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A Closer Look at Lordosis

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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.

normal lateral spine

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.

Contributing Factors
Certain disease processes can adversely affect the structural integrity of the spine and contribute to lordosis. Some common causes include discitis, kyphosis, obesity, osteoporosis, and spondylolisthesis.

*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.

Updated on: 12/10/09
Harry N. Herkowitz, MD
Most problems related to lordosis occur when the normal lordotic curve or sway is lost. This results in ?poor posture? and a forward tilt. As people age, some loss of lordosis occurs. It is important to maintain regular ?aerobic exercise? along with abdominal strengthening and spine flexibility in order to keep a ?good posture?. In addition, excessive weight, especially in the abdominal area puts excessive stress on the low back, which can lead to postural problems. Surgery is considered in ?extreme? cases and is often related to compensatory problems in other areas of the spine, which may need to be addressed.
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