visceral fat, and pregnancy. Rickets, a vitamin D deficiency in children, can cause lumbar lordosis.

Signs and symptoms of hyperlordosis

Although hyperlordosis gives the impression of a more muscular back, incongruously, it can lead to moderate to severe low back pain.

The most troublesome symptom is a herniated disc where the dancer has put so much stress on their back that the discs between the vertebrae have been damaged or ruptured.

Technical problems with dancing, such as difficulty in attitude positions and arabesque, can signify weak iliopsoas. The stiffness of the iliopsoas makes it difficult for a dancer to lift the leg in high places.

The abdominal muscles are weak, and the rectus femoris is tight are signs that the improper muscles are being worked during the dance leading to lumbar hyperlordosis.

The most apparent signs of lumbar hyperlordosis are low back pain in dancing and walking activities, as well as the appearance of a sloping back.

Is there a relationship between low back pain and hyperlordosis?

An increase in the lordotic angle proportionally increases the stress or shear stress in the anterior direction and shifts the center of gravity forward.

Some think that this increase in angle and stress is associated with poor posture and back pain. From a biomechanical point of view, marked lumbar lordosis is associated with a higher prevalence of low back pain.

However, several studies have concluded that low back pain is not directly related to low back hyperlordosis. Some factors contribute to an increased amount of lumbar lordosis.

These etiologic factors, such as trunk weakness, short back muscles, weak thighs, and hamstrings, can cause low back pain.

But it is essential to mention that it is not only lumbar hyperlordosis that is the causative factor for low back pain. Therefore, it is not reasonable to conclude that there is a relationship between low back pain and the size of the lumbar lordosis.

On the other hand, it is likely that trunk weakness can influence the shape of the lumbar lordosis and could cause low back pain.

The multifidus, the transverse abdominal muscle, and the internal forces of the trunk act late in patients with hyperlordosis.

Weakness in any pelvic-belt muscles can follow pelvic rotations and deviations of the back of the arch by affecting muscle balance in this area. Therefore the person may be prone to musculoskeletal disorders.

Several factors affect lumbar hyperlordosis. Some studies show that the range of lumbar hyperlordosis is affected by age, gender, and movements in the center of mass, such as pregnancy and obesity. Possible causes of hyperlordosis:

  • Congenital deformities of the spine.
  • The anterior incline of the hip.
  • Short back muscles.


Hyperlordosis is generally caused by one of two conditions. The first cause is muscular. The muscles surrounding the affected area cause the bones to become misaligned so that the normal curvature becomes exaggerated.

The other cause of hyperlordosis is actual structural changes in the discs or bones of the spine:

  • Poor posture.
  • Obesity.
  • Osteoporosis (weakening of the bones with age).
  • Discitis (a disorder of the discs between the spinal vertebrae).
  • Kyphosis (excessive outward curvature of the upper back).
  • Spondylolisthesis.

The possible causes that lead to the condition of lumbar hyperlordosis are as follows:

Spines – Natural factors in how spines are significantly formed increase the likelihood that some individuals will experience a strain or sprain to the back or neck.

Factors like having more lumbar vertebrae that allow too much flexibility, and then in cases of less lumbar, the individual does not meet their need for flexibility and then pushes their bodies to injury.

Legs – Another strange body formation is when an individual has one leg shorter than the other, which can be an immediate cause of imbalance of the hips and then putting pressure on the back posture that an individual has to adjust into vulnerable positions to meet aesthetic appearances.

This can lead to permanent back damage. Genu recurvatum (swinging the knees) also forces a dancer to adapt to unstable postures.

Hips: Common problems in the hips are hip flexors, which cause poor lifting posture, hip flexion contracture, which means a lack of postural awareness, and thoracic hyperquophysis, which causes the individual to compensate for the limited hip (which is essential to dances such as ballet).

The weak psoas (short for the iliopsoas muscle that controls the hip flexor) force the dancer to rise from the back force rather than from the hip by lifting the leg into the arabesque or pose.

This causes great stress and risk of injury, especially since the dancer will have to compensate to obtain the required positions.

