Lordosis

Lordosis, a condition affecting the spine's natural curvature, significantly impacts posture and overall well-being. This spinal abnormality occurs when the lower back curves inward excessively, causing the buttocks to stick out and the abdomen to protrude. Lordosis posture can lead to discomfort, pain, and reduced mobility, making it crucial to understand its causes and seek appropriate lordosis treatment.

Recognising lordosis symptoms early is key to preventing further complications and finding an effective cure for lordosis. Let's explore various lordosis types, their causes, and available treatment options. 

What is Lordosis?

Lordosis is a condition characterised by an exaggerated inward curve of the spine. This curvature typically occurs in the lower back (lumbar lordosis) or neck (cervical lordosis). While some degree of curvature is normal and necessary for supporting the body, excessive lordosis can lead to various issues. Lordosis posture can affect both children and adults. 

The spine naturally has several curves that help distribute weight and maintain balance. In lordosis, however, these curves become more pronounced. This exaggeration can cause the buttocks to protrude outwards and the abdomen to stick out, resulting in what some people refer to as a 'swayback' appearance.

Types of Lordosis

The following are five primary types of lordosis:

• Postural Lordosis: This type of lordosis often results from being overweight and having weak abdominal and back muscles. The excess weight in the stomach area pulls the back forward, and weak muscles cannot support the spine adequately. 
• Congenital or Traumatic Lordosis: This can occur due to injury or developmental issues in the spine's connecting links. It's particularly common in children who have experienced sports injuries or accidents.
• Post-surgical Laminectomy Hyperlordosis: This type of lordosis is more commonly seen in children following procedures to remove spinal cord tumours.
• Neuromuscular Lordosis: This type of lordosis encompasses many conditions that can cause spinal curvature problems. Each disorder within this category may require different lordosis treatment approaches.
• Lordosis Secondary to Hip Flexion Contracture: This is a unique type where hip joint issues pull the spine out of alignment. This can stem from various causes, including infection, injury, or muscle imbalance disorders.

Causes of Lordosis

Lordosis has a variety of causes, ranging from genetic factors to lifestyle choices:

• Genetics: Research suggests that genetic factors substantially influence lumbar lordosis and sagittal flexibility. 
• Postural Habits: Poor posture, especially when combined with excess weight and weak abdominal and back muscles, can lead to postural lordosis. 
• Medical Conditions: Certain systemic conditions, such as spondylolisthesis, osteoporosis, and osteosarcoma (a type of bone cancer), may contribute to the development of lordosis.
• Injuries: Traumas or injuries to the spine can result in congenital or traumatic lordosis. This is particularly common in children who have experienced sports injuries or accidents. 
• Surgical intervention: In some cases, lordosis can develop after spinal surgeries, known as post-surgical laminectomy hyperlordosis.
• Pregnancy: Pregnancy often causes temporary lordosis as the spine adjusts to realign the centre of gravity. However, this typically resolves after childbirth.

Symptoms of Lordosis

Lordosis has a significant impact on posture and can cause various symptoms. The most noticeable sign of lordosis is an exaggerated inward curve of the spine, which leads to a distinctive appearance. People with lordosis often have a pronounced C-shape in their lower back, causing their buttocks to protrude outward and their stomach to stick out.

Other lordosis symptoms are:

• Difficulty in lying flat on a hard surface
• Lower back pain and discomfort 
• Muscle spasms or trouble moving in certain ways due to the curvature of the spine.

In more severe cases, lordosis can cause additional symptoms. These may include: 

• Pain that radiates into the legs and feet (sciatica) 
• Tingling or numbness in their extremities
• Temporary loss of bladder control 

Diagnosis

Diagnosing lordosis typically involves a comprehensive approach that combines the following: 

• Physical Inspection: Doctors conduct a thorough physical exam to assess the patient's posture and spinal curvature. They carefully observe the spine's alignment, check for unnatural curves, and evaluate the flexibility of the lordotic curve. If the curve moves with the patient when they bend their neck or lower back, it's less likely to require extensive treatment or surgery. The physical investigation helps determine the severity of the condition and guides the treatment plan.
• Imaging Tests:
  • X-rays to visualise the bones and measure the degree of spinal curvature. 
  • CT scans or MRIs provide detailed images of the bones, muscles, and soft tissues, allowing doctors to identify any underlying causes of lordosis.
  • Bone scans can help detect bone diseases or tumours that might contribute to lordosis. 
  • Blood tests may be used to investigate associated metabolic conditions.

