About this post: Understanding
Hyperlordosis as a Spinal Deformity
Hyperlordosis is the term used to describe a hollow lumbar spine. Hereby the alignment of both the Thoracic spine as well as the relation between the lumbar spine to the pelvis is affected.
When looking at the spine from the side, the normal spine has 4 curves. These curves in a healthy patient fall within specific parameters. However, in certain circumstances, these curves may be outside normal parameters. If that happens, patients may experience symptoms.
The most common curvature disorders in the sagittal plane are classified as:
- Hyperlordosis that may be seen in the lumbar or the cervical spine.
- Hyperkyphosis or Humpback deformity.
The healthy spine has 4 curves when viewed from the side:
- Cervical lordosis – In a rather short portion of the spine, the range of normal varies between 20° to 40°
- Thoracic kyphosis – The standard thoracic curve ranges between 20° to 40°
- Lumbar lordosis – The normal lumbar range is between 30° to as much as 50°
- Sacral kyphosis
Hyperlordosis reflects an excessive spinal curvature in the lower back. The standard lumbar inward curve is increased, in most instances with compensatory additional curvature changes in the thoracic spine (kyphosis) and often accompanied by cervical Hyperlordosis.
An increased curve in the lower or lumbar spine is called an “Increased Lordotic curve” and is commonly seen in overweight people, in pregnancy, in patients with weak abdominal muscles or with a spasm in the lower back muscles.
Seen clearly is the hollow spine and the buttocks appear quite prominent. The abdomen may be protuberant. This is especially conspicuous when a spinal deformity like Spondylolisthesis or Spondyloptysis exists.
Most often the Hyperlordosis is caused by a poor posture brought on by:
- Lack of exercising resulting in muscular weakness of the core muscles
- The tightness of the Hip flexors and back extensors in association with weakness of abdominal and hamstring muscles.
- Hyperlordosis may be seen during late stages of pregnancy.
- Other causes of hyperlordosis may be bony diseases of the spine (e.g. Spondylolisthesis)
Diagnosing Lumbar Hyperlordosis
Visible is a significant arch in the lumbar spine, often also accompanied by an accentuated cervical spine.
Lying on a firm surface on their back the lumbar arch is clearly visible, causing from discomfort to pain to the patient.
In many instances, an Anterior pelvic tilt can be demonstrated with tight hip flexor muscles and weak abdominals.
Muscle spasms in the lumbar extensors may be a repetitive or constant feature.
How to manage hyperlordosis
Managing the hyperlordosis depends entirely on the cause.
Even in cases where the patient does not have pain or other clinical symptoms, the incidental diagnosis warrants management.
In most cases, moderate hyperlordosis could be managed by:
- Weight reduction if obesity is a factor
- An exercise program with specific stretches of the shortened muscles and muscle strengthening exercises of the weak muscles often forms the backbone of the management. Included is core muscle training.
- While sleeping on their back patients with hyperlordosis would benefit from having cushions under their knees. This will flex both hips and knees and slightly diminish the lordotic curve.
Should patients have pain:
Specific physiotherapist modalities are available and worth the effort.
Postural bracing could be of assistance regarding postural improvement, however, bracing should not be used continuously to prevent muscle weakening, especially the deep pelvic and spinal stabilisers.
Also read “Body Planes“
Feature Image Credit: masaaki-komori-604389-unsplash.