Muscles – One of the most significant contributors is uneven muscles. Because all forces have a strength that works in opposition, the opposing power mustn’t be more substantial than the muscle at risk to keep all muscles protected.

In lumbar lordosis, the abdominal muscles are weaker than the lumbar spine muscles and the hamstring muscles. The muscle imbalance produces a downward pull of the pelvis in the front of the body, creating a curvature in the spine.

Accelerated Growth: Younger dancers are at higher risk of developing lumbar hyperlordosis because the lumbar fascia and hamstrings tighten when a child begins to experience growth spurts in adolescence.

Technical factors

Inappropriate ascents: When dancers perform dance lifts with another dancer, they are prone to lifting in the wrong posture, raising their arms to lift the other dancer while letting their spine and curve go easy, and then hyperlordosis in the back of a dancer.

Overuse: Over 45% of dancers’ anatomical injury sites are in the lower back. This can be attributed to the stresses of repetitive dance training that can lead to minor trauma. If the damaged area does not have time to heal, the damage from the injury will increase.

Abrupt increases in the intensity of the dance or sudden changes in the dance choreography do not allow the body to adapt to the new stresses. New dance styles, re-dancing, or increasing dance time will significantly lead to body exhaustion.

Many people have hyperlordosis due to weak abdominal muscles and obesity, where excess fat is mainly found in the abdominal and buttock area.

A sedentary lifestyle is also an essential factor, especially for those who spend an excessive amount of time sitting, such as truck or bus drivers and office workers.

Both excess weight and poor muscle tone due to lack of exercise cause the muscles in the lower back to over-strain for prolonged periods to provide support and stabilization to the spine.

The muscles gradually pull the spine out of normal alignment, resulting in an excessive curve. Structural problems in the spine can cause less joint hyperlordosis.

Some conditions that can aggravate the spine’s structure are osteoporosis, a disease that causes bones to weaken, and a condition called spondylolisthesis.

Spondylolisthesis is when the spinal vertebrae pop out of their normal position. A misaligned vertebra can damage adjacent discs and impair normal nerve function.

When to see a medical professional

How can you tell if you have hyperlordosis?

Take a photo of yourself standing sideways. Do you have a significantly arched back? If it does, you cannot ignore it. Feel the muscles in your back; in hyperlordosis, the muscles on both sides of the lumbar spine are prominent and significantly firm to the touch.

If you see a doctor for your low back pain, he may initially prescribe medication to relieve pain and inflammation, but a long-term treatment plan will be needed to reverse or at least prevent further curvature.

  • Muscle spasms.
  • Tingling or numbness
  • Bladder or bowel difficulties.
  • A fixed curve in the lower back (stays in place even when leaning forward).

Treatment will likely include a weight loss plan and physical therapy exercises to stretch and strengthen the abdominal, hip, and buttock regions and improve posture.

While working on weight loss and exercise goals, those suffering from lumbar hyperlordosis can also find some temporary relief by sleeping on their backs with pillows under their knees. This will allow your lower back muscles to get much-needed time to relax.

Preventive care is the best way to avoid spinal problems for the average person. Maintaining flexibility and muscle strength is particularly important for those with sedentary jobs.

Diagnosis of hyperlordosis

The measurement and diagnosis of lumbar hyperlordosis can be difficult. Obliteration of vertebral plate landmarks by interbody fusion can make the traditional measurement of segmental lumbar lordosis more difficult.

Because the L4-L5 and L5-S1 levels are most commonly involved in fusion or arthrodesis procedures and contribute to normal lumbar lordosis, it is helpful to identify a reproducible and accurate means of measuring segmental lordosis at these levels.

A visible sign of hyperlordosis is an abnormally large arch in the lower back, and the person appears to swell the stomach and buttocks.

An accurate diagnosis is made by looking at a complete medical history, physical exam, and other patient tests. X-rays are used to measure lumbar curvature.

On a lateral radiograph, Stagnara et al. have proposed a standard range of lordotic curvature of between 20 ° and 60 °, measured from the lower endplate of Th12 to the more inferior endplate of L5.

