What Is Lordosis?

Your spine’s not supposed to be perfectly straight. A healthy spine has three gentle curves—two curves, in the neck and lower back, that reach toward the front of the body, known as lordosis, and one called kyphosis in the upper back that bows outward. These curves help your spine absorb shock, support your head, and keep your body stable.

But, too much of a good thing can be not so good. When the lordosis curve at your lower back or (less frequently) your neck becomes too pronounced, you’re said to have hyperlordosis (somewhat confusingly also referred to as just lordosis), which can bring with a host of problems such as low back pain, neck pain, numbness, weakness, and more. Here’s how you can recognize if your lordosis curves are too extreme.  

What Is Lordosis?

Lordosis is defined as an excessive inward curve of the spine. It differs from the spine's normal curves at the cervical, thoracic, and lumbar regions, which are, to a degree, either kyphotic (near the neck) or lordotic (closer to the low back). The spine's natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.
Lordosis is defined as an excessive inward curve of the spine. Photo Source: Shutterstock.

Different Types of Lordosis

Lordosis is found in all age groups. It primarily affects the lumbar spine, but can occur in the neck (cervical). When found in the lumbar spine, the patient may appear swayback, with the buttocks more prominent, and in general an exaggerated posture. Lumbar lordosis can be painful, too, sometimes affecting movement.

Lordosis of the Lower Back

As mentioned, the majority of lordosis cases affect the lower back. When someone has lordosis in the lower back, they can lie on a flat surface and have space between the lower back and the surface. Although low back pain is experienced by many with lordosis, the pain doesn’t immediately stem from the condition—it actually often derives from other surrounding factors, such as trunk weakness, short hamstrings, and weak thighs.

Lordosis of the Neck

Cervical lordosis is lordosis of the neck, and while it’s less common than lordosis of the lower back, it can happen. It can result in a “swayback” neck, and at times, the curve doesn’t compress any nerves or vertebrae. But it does mean that the curve causes the muscles of the neck to work even harder, which can result in neck pain, spasms, and restrained mobility.

Common Causes of Lordosis

Certain disease processes can adversely affect the structural integrity of the spine and contribute to lordosis. Some common causes include: 

• Discitis is inflammation of intervertebral disc space.
• Kyphosis (eg 'humpback') may force the low back to compensate for the imbalance created by a curve occurring at a higher level of the spine.
• Obesity may cause some overweight people to lean backward to improve balance. This has a negative impact on posture.
• Osteoporosis is a bone density disease that may cause vertebrae to loose strength, compromising the spine's structural integrity.
• Spondylolisthesis occurs when one vertebra slips forward in relation an adjacent one, usually in the lumbar spine.

Not every lordosis requires medical treatment. However, when the curve is rigid (fixed), medical evaluation is warranted.

Lordosis in Children

Children can experience lordosis as well. Gbolahan Okubadejo, MD, a New York City-area spinal and orthopedic surgeon, says that children can be born with lordosis, or they can form it due to poor posture, health issues, or problems with their hips. Most children with lordosis will look as though they have a “swayback” and may be unable to press their lower back to the floor when they lie down. While most cases of lordosis in children are congenital, adults tend to form lordosis due to obesity or a decrease in bone density, Dr. Okubadejo says. 

Lordosis in Pregnant Women

One population that frequently experiences lordosis is pregnant women, “especially those in their first pregnancy,” Dr. Okubadejo says. In fact, he says that around one-third of all pregnant women will experience severe lordosis.

“While some women may previously have had lordosis that is exacerbated by pregnancy, most see it brought on by their spine attempting to compensate for increased weight in the front of their body,” Dr. Okubadejo explains. “A mother may see an increase in back pain and difficulty moving due to lordosis, but it likely will resolve after birth.”

Lordosis does not negatively affect the baby.

Symptoms of Lordosis

Lordosis throws off the careful structure and alignment of the rest of the spine and, indeed, the entire body, forcing muscles and tendons to work harder to provide the necessary support. That’s why the top symptoms of lordosis is pain, either in the neck or the lower back.

Other symptoms can include:

• Numbness
• Tingling
• Weakness
• Bladder incontinence

Diagnosing Lordosis

Diagnosing lordosis is a relatively straightforward process. Dr. Okubadejo says that a doctor will first go about performing a physical exam in which they look to see if there is an abnormal inward curvature of the spine or lack of mobility. A physician will likely also order X-Rays to be taken of the patient both of their lateral profile and their front and back. 

When To See a Doctor for Lordosis

Dr. Okubadejo shares this rule of thumb that should tip you off to go see a doctor: “If you can bend over and your spine no longer curves inwards, there is less cause for concern,” he says. “However, if the curve cannot be undone with any movement, or you feel tingling or numbness in your lower body, you should seek treatment from a medical professional.”  

Treating Lordosis

Luckily, you don’t have to live with that curved spine forever, as long as you seek treatment for your lordosis. According to Dr. Okubadejo, these treatments can include:

• Physical therapy performed several times a week to strengthen the spine and improve range of motion
• Anti-inflammatory medications to ease pain and discomfort
• For children and teens, a back brace to prevent the curvature of the spine from getting worse
• In very severe cases of lordosis, a spinal surgeon may have to perform surgery to ensure that there are no neurological issues being exacerbated.

Lordosis Prevention

In addition to these treatment methods, there are ways to prevent lordosis in the first place.

“Lordosis tends to arise due to poor posture,” Dr. Okubadejo says. “If you are trying to prevent lordosis, keep your shoulders upwards and pulled back with your chest pushed out.”

He also says that maintaining a healthy weight and performing core-strengthening exercises can take pressure off your spine, adding that sometimes, lordosis is caused by a trauma accident, and in this case, requires physical therapy.  

Lordosis Prevention Exercises

Speaking of helpful exercises, Dr. Okubadejo shares his top exercises to prevent and treat lordosis along with their steps:

• Cat-Cow: Perform this exercise once a day for a total of 2 minutes to help strengthen the abdominal muscles and stretch the spine. To complete cat-cow, place your palms and knees on the floor in a “tabletop” position. Inhale for 10 seconds and drop your spine to the floor so it looks like an upwards U. Then, exhale and push your spine to the ceiling so it looks like an upside-down U.

The cat-cow sequence of yoga poses can help prevent excessive lordosis.

• Bent-Knee Exercise: This exercise involves lying on the floor with your feet flat on the ground and your knees bent upwards. Place your palms by your side and inhale for 10 seconds. Then, exhale and push your pelvis to the ceiling and hold this position for 10 seconds. This exercise can help release tension from the lower back and help undo some of the inward curvature from lordosis. Perform this exercise once a day for 2 minutes total.

Dr. Okubadejo concludes by emphasizing that lordosis can cause different problems for every person.

“There is no one way that lordosis affects others, and no one treatment plan,” he says. “If you feel you are suffering from lordosis, make an appointment with a medical professional for a treatment plan that is right for your body.”