Treatment

The approach to treating lordosis depends on the severity of the curve and its underlying cause. For most individuals with lordosis, medical intervention is not necessary unless the condition is severe. However, when treatment of lordosis is required, several options are available, including:

• Medications: Over-the-counter pain relieving medicines can manage discomfort and reduce inflammation for mild cases. 
• Physical Therapy: Daily physical therapy exercises help strengthen muscles and improve range of motion. These exercises target the core, hips, glutes, and hamstrings, helping to correct lordosis posture by realigning the pelvis.
• Weight Management: Weight loss can also positively impact lordosis symptoms, as excess weight in the abdominal area can contribute to the condition. 
• Bracing: In children and adolescents, bracing helps support the spine and prevent further curvature. These braces are specially customised to your curvature, and they support your spine and stop it from curving any further. Your doctor will tell you how often you should wear your brace and for how long you'll need to wear it.
• Surgery: For more severe cases, especially those involving neurological concerns, surgery might be necessary. This typically involves spinal fusion to straighten the spine and reduce the curve. 
• Nutritional Supplements: Doctors may recommend dietary supplements, particularly vitamin D, may be recommended to support bone health. 

When to See a Doctor

While mild lordosis may not require immediate medical attention, there are instances when consulting a doctor becomes necessary: 

• If you notice that the curve in your spine remains unchanged when bending forward
• If you experience additional symptoms associated with lordosis, such as numbness, tingling sensations, electric shock-like pains, weak bladder control, or difficulty maintaining muscle control
• If you're experiencing pain that interferes with your daily activities

Prevention

While it's not always possible to prevent lordosis, there are steps you can take to maintain good posture and spine health. 

• Regular exercise plays a pivotal role in preventing excessive curvature of the spine. Gentle exercises can help reduce pain and strengthen muscles, supporting better posture and potentially keeping the condition from worsening.
• Specific exercises that can be beneficial include shoulder shrugs, neck side tilts, and leg raises. 
• Yoga poses such as the Cat and Bridge pose can also help improve flexibility and strengthen core muscles. 
• Performing pelvic tilts on a stability ball can improve pelvic alignment, especially for those with a forward-tilted pelvis.
• Always consult an expert before starting an exercise regimen to ensure it suits your condition.
• Practising good postural habits throughout the day is essential. Be mindful of your posture during prolonged standing, as this can affect the curve of your spine. 
• Choosing ergonomic furniture, such as supportive chairs and mattresses, can help maintain proper spinal alignment.

Conclusion

Understanding lordosis and its effects on posture is crucial to maintaining a healthy spine and overall well-being. This condition is characterised by an exaggerated inward curve of the spine. Lordosis can significantly impact a person's quality of life. By recognising the symptoms early and seeking appropriate treatment, individuals can prevent further complications and improve their posture.

Managing lordosis often involves a combination of approaches, including exercises, lifestyle changes, and sometimes medical interventions. Remember, if you notice persistent changes in your spinal curvature or experience pain, it's essential to consult an expert doctor to get a proper diagnosis and tailored treatment plan.

FAQs

1. How does this condition affect my body?

Lordosis has a significant impact on posture and can affect different parts of the body. Cervical lordosis, in rare cases, interferes with talking or swallowing. Lumbar lordosis, also known as swayback, can result in lower back pain and an exaggerated space beneath the lower back when lying down. In severe cases, lordosis may make it difficult to move the neck or back and could even affect bladder or bowel control.

2. Who does lordosis affect?

Lordosis can affect people of all ages, but certain groups are more susceptible. Adults over 50, children going through growth spurts, & pregnant women are more likely to develop this condition. Additionally, people with certain medical conditions such as achondroplasia, discitis, kyphosis, obesity, osteoporosis, and spondylolisthesis may be more prone to developing lordosis.

3. Is lordosis painful?

While many individuals with lordosis may not experience any physical discomfort, others might face various challenges. Back pain and discomfort are common lordosis symptoms, particularly in the lower back area. Some people may also experience muscle spasms or have trouble moving in certain ways due to the curvature of their spine. In more severe cases, lordosis can cause pain that radiates into the legs and feet, a condition known as sciatica.

4. Can sitting cause lordosis?

Prolonged sitting is a big risk factor for low back pain and can contribute to the development of lordosis. When sitting, the knees and hips are flexed, causing the pelvis to rotate backwards and the lumbar lordosis to flatten. This position increases the load on the spine, as indicated by measurements of intervertebral disc pressure. 

5. How serious is lordosis?

The severity of lordosis can vary greatly. In many cases, lordosis only alters a person's appearance without causing symptoms. However, severe lordosis may lead to back or neck pain, sciatica, and, in rare instances, loss of bladder or bowel control. Early detection and appropriate lordosis treatment are crucial for managing the condition effectively.

Dr. Vikas Jain

M.B.B.S, M.S. (Orthopaedics), F.I.J.R, F.I.R.J.R, F.A.S.M
CARE CHL Hospitals, Indore

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