Human spines are naturally curved, but too steep a curve can cause problems.
If the curve becomes too great, stress is placed on other parts of the spine and causes pain.
Lumbar hyperlordosis occurs when the inward curve of the spine in the lower back is exaggerated.
This condition is also called swayback or saddleback.
Lumbar hyperlordosis can occur in all ages, but is rare in children. It is a reversible condition.
Symptoms of lumbar hyperlordosis
The spine needs a natural curve to function properly. This is due to the shape of the individual bones in the spine called vertebrae.
If you have lumbar hyperlordosis, the exaggerated curve of your spine will cause your stomach to push forward and your bottom to push out.
From the side, the inward curve of your spine will look arched, like the letter C. You can see the arched C by looking at your profile in a full-length mirror.
You may feel low back pain or neck pain or restricted movement. However, there is limited evidence linking hyperlordosis to low back pain.
Most hyperlordosis is mild, and your back remains flexible.
If the arch in your back is stiff and doesn’t go away when you lean forward, there may be a more serious problem.
The most common cause of lumbar hyperlordosis is poor posture. Other factors that can contribute to lumbar hyperlordosis are:
- Wearing high-heeled shoes for long periods of time.
- Spinal injury
- Neuromuscular diseases.
- Standing or sitting for long periods of time.
For pregnant women, a 2007 study found that hyperlordosis is the way the female spine has evolved to adjust to the extra weight of the baby.
The onset of this disease can be affected by factors such as gender, age, and movement in the center of mass, such as obesity and pregnancy.
Other possible causes of hyperlordosis are:
- Anterior incline of the hip.
- Short back muscles.
- Congenital deformities of the spine.
- Due to a muscle imbalance, the thigh and hamstrings are too weak (lower cruciate syndrome): the postural muscles shorten in response to stress and, in turn, inhibit their antagonists.
You can verify your posture with a simple test:
- Stand straight against the wall. Keep your heels 2 inches from the wall and your legs shoulder-width apart.
- Your head, shoulder blades, and bottom should touch the wall. There should be enough room to slide your hand between the wall and the small of your back.
- With lumbar hyperlordosis, there will be more than one hand space between the wall and the back.
Other health conditions and disorders that can cause lumbar hyperlordosis:
- Spondylolisthesis: This disease occurs when one vertebra slides over another.
- Osteoporosis : in this condition, bone density is lost, leaving the bones weaker.
- Achondroplasia : is a disorder where the bones grow abnormally, which can result in dwarfism.
- Hyperkyphosis: a disorder where the thoracic curvature of the spine is round.
- Juveniles lordosis friendly.
When should you visit a doctor?
Most cases of hyperlordosis do not require special medical attention. You can correct your posture on your own.
You will need to do some regular exercises and stretches to help maintain good posture.
If you are in pain or your hyperlordosis is stiff, see a doctor to determine the cause.
Depending on the diagnosis, your doctor may refer you to a back specialist or physical therapist.
Sometimes hyperlordosis can be a sign of a pinched nerve, bone loss in the spine, or a damaged disc.
Your doctor will do a physical exam. They will ask you when your pain started and how it has affected your daily activities.
Your doctor may also take X-rays or other images of your spine to aid in the diagnosis.
Diagnosis of lumbar hyperlordosis
X-rays can be used to measure the lumbar angle.
They are the gold standard for evaluating spinal curves, but ionizing radiation limits routine use.
There are several methods to measure the lumbar angle:
- Between the lower endplate of T12 and the upper endplate of S1: this had the best intraobserver reproducibility.
- Between the upper terminal plate of L1 and the upper terminal plate of S1.
- Between the upper end plate of L1 and the lower end plate of L5: this had the best overall agreement among various observers
- Between the lower terminal plate of T12 and the lower terminal plate of L5
There are several types of medical images, which can be used to diagnose different things. For instance:
- Magnetic resonance imaging to investigate soft tissue abnormalities.
- X-rays to measure lumbar curvature.
- CT scans to visualize the intervertebral disc.
Your treatment plan will depend on your doctor’s diagnosis. In most cases, treatment will be conservative. In rare cases, surgery may be required.
Conservative treatment may include:
- Over-the-counter pain remedies: such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
- A weight loss program.
- Physical therapy.
Children and adolescents with hyperlordosis may need to wear a brace to guide spinal growth .
To correct an increased curve in the lower back, the hip flexor muscles must be stretched along with the lower back.
The glutes and abs may need strengthening.
Hip flexor stretch
- This will stretch the iliopsoas muscle, the most powerful hip flexor.
- Assume the position with one knee on the ground.
- Gently push your hips forward keeping your back straight until you feel a stretch.
- Hold for 20-30 seconds, repeat 3-5 times, several times a day.
- Lie on your back with your knees bent.
- Pull your knees toward your back, as comfortable as possible.
- Hold for 20-30 seconds and repeat 3-5 times, several times a day.
Abdominal contraction (easy)
- You must lie on your back with your knees bent.
- Gently slide your hands toward your knees and lower yourself back down, lifting your head and shoulders off the floor.
- Repeat this exercise until you feel like your stomach muscles are working hard (initially this may be only 10 reps).
- Rest for a minute and aim for 2-3 sets.
- Lie on your back with your knees bent and your feet flat on the floor.
- Place your hands on your temples.
- As you lift your head and shoulders off the ground, rotate your upper body so that your right elbow is moving toward your left knee.
- Return to the starting position and repeat, alternating between turns to the left and to the right.
- Begin by doing 2 sets of 10 reps and gradually work your way up to 3 sets of 20.
- Lie on your back with your knees bent and your feet flat on the floor.
- Slowly lift your buttocks and then the bottom of the floor.
- Push your buttocks as high as possible to feel the muscles working hard there.
- Hold for 5-10 seconds, rest, and repeat.
- Aim for 2 sets of 10 reps initially, building 3 sets of 20.
- This exercise can be done on one leg to make it more difficult.
Prognosis of lumbar hyperlordosis
Most cases of hyperlordosis are the result of poor posture. Once you’ve corrected your posture, the condition should resolve itself.
The first step is knowing your posture during your normal daily routine. Once you know what it feels like to stand and sit correctly, keep going.
You should see results right away, even if it seems awkward at first.
Develop an exercise and stretching routine to do daily. Check with your doctor if you are unsure of the activity level that is right for you.
Ask your friends and family to tell you when they see you hunched over or hunched over at your computer.
Good posture takes vigilance until it becomes automatic.
You can often prevent hyperlordosis by practicing correct posture.
Keeping your spine in proper alignment will prevent stress on your neck, hips, and legs, which could lead to problems later in life.
Here are some more tips to help prevent this condition:
- If you are concerned about weight control, start a weight loss program. Talk to your doctor if you need help getting started.
- If you sit a lot during the day, take short breaks to get up and stretch.
- If you have to stand for a long time, periodically shift your weight from one foot to the other, or from heels to toes.
- Sit with your feet flat on the floor.
- Use a rolled pillow or towel to support your lower back when sitting.
- Wear comfortable low-heeled shoes.
- Stay with an exercise program of your choice.