Lordosis Treatment

Lordosis, Its cause, Its Implication and Its Correction

lordosis treatment - kyphosis treatment

What is Lordosis?

A normal spine, when viewed from behind, appears straight. From the side, the spine normally curves at the neck, the torso and the lower back area.

Lordosis is the inward curvature of a portion of the lumbar (lower back) and cervical (upper back) spine. These normal “lordotic curves” of the spine (secondary curvatures) are caused by differences in thickness between the front and back part of the discs between each vertebra (back bone) in the spine. These curves position the head over the pelvis naturally and also act as shock absorbers distributing the stress that occurs during movement.

Hyperlordosis (Swayback, Saddleback, Hollow back, Anterior Pelvic Tilt)

Normal spinal contours are essential for the correct movement and function of the spine. In a spine affected by hyperlordosis or an excessive or exaggerated inward curve, the vertebrae of the lumbar area are more curved, giving a swayback appearance. Excessive or hyperlordosis is commonly referred to as hollow back, sway back or saddle back, a term that originates from the similar condition that arises in some horses. A major contributing factor of lumbar lordosis is anterior pelvic tilt, when the pelvis tilts forward when resting on top of the femurs (thigh bones).

anterior pelvic tilt

When lying on your back on a hard surface, a large degree of lordosis will appear as a space beneath the lower back and the surface. Excessive lordosis may also increase at puberty, sometimes not becoming evident until your early or mid 20s.

Hypolordosis (Flatback)

More common than hyperlordosis, Hypolordosis means there’s less of a curve in the lower back or a flattening of the lower back. This occurs because the vertebrae are oriented toward the back of the spine, stretching the disc towards the back  and compressing it in the front . This can cause a narrowing of the opening for the nerves, potentially pinching them.

Lordosis Symptoms

Hyper (too much) or Hypo (too little) lordosis can cause moderate to severe lower back pain and can cause pain that affects movement. If the curve is flexible (reverses itself when the person bends forward), there is little need for concern. If the curve does not change when the person bends forward, the lordosis is fixed or locked and treatment is needed.

Causes of Lordosis

Causes of Hyperlordosis

Hyperlordosis affects people of all ages. It is common in dancers gymnasts and certain conditions can contribute to lordosis, including achondroplasia, discitis, kyphosis, obesity, osteoporosis and spondylolisthesis. Imbalances in muscle strength and length are also a cause, such as weak hamstrings, or tight hip flexors. Rickets, a vitamin D deficiency in children, can also cause lumbar lordosis. Common causes of hyperlordosis include tight lower back muscles, excessive visceral fat (belly fat), and pregnancy. Excess belly fat pulls the pelvis to the front and makes the pelvis tilt.

Causes of Hypolordosis

Hypolordosis can be congenital, acquired from sitting with bad posture, or from trauma. A common cause is whiplash trauma to the cervical spine. Hypolordosis is commonly found in Adolescent Idiopathic scoliosis (AIS) patients.

Lordosis Diagnosis

To diagnose lordosis the patient’s medical history & a physical examination are necessary to determine:

  • When did the excessive or diminished curve become noticeable?
  • Is it getting worse?
  • Does the size of the curve seem to change?

The patient is asked to bend forward and to the side to see whether the curve is flexible or fixed, how much range of motion the patient has and if the spine is aligned properly. The doctor may feel the spine to check for abnormalities. X-rays may be taken of the whole and the lower back.

A neurological assessment may be necessary if the person is having:

  • Pain
  • Tingling
  • Numbness
  • Muscle spasms or weakness
  • Sensations in the arms or legs
  • Changes in bowel or bladder control

How to Fix Lumbar Lordosis

Lordosis treatment involves building strength and flexibility to increase range of motion. Lumbar lordosis treatment consists of strengthening the hip extensors (group of muscles that extend the thigh) on the back of the thighs and stretching the hip flexors (group of muscles that flex the thigh) on the front of the thighs. The muscles on the front and on the back of the thighs can rotate the pelvis forward or backward while in a standing position. They can release the force on the ground through the legs and feet.


Back extensions on a exercise ball will strengthen the entire posterior chain (group of muscles on the back of the body) and help lordosis. Stiff legged deadlifts and supine hip lifts and other similar movement strengthen the posterior chain without involving the hip flexors on the front of the thighs. Neuromuscular re-education techniques are used to specifically target the problem.

