Lordosis

Definition and Overview

Lordosis is a term used in medicine to describe an inward curvature of a portion of the lumbar and cervical vertebral column. More specifically, it refers to the natural lordotic curvature, which is normal. However, the term is often used to refer to abnormal excessive curvature of the spine, also known as hyperlordosis. Lordosis can occur in various parts of the spine, but it most commonly affects the lumbar spine.

Anatomy and Physiology

The human vertebral column is divided into different regions, which include the cervical, thoracic, lumbar, sacral, and coccygeal regions. Each region has a characteristic curve. The cervical and lumbar regions have a lordotic curve, which is convex anteriorly. This is in contrast to the thoracic and sacral regions, which have a kyphotic curve, convex posteriorly. These curves help to distribute mechanical stress during body movement.

The degree of normal lordosis varies widely among individuals and can be affected by factors such as age, sex, and physical condition. In general, a lumbar lordotic curve between 20° and 60° is considered normal. A lordotic curve greater than 60° is considered excessive and may indicate a condition of hyperlordosis.

Causes

There are many potential causes of lordosis. It can be congenital, meaning present at birth, or it can develop over time due to various conditions. Some of the common causes include:

Spondylolisthesis: This is a condition in which one vertebra slips forward over the one below it. It can lead to an abnormal curvature of the spine, including lordosis.
Osteoporosis: This is a condition characterized by a decrease in bone density, which can lead to fractures and changes in the curvature of the spine.
Obesity: Excessive weight can put strain on the spine and lead to changes in its curvature.
Achondroplasia: This is a type of dwarfism that affects bone growth and can lead to an abnormal curvature of the spine.
Discitis: This is an inflammation of the intervertebral disc space that can lead to changes in the curvature of the spine.

Symptoms

The symptoms of lordosis can vary depending on the severity and location of the condition. Some people with lordosis may not have any symptoms. However, when symptoms do occur, they may include:

A pronounced curve in the lower back
Discomfort or pain in the lower back
Difficulty moving certain ways due to stiffness in the back
A gap between the lower back and the floor when lying down on a hard surface

In severe cases, lordosis can affect the nerves of the spinal cord, leading to symptoms such as numbness, tingling, or weakness in the legs.

Diagnosis

The diagnosis of lordosis is typically made through a combination of physical examination and imaging studies. During the physical examination, the doctor may observe the curve of the spine and look for any signs of nerve damage, such as weakness or numbness in the legs. The doctor may also measure the angle of the lordotic curve.

Imaging studies, such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI), can provide detailed images of the spine and help to confirm the diagnosis. In some cases, additional tests may be needed to determine the underlying cause of the lordosis.

Treatment

The treatment of lordosis depends on the underlying cause, the severity of the condition, and the presence of any associated symptoms. Treatment options may include:

Physical therapy: This can help to strengthen the muscles of the back and abdomen, improve posture, and increase flexibility.
Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help to relieve pain and inflammation.
Weight loss: If obesity is a contributing factor, weight loss can help to reduce strain on the spine and improve lordosis.
Surgery: In severe cases, surgery may be needed to correct the curvature of the spine.

Prognosis

The prognosis for individuals with lordosis depends on the underlying cause and the severity of the condition. Many people with mild lordosis do not have any symptoms and do not require treatment. In cases where lordosis is caused by a treatable condition, such as obesity or osteoporosis, treatment of the underlying condition can often improve the lordosis.