Lordosis

Overview

The spine has natural curves that help it absorb stress and balance the body. The lower back (lumbar spine) and the neck normally curve slightly inward, a shape called lordosis. The term lordosis is also used to describe an exaggerated inward curve, sometimes called hyperlordosis or swayback, where the curve is more pronounced than usual.

A mild inward curve is normal and healthy. When the curve becomes excessive, it can change posture so that the abdomen and buttocks appear to stick out, and it may contribute to back discomfort. Lordosis can affect people of any age. In many cases it is mild and does not cause problems, but sometimes it is linked to an underlying condition or causes symptoms that benefit from treatment. Most cases are managed without surgery.

Symptoms

Many people with mild lordosis have no symptoms. When the curve is more pronounced, signs can include:

• A visibly exaggerated inward curve of the lower back (swayback)
• The buttocks and abdomen appearing to stick out
• A noticeable gap under the lower back when lying flat on the back
• Low back discomfort or aching, especially with prolonged standing
• Muscle tightness in the lower back

If lordosis is accompanied by numbness, tingling, weakness in the legs, problems with bladder or bowel control, or a curve that does not flatten when bending forward, it should be evaluated, as these may point to an underlying problem.

Causes

Lordosis can have several causes:

• Posture and muscle imbalance: Weak core or tight hip muscles can pull the lower back into a deeper curve.
• Obesity: Extra abdominal weight can increase the inward curve.
• Pregnancy: A temporary, normal increase in the curve as the body adjusts to the growing baby.
• Other spine conditions: Such as spondylolisthesis (a slipped vertebra) or, in some cases, hip problems.
• Developmental or neuromuscular conditions: Certain conditions affecting the muscles or spine, sometimes seen in children.

In many people no specific disease is found, and the curve relates to posture and body mechanics.

Risk Factors

• Obesity or excess abdominal weight
• Weak core and back muscles or tight hip muscles
• Pregnancy
• Certain spine conditions, such as spondylolisthesis
• Some neuromuscular or developmental conditions
• Poor posture habits

Diagnosis

A clinician evaluates the spine to assess the curve and look for any cause:

• Physical examination: Observing posture and checking how the curve changes when bending forward; a flexible curve that corrects with movement is usually less concerning.
• Medical history: Including pain, function, and any neurological symptoms.
• X-rays: Measure the degree of curvature and check the alignment of the vertebrae.
• Other imaging: MRI or CT scans if a specific spine or nerve problem is suspected.

Treatment

Treatment depends on the severity, the cause, and whether there are symptoms. Most cases do not need surgery.

• Physical therapy and exercise: Strengthening the core and back, stretching tight muscles, and improving posture are the mainstays of care.
• Weight management: Reducing excess abdominal weight can lessen the curve and relieve strain.
• Pain relief: Over-the-counter pain relievers and measures such as heat for discomfort, as advised.
• Bracing: Sometimes used in children and teens whose spines are still growing.
• Treating an underlying cause: Managing conditions such as spondylolisthesis when present.
• Surgery: Rarely needed, and reserved for severe curves or significant underlying spine problems.

Pregnancy-related lordosis usually resolves after delivery.

Prevention

• Maintain a healthy weight
• Strengthen your core and back muscles with regular exercise
• Stretch tight hip and lower-back muscles
• Practice good posture when sitting and standing
• Take breaks and move during long periods of sitting
• Use proper technique when lifting

When to See a Doctor

See a doctor if you have an exaggerated lower-back curve with ongoing pain, or if you notice a curve in a child that does not flatten when they bend forward. Seek prompt medical care if lordosis is accompanied by:

• Numbness, tingling, or weakness in the legs
• Loss of bladder or bowel control
• Severe or worsening back pain
• A rigid curve that does not change with position

These features can signal an underlying spine or nerve problem that needs evaluation.

Related Topics

Frequently Asked Questions

References

1. MedlinePlus, U.S. National Library of Medicine. Lordosis.
2. American Academy of Orthopaedic Surgeons (OrthoInfo). Spinal curvature.
3. Mayo Clinic. Kyphosis and spinal curvature.
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Spine conditions.