Lordosis is a normal inward curve in the lower back and neck. Hyperlordosis occurs when the angle of the inward curve is exaggerated. The sooner hyperlordosis is treated, the better the outcome.

Hyperlordosis

The shadowed spine to the left shows ideal lordosis.

Causes

The exact cause of hyperlordosis is often unknown.

Risk Factors

Factors that may increase your chance of hyperlordosis include:

Achondroplasia —a genetic disorder that results in abnormal cartilage growth and dwarfism
Spondylolisthesis —displaced vertebrae of back
Neuromuscular disorders such as muscular dystrophy or cerebral palsy
Congenital abnormalities of the spine
Back surgery
Hip disorders
Poor posture
Abnormal vertebral bodies—more commonly found in children with hyperlordosis
Hyperkyphosis —an exaggerated outward curve of the thoracic spine
Osteoporosis
Disc problems
Obesity

Symptoms

Often, there aren't any symptoms with hyperlordosis. Depending on the degree of abnormal curving, you may experience back pain.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. During the physical, your doctor may ask you to bend and move your back. Hyperlordosis can be seen during the exam. Some tests may be done to rule out or confirm other conditions that may be causing hyperlordosis.

Your doctor may recommend imaging tests to see the spinal curve and the structures around it. These may include:

Treatment

For mild cases of hyperlordosis, treatment is often not necessary. Additional treatment may be needed to resolve any underlying conditions that contribute to the hyperkyphosis. A referral may be made to a specialist who treats spinal disorders.

Options include the following:

Physical Therapy

A referral may be made to a therapist to learn specific exercises. Exercises may be used to strengthen muscles and increase range of motion. This may include learning how to maintain a correct posture.

Medications

Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may be given for discomfort or to decrease swelling.

Back Brace

Braces are sometimes used with children. The brace may prevent the curve from worsening as a child grows.

Surgery

Surgery may be used when the curve is severe, progresses, or when other treatment methods fail. The goal of surgery is to correct the exaggeration of the curve. The spine is corrected with a metal rod, hooks, or screws in the back bones. Surgeons also use a bone graft to promote new growth and stability.

Prevention

There are no current guidelines to prevent hyperlordosis.

RESOURCES:

North American Spine Society
http://www.spine.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Acute low back pain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114958/Acute-low-back-pain . Updated October 25, 2017. Accessed November 15, 2017.

Lordosis. Seattle Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed November 15, 2017.

Lordosis in children. Boston Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed November 15, 2017.

Spine basics. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated December 2013. Accessed November 15, 2017.

Swayback (Lordosis). Cedars Sinai Health System website. Available at:
...(Click grey area to select URL)
Accessed November 15, 2017.

Vialle R, Khouri N, et al. Lumbar hyperlordosis of neuromuscular origin: pathophysiology and surgical strategy for correction. Int Orthop. 2007;31(4):513-523.

Last reviewed November 2018 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 12/20/2014

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