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  • Cynthia M. Johnson, MA
Publication Type:



(Saddle Back)


Hyperlordosis is an excessive inward curve of the lower spine. It is sometimes called saddle back.

Early treatment can improve outcomes.


The shadowed spine to the left shows ideal lordosis.

Lordosishttp://services.epnet.com/getimage.aspx?imageiid=77517751FJ00005_105433_1.jpgFJ00005NULLjpgLordosisNULL\\hgfiler01a\intellect\images\FJ00005_105433_1.jpgNULL42NULL2008-12-16400119Copyright © Nucleus Medical Media, Inc.


The exact cause of hyperlordosis is not known.

Risk Factors

Things that may raise the risk of hyperlordosis are:

  • Poor posture
  • Obesity
  • Trauma to the spine
  • Prior back surgery
  • Neuromuscular problems, such as cerebral palsy
  • Hip disorders
  • Achondroplasia —a genetic bone disorder that is the most common type of dwarfism
  • Having other structural problems of the spine, such as spondylolisthesis
  • Hyperkyphosis —an exaggerated outward curve of the thoracic spine
  • Problems that weaken the bones, such as osteoporosis


Most people do not have symptoms. Those who do may have back pain.


This problem may be diagnosed during a routine exam or spinal check at school.

The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the spine. This is often enough to make the diagnosis.

Pictures of the spine may be taken. This can be done with:


Any underlying causes will need to be treated.

A mild curve may not need treatment. It will be watched for any changes.

The goal of treatment is to manage any pain and stop the curve from getting worse. Choices are:

  • Over the counter medicine to ease pain
  • A back brace to keep the spine in line
  • Physical therapy to learn exercises that improve posture and ease back pain

Surgery may be needed by people with severe symptoms and those who are not helped by other methods. The goal of surgery is to correct the curve. This is done with a metal rod, hooks, or screws.


There are no known guidelines to prevent hyperlordosis.





  • Acute low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-low-back-pain.
  • Lordosis. Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions-and-treatments/conditions/l/lordosis.
  • Spine basics. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/spine-basics.
  • Swayback (Lordosis). Cedars Sinai Health System website. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html.


  • Teresa Briedwell, PT, DPT, OCS
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.