Lordosis (Swayback): Types & Treatment

Overview: Lordosis (Swayback)

Lordosis, or swayback, is a condition where the spine curves excessively forward in the neck (cervical spine) or lower back (lumbar spine). While a slight forward curve in these areas is normal and helps maintain posture and absorb shock, lordosis occurs when the curvature is too pronounced, disrupting normal alignment.

In sway-back posture, the pelvis tilts backward, and the lower spine curves excessively. This posture involves increased activity in the rectus abdominis muscle and decreased activity in the abdominal internal oblique, iliopsoas, and gluteus maximus muscles. This imbalance reduces skeletal muscle contraction and increases stress on the lumbar spine.

There are four main types of posture misalignments: lordotic, kyphotic, flat-back, and sway-back. Each can affect the musculoskeletal system uniquely, potentially leading to functional disorders. Most people with lordosis don’t need treatment, but exercises and stretches can help improve posture. Children with lordosis usually grow out of it naturally.

Lordosis vs. Scoliosis and Kyphosis

Lordosis, scoliosis, and kyphosis are conditions that alter the spine’s curvature, each affecting different regions and curving in distinct directions.

Lordosis:

Lordosis is characterized by an excessive inward curve of the spine in the cervical (neck) and lumbar (lower back) regions. This condition accentuates the natural forward curvature, causing the abdomen and buttocks to protrude more than usual. It can lead to discomfort, pain, and issues with movement. Causes can include poor posture, obesity, spinal conditions, or a genetic predisposition. Treatment often involves physical therapy, exercise, and in severe cases, surgery.

Scoliosis:

Scoliosis involves a lateral (sideways) curvature and rotation of the spine, often forming an “S” or “C” shape. It is most commonly diagnosed in children and teenagers, particularly during growth spurts. The severity can range from mild to severe, and in some cases, scoliosis can lead to back pain and respiratory issues. Treatment options include bracing for moderate cases and surgery for severe curves. Early detection and monitoring are crucial to managing this condition effectively.

Kyphosis:

Kyphosis is defined by an exaggerated outward curve of the thoracic spine (upper back), resulting in a rounded or hunched back appearance. This condition can arise from developmental issues, degenerative diseases like arthritis, osteoporosis, or trauma. Severe kyphosis can cause pain, stiffness, and, in extreme cases, affect lung function due to the chest cavity being compressed. Treatments include physical therapy, medications, and, for severe cases, surgical correction to reduce the curve and alleviate symptoms.

Understanding these differences helps in identifying and treating each condition appropriately, aiming to improve spine health and overall quality of life

Symptoms and Causes

What Are the Symptoms of Lordosis?

Many people with lordosis experience no noticeable symptoms and may only become aware of the condition upon diagnosis. However, changes in posture are often more apparent to others and can include:

• Head and neck leaning forward.
• Hips pushed forward.
• Buttocks protruding.
• Increased space beneath the lower back when lying down.
• Severe lordosis can lead to neck or lower back pain and restrict normal movement.

What Causes Lordosis?

Most cases of lordosis are idiopathic, meaning they have no identifiable cause and develop independently. This is especially true for swayback in children and individuals with increased thoracic kyphosis. However, several medical conditions can contribute to the development of lordosis, including:

• Spondylolisthesis
• Achondroplasia
• Osteoporosis
• Osteosarcoma
• Muscular dystrophy
• Kyphosis
• Static encephalopathy

Pregnancy can also increase the likelihood of developing swayback due to changes in body posture and weight distribution.

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Diagnosis and Tests

How Is Lordosis Diagnosed?

Lordosis is typically diagnosed through a physical examination conducted by your healthcare provider. During this examination, they will assess your posture and examine your spine for any abnormal curvature. They will also determine if the lordotic curve is flexible by observing how it moves when you bend your neck or lower back. A flexible curve may indicate a lesser need for treatments or surgical intervention.

Additionally, your provider may screen you for other spine-related conditions such as scoliosis and kyphosis.

What Tests Are Done to Diagnose Lordosis?

If signs of lordosis are detected during the physical examination, your healthcare provider may recommend imaging tests to obtain detailed images of your spine. These tests can include:

• X-rays: Provides detailed images of the bones in your spine, helping to visualize the extent and location of the curvature.
• MRI (Magnetic Resonance Imaging): Uses magnetic fields and radio waves to create detailed pictures of the soft tissues and bones in your spine. This can help in assessing any potential complications or underlying conditions.
• CT scan (Computed Tomography): Produces cross-sectional images of your spine, offering more detailed information about the structure and alignment of the vertebrae.

These imaging tests are essential for accurately diagnosing lordosis and planning appropriate treatment strategies.

Management and Treatment

How Is Lordosis Treated?

The treatment for lordosis depends on its location on the spine and the presence of symptoms. Most people with lordosis do not require any treatment. However, if you experience symptoms like neck or back pain, treatment may include:

Over-the-Counter NSAIDs: Medications such as aspirin or ibuprofen can help manage pain. Consult your provider before taking NSAIDs for more than 10 days.

Stretching and Strengthening Exercises: These exercises can alleviate symptoms and improve posture.

Regular follow-up appointments every few months are important to monitor the curvature and ensure it does not worsen. If the curve progresses or is not flexible, additional treatments may be recommended, including:

Physical Therapy: Specific exercises and stretches to strengthen muscles around the spine, such as hamstrings, hips, abs, and glutes. While exercises can’t correct the curve, they can reduce symptoms and improve posture.

Bracing: A customized brace may be used to support the spine and prevent further curvature. The duration and frequency of brace usage will be advised by your provider, typically at least 20 hours a day.

Surgery: Rarely needed, but in severe or worsening cases, spinal fusion surgery may be recommended to straighten the spine. This may also involve bone grafting. Your provider will explain the surgical options and recovery process.

Conclusion

Diagnosing lordosis involves a thorough physical examination to assess posture and spine curvature, determining if the lordotic curve is flexible or rigid. At York Rehab Clinic in Richmond Hill, our healthcare providers specialize in diagnosing and treating spine-related conditions like lordosis. We utilize these diagnostic tools to accurately evaluate the extent and impact of lordosis on your spine. These assessments help us tailor effective treatment plans, which may include physical therapy and personalized exercise programs to alleviate pain and improve mobility. Whether you’re experiencing mild discomfort or severe limitations, our dedicated team is committed to providing non-surgical rehabilitation care to improve your spine health and overall well-being. Contact York Rehab Clinic today to schedule a consultation and take the first step towards a healthier spine.