How Doctors Diagnose and Treat Lordosis
A thorough physical examination reveals a lot about the health and general fitness of the patient. The physician will want to know when the curvature was first noticed, past progression, and other related symptoms the patient experiences. The exam provides a baseline from which the physician can measure the patient's progress during treatment. The physical exam may include:
1. Palpation determines spinal abnormalities by feel.
2. Range of Motion measures the degree to which a patient can perform movement of flexion, extension, lateral bending, and spinal rotation. Asymmetry is also noted.
A neurological evaluation includes an assessment of the following symptoms: pain, numbness, paresthesias (e.g. tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes.
The patient stands to reveal the entire length of the spine when PA (posterior/anterior, or back and front) and Lateral (side) x-rays are taken. Side bending AP x-rays are sometimes used to evaluate spinal flexibility. An MRI may be ordered if the spinal cord has been compromised (or suspected).
Further, the Cobb Angle Method may be used to measure the lordotic curve in degrees using a standard full-length AP x-ray.
Non-surgical conservative treatment measures may include:
1. Analgesics and anti-inflammatory medication.
2. Physical therapy enabling the patient to build strength, flexibility, and increase range of motion. The therapist may provide a customized home exercise program.
3. Bracing may be used control curve progression in adolescents.
4. Reduction of body weight to ideal.
5. Surgery may be considered if the lordotic curve is severe with neurologic involvement.
Surgical intervention is considered if the lordotic curve is severe, when neurologic involvement exists, or non-surgical conservative treatment has failed to provide relief. A spine surgeon decides which surgical procedure and approach (anterior/posterior, front or back) is best for the patient. His decisions are based on the patient's medical history, symptoms, and radiographic findings. A variety of surgical treatment options are utilized. You should discuss what is best for your condition with your spine surgeon.
Whether the treatment course is conservative or surgical, it is important to closely follow the physician and/or physical therapist's instructions. Discuss any concerns about activity restrictions. They will be able to suggest safe alternatives. Physical therapy may be incorporated into the treatment plan to build strength, flexibility, and increase range of motion. The therapist may provide the patient a customized home exercise program. If the patient undergoes spine surgery, written instructions and prescriptions for necessary medication are given prior to release from the hospital. The patient's care continues during follow-up visits with their surgeon.