The Scoliosis Research Society has proposed a range of 40 ° and 60 ° measured between the upper endplate of Th12 and the upper endplate of S1.

While using other benchmarks, individual studies have found normal ranges up to about 85 °. It is generally more pronounced in women. It is relatively constant during adolescence and young adulthood but decreases in the elderly.

Bone scans are performed to rule out possible fractures and infections, magnetic resonance imaging (MRI) is used to eliminate the possibility of the spinal cord or nerve abnormalities, and computed tomography (CT) scans are used to obtain a more detailed image of the bones, muscles, and organs of the lumbar region.

Hyperlordosis increases the risk of:

  • Pinched nerve.
  • Joint degeneration.
  • Muscular stiffness.
  • Postural problems.
  • Back pain.

Things to avoid, do not put your body in positions where there is an excessive extension in your lower back.


It can be reversed because lumbar hyperlordosis is usually caused by habitual poor posture, not by an inherent physical defect such as scoliosis or hyperquofosis. This can be accomplished by stretching the lower back, hip flexors, and hamstrings and strengthening the abdominal muscles.

Dancers must ensure that they do not strain during dance rehearsals and performances. To help with lifts, the concept of the isometric contraction, during which the length of the muscle remains the same as the contraction, is essential for stability and posture.

Lumbar hyperlordosis can be treated by strengthening the hip extensors in the back of the thighs and stretching the hip flexors in the front of the thighs.

Only the muscles in the front and back of the thighs can rotate the pelvis forward or backward while standing because they can discharge force to the floor through the legs and feet.

The abdominal muscles and the erector spine cannot exert force on an anchor point while standing unless one holds their hands somewhere. Therefore their function will be to flex or extend the torso, not the hips.

Rear hyper-extensions on a Roman chair or inflatable ball will strengthen the entire posterior chain and treat hyperlordosis.

The same will happen with deadlifts, stiff hip lifts, and any similar movement that strengthens the posterior chain without affecting the hip flexors in the front of the thighs.

Abdominal exercises could be avoided entirely if they overstimulate the psoas and other hip flexors. Controversy regarding the degree to which manipulative therapy can help a patient still exists.

If therapeutic measures reduce symptoms but not the measurable degree of lordotic curvature, this could be a successful treatment outcome, albeit based solely on subjective data.

The presence of a measurable abnormality is not automatically equated with a level of reported symptoms.


Release tight muscles in your lower back
  • Lie on the floor with your hips and knees bent.
  • Place a massage ball on the tense muscles under the lower back region.
  • Relax your body weight on top of the ball.
  • Move your body in a circular motion on top of the ball to target tight areas.
  • Proceed to cover all muscles for at least 1 minute each.
  • Don’t hold your breath. Remember to breathe!
I was stretching in the prayer posture.
  • Kneel on the floor.
  • Extend and reach your hands as far away from you as possible.
  • Sit on your hips.
  • Try to feel a stretch in your lower back.
  • Breathe in / out profoundly for 1 minute.
Lateral stretch
  • Stand with your feet shoulder-width apart.
  • Fold everything to the side.
  • To emphasize the stretch, reach out for your arm.
  • Try to feel a bit on the side of your body toward your lower back.
  • Hold this position for 1 minute, alternating sides.
Learn to breathe

Your breathing is crucial to maintaining correct posture, especially when fixing your hyperlordosis.

The abdominal muscles not only assist with complete exhalation but also help maintain ideal lower alignment by controlling the position of the lower ribs.

  • Lie on your back with your knees bent and your feet on the floor.
  • You can tilt your pelvis back to help flatten your back on the floor.
  • Take a deep breath through your nose and slowly let the air out through your mouth.

When you get to the point where you empty your lungs, watch your lower ribs and lower backdrop to the ground.

Maintain this low rib position by engaging your abdominal muscles; continue diaphragmatic breathing for ten reps, and imagine you are breathing deeply into your stomach. Your upper chest should not move excessively while you live.

Practice this so many times throughout the day; it takes time to breathe correctly.