Back Extensions

Stiff Legged Deadlifts

Supine Hip Lifts








Neutromuscular ReEducation 

Hypolordosis tends to co-occur with scoliosis. That may be due to instability in the spine caused by a lack of the normal curve. Part of scoliosis care must be to protect and strengthen the normal spinal contours. A downside of poor quality scoliosis braces and scoliosis surgery is that they both exacerbate hypolordosis in both the neck and back which weakens the spine.

If the hyperlordosis is the result of excess belly fat weight loss may be required to reverse the curve.

Hypolordosis can be corrected non-surgically through rehabilitation exercises and if done correctly, symptoms can be reduced in 3-6 months.

Only the most severe cases of lordosis require surgery: spinal instrumentation, artificial disc replacement and(a type of minimally invasive surgery that restores the vertebral height after a spinal compression fracture has occurred).

As with AIS, early detection is key to treating lumbar lordosis. For more information contact our office.

Posted in Non Surgical / Non Bracing Scoliosis Treatment
18 comments on “Lordosis Treatment
  1. Lynda says:

    This came in handy while I’m studying to get my personal trainer certification! Also my 9 year old daughter is complaining of lower back pain and reading this has helped me determine she has symptoms of a lordosis posture and I know what’s causing it and how I can help reduce it. Thanks for the information.
    Also my aunt Dr. Bonnie Langrehr is a graduate from Palmer College of Chiropractic. She works in Madison WI.

    • Dr. Andrew Strauss says:

      Great to hear that all the info is getting used! We are working hard to create a strong website by writing an average of one or two articles per week. I think we are up to approximately 80 now! I want this site to be a community resource on scoliosis.
      Best regards,

      Dr. Strauss

  2. Banana cream pie says:

    Thanks! Its helpful:)

    • Dr. Andrew Strauss says:

      Pleased to hear you are helped by our site.
      Best regards,

      Dr. Strauss

  3. aarti says:

    My son is 17 year old he is having scoliosis 28 degree in his lumber region and Vitamin D levels at 15. Can Vitamin D suppliment and Brace can Reduced his curve

    • Dr. Andrew Strauss says:

      Dear Aarti,

      While there is evidence in the literature of a link between lowered bone density and scoliosis, there is no direct evidence of a link between Vitamin D deficiency and scoliosis.
      Bracing is a complex subject and I have several articles on this website that address the efficacy of bracing. I suggest you review those articles.
      To give you a brief answer… bracing only works in a small percentage of cases, is a very unpleasant experience for the patient, AND exercise based therapy works much better and takes only an hour or two a day to complete. A much better option!!
      Send my a picture of your son’s most recent X-rays and I can comment further.
      Best regards,
      Dr. Strauss

  4. I am a paraplegic of 15 years. I’ve got photos of my back from the side and back showing scoliosis and the progression of my lordosis. I would like to send them to you. They are quite shocking. Or you could go to my website and see them there: //www.spinalman.com/my-back.html

    • Dr. Andrew Strauss says:

      It was good talking to you this evening. The pictures are very informative. Your case is very unusual. I am going to talk to some of my colleagues when I attend the SOSORT convention in Chicago in May (//www.gss.net/displaycommon.cfm?an=1&subarticlenbr=19 )and will get back to you if I can find out anything of value. Best regards,

      Dr. Strauss

  5. Kelly says:

    Thank you for the article. It is very helpful in understanding the severities and treatments for lordosis 🙂

  6. LEE MYUNGKWON says:

    Thanks for your excellent article, which is very helpful for my case. I think my 10-year daughter has some lordotic back spine. Now, she has no symptoms. Could you explain me to exercise or stretch in detail with figures.
    Thanks for your kindness ^^

  7. amith says:

    Hi i am suffering from Minimal Loss of Lumbar lordosis and minimal reduction in disc height between L5-S1. suggestive of disc lesion.

    Pls help me out to be fit again……..

  8. Miranda says:

    After reading this. I think I now understand why my lower back hurts. Making a doctors appointment to determine whether or not I have lordosis. Thank you.

  9. Vivien Harris says:

    Can you do online consults. I believe my daughter has lordosis and has always had this condition since she was very young (2 years old). Her posture exactly matches your picture of lumbar lordisos. Thanks

    • Unfortunately there are legal reasons why I am not allowed to offer online consulting. Due to differing state laws, the requirement to be licensed in any state in which a doctor practices, as well as taxation requirements make online consulting impractical at this time. All best regards,

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