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A normal spine when seen from the back usually appears straight. Lordosis however is the curvature of the back bones (vertebrae), giving the spine a swayback kind of appearance. People with significant Lordosis have a more than normal space beneath their lower back, when laying down on a hard surface. In cases where the lordotic curve is flexible it is not a concern however when the curve doesn’t move, medical examination and treatment is be needed. The main clinical feature of Lordosis is prominence of a pelvic lift.

Symptoms

Symptoms of Lordosis differ from people to people, and may bear resemblance to other spinal conditions or deformities. Symptoms vary depending on the underlying cause of the condition. Lordosis can be due to the following reasons:

• Achondroplasia: Is a genetic bone disorder that occurs in one in 25,000 births. It is the most common type of dwarfism. This condition is inherited by an autosomal dominant gene that causes cartilages to form abnormally. One of the symptoms of this condition is Lordosis.
• Spondylolisthesis: Is a condition where a vertebra or bone in the lower part of the spine slips out of its normal position, and onto the bone below it. It is usually caused by a birth defect or due to acute trauma or injury. Spondylolisthesis can produce increased Lordosis as one of its symptoms.
• Poor Posture: A poor posture over time can result in stress caused to the lower back, and may eventually lead to Lordosis. This problem is common amongst professional footballers.
• Vertebrae Related Congenital Problems: Are caused by anomalous vertebral development in the embryo. Minor deformities of the spine are rare, the more severe ones result in congenital hyperlordosis.
• Neuromuscular Conditions: Children who suffer from neuromuscular conditions like myelomeningocele, cerebral palsy, muscular dystrophy, spinal muscular atrophy and arthrogryposis are more prone to hyperlordosis (a form of Lordosis) than others. Hyperlordosis often occurs when muscles near the hips happen to be weak or tightened.
• Hip Problems: Hip problems are caused by tight hip flexors, this can be due to poor lifting postures, the lack of posture awareness and thoracic hyperkyphosis (commonly seen in dancers). These hip conditions can also cause Lordosis.

Diagnosis of abnormal Lordosis is done by a physical examination first, and the doctor will then recommend either x-rays, MRI scans, CT scans, bone scans or a neurologic examination. Based on the findings, the level of severity is examined.

Treatment

The treatment of Lordosis depends on the severity and the underlying cause. Usually mild cases of Lordosis don’t require treatment at all however if serious, the main focus of the treatment is to halt the progression of the curvature, to avoid further deformity. Treatment can be in the form of:

• Physical Therapy: Certain exercises as advised by a physiotherapist, strengthens the back muscles and increases range of motion. Maintaining the right posture may also be part of the course.
• Medications: NSAID or non-steroidal anti-inflammatory drugs may be administered to reduce swelling and help with discomfort.
• Back Brace: A back brace is often used for children suffering from Lordosis as it helps prevent further worsening of the curve.
• Surgery: Is only advised in the most severe of cases. Surgery involves straightening of the spine with the help of a metal rod, and some screws or hooks in the backbone. The doctor may also recommend bone graft in order to facilitate growth and strength.

Long term management of Lordosis depends on age, the amount of curvature and the amount of skeletal growth remaining. Frequent trips to the physicians will be required to monitor the curve as one grows